What to expect from insurers when making a claim
The greenslips.com.au Calculator helps vehicle owners find the cheapest price from all six NSW CTP insurers. These are AAMI, Allianz, GIO, NRMA Insurance, QBE and Youi. State Insurance Regulatory Authority (SIRA) provides quarterly data on insurer performance to help people make more informed comparisons and know what to expect if they make a CTP claim.
Since March 2023, SIRA reports in less detail and without showing the previous year:
1. What are the chances of having my claim accepted? ›
2. How long will I wait for income support and treatment and care? ›
3. How soon will I be working after my accident? ›
4. What happens if I disagree with the insurer? ›
5. How many complaints and active claims do insurers have? ›
1. What are the chances of having my claim accepted?
The new scheme since 1 December 2017 made benefits available to all injured parties in the first 6 months after a car accident. Since 1 April 2023, benefits can be extended to 12 months after the accident. Benefits include payments for loss of income, medical and rehabilitation costs.
All insurers accept over 96% of claims and, if they deny any claims, must explain why. The main reason is late claims (over 90 days) and the second is no injury present or not under the legislation.
Table 1: Percentage of claims insurers accepted
September 2023 | |
Accepted | |
AAMI | 95.4% |
Allianz | 95.7% |
GIO | 96.6% |
NRMA Insurance | 97.6% |
QBE | 98.3% |
Youi | 97.5% |
Total | 96.9% |
2. How long will I wait for income support and treatment and care?
How quickly insurers pay benefits is important for helping injured people make a full recovery after an accident. That is why insurers also pay pre-claim support before someone lodges a formal claim. At June 2023, it took an average of 4.2 weeks to receive first income support and 95% received treatment and care within 4 weeks.
Table 2a: Time in weeks to receive first income support
September 2023 | ||
First income support (weeks) |
||
AAMI | 4.5 | |
Allianz | 3.4 | |
GIO | 4.6 | |
NRMA Insurance | 3.9 | |
QBE | 4.5 | |
Youi | 4.2 | |
Average | 4.2 |
Table 2b: Percentage who received treatment and care within 4 weeks
September 2023 | |
0-4 weeks | |
AAMI | 94% |
Allianz | 97% |
GIO | 95% |
NRMA Insurance | 96% |
QBE | 94% |
Youi | 96% |
Total | 95% |
3. How soon will I be working after my accident?
The percentage of people who are working at 26 weeks after the date of the accident varies among insurers so we have not shown an average.
Table 3: Percentage of people working at 26 weeks after date of accident.
September 2023 | ||
26 weeks |
||
AAMI | 64% | |
Allianz | 80% | |
GIO | 58% | |
NRMA Insurance | NA* | |
QBE | 68% | |
Youi | 71% | |
Average |
NA |
*NRMA Insurance says it currently does not have confidence in the quality of its data.
4. What happens if I disagree with the insurer?
When customers disagree with the insurer’s decision, they can request an internal review by the insurer. Types of decisions include threshold injury, treatment and care, weekly payments, or who was at fault in the accident. Insurers carry out 98.8% of internal reviews within 28 days on average.
Table 4: Percentage of internal reviews within 28 days
September 2023 | |
28 days |
|
AAMI | 99.6% |
Allianz | 99.0% |
GIO | 99.5% |
NRMA Insurance | 97.6% |
QBE | 99.5% |
Youi | 97.3% |
Total | 98.8% |
5. How many complaints and active claims do insurers have?
Since 1 March 2021, injured people can complain about insurers to the Independent Review Office. SIRA continues to manage complaints about all other aspects of the scheme. Complaints volumes do not include those directed to insurers.The percentage of active claims with each insurer is a new metric.
Table 5: Market share of complaints and active claims
Complaints | Active Claims | |
Year end 30 September 2023 | Year end 30 September 2023 | |
AAMI | 10.6% | 9.0% |
Allianz | 12.5% | 20.0% |
GIO | 17.3% | 14.5% |
NRMA Insurance | 38.4% | 32.7% |
QBE | 19.3% | 22.0% |
Youi | 1.9% | 1.8% |
Sources: State Insurance Regulatory Authority (SIRA) CTP Insurer Claims Experience and Customer Feedback Comparison, September 2023. Note, SIRA stated in March 2023 many of the metrics provided in previous years are no longer provided.