Filing a Dispute with the Personal Injury Commission (PIC)
The Personal Injury Commission (PIC) is the independent tribunal that resolves CTP disputes in NSW. If an insurer stands by a decision after an Internal Review, the PIC is the impartial umpire that makes the final binding determination. General information only.
1) The Role of the PIC
The PIC was established to provide a fair, fast, and cost-effective way to resolve motor accident disputes. It is completely independent of insurance companies.
The Commission assigns either a Member (for legal/factual issues) or a Medical Assessor (for clinical issues) to determine your case.
2) Two Main Pathways
Depending on what you are disputing, your case will follow one of two paths:
- Merit Review: For factual or administrative issues like earnings (PAWE) or benefit suspensions.
- Medical Assessment: For clinical issues like whether surgery is "reasonable and necessary", threshold injury disputes, or WPI assessments.
3) What to expect after filing
Once your application is accepted, the process typically involves:
- Teleconferences: A preliminary meeting to identify the issues and see if the matter can be settled.
- Assessments: For medical disputes, you will likely attend an examination with a PIC-appointed specialist.
- Determination: The PIC issues a Certificate of Determination that is legally binding on the insurer.
4) Why professional help matters
Insurers are always represented by experienced legal teams at the PIC. To level the playing field, you should ensure your evidence (especially specialist medical reports) is targeted to the specific legal criteria the PIC uses to make decisions. Contact us to discuss your PIC application immediately.
Frequently asked questions
- When can I lodge a dispute with the PIC?
- Generally, you must exhaust the insurer’s Internal Review process first. Once you have an Internal Review decision (or if the insurer fails to respond in time), you can apply to the Personal Injury Commission.
- What is the deadline for filing with the PIC?
- For most disputes, you must lodge your application within 28 days of receiving the Internal Review decision. Missing this deadline can make the process much more difficult.
- Do I need a lawyer for the PIC?
- While not strictly required, the PIC process involves complex legal and medical arguments. Having specialized legal representation ensures your evidence is presented correctly and your rights are protected.