PROTECT YOUR CTP CLAIM –
SAY ‘NO’ TO INSURANCE INVESTIGATORS

THE OVERVIEW

Investigators are hired by insurance companies to investigate motor accident details, the people involved in the accident and the injuries sustained by the people involved. They are skilled in the legalities of CTP claims and have been employed to protect the insurer’s interests by uncovering information that will allow the insurer to deny or reduce a claim for personal injury compensation. Although an investigator will assert that their investigation is independent, as they are paid by an insurance company, they have a natural bias in favour of the insurer and will frame questions to obtain answers that are detrimental to your claim. Injured people are not legally obligated to agree to be interviewed or respond to an investigator in NSW and should always seek legal advice from an Accredited Specialist in Personal Injury Law to protect their interests immediately after sustaining an injury in a motor accident.

THE DETAIL

Why Investigators Are Appointed by an Insurance Company

After lodgement of a CTP claim, an insurance company will review the circumstances of the accident, the person(s) involved and the injuries sustained. If further explanation is required or the information provided is not consistent with their own insured driver’s version of events, they will typically engage the services of an investigator. Upon appointment, an investigator will typically request a recorded interview to be conducted which could take anywhere from 30 minutes to two hours. The investigator will almost always indicate that they are conducting an independent investigation to entice people to voluntarily participate. The reality however couldn’t be further from the truth when you consider that investigators are engaged by, take instructions from and are paid by insurance companies. Put simply, some investigators derive a large amount of their business income from insurers, so it is unavoidable that they possess an inherent bias in favour of assisting the insurer to decline or reduce a claim.

The Risks of Engaging With an Investigator Appointed by a CTP Insurer

There is no specific legislative requirement in NSW which mandates that an injured person must agree to be interviewed by an investigator appointed by the insurer. An injured person has a general duty to act in good faith, but this however does not mean that you must do everything that the insurance company demands. Provided you act honestly and provide the insurance company with the relevant information relating to your claim within the legislative time limits, this duty will be satisfied. 

Investigators typically possess many years of experience and an in-depth knowledge of the legal intricacies associated with CTP claims. When this knowledge and experience is utilised  during the investigation process, injured people can inadvertently provide information that can be misconstrued or used against them, effectively jeopardising their claim in part or total. The interview process is typically quite a stressful process, which when you are injured can lead to significant confusion and uncertainty. 

In short, you do not need to speak with an insurer’s investigator and there is a good chance that if you do, your claim could be compromised.

Why Engaging a Lawyer is Your Safest Bet

The primary reason you engage a lawyer is that they have experience in CTP claims. Lawyers like those at Advantage Legal are Accredited Specialists in personal injury law and have previously worked in insurance companies, so they have a wealth of experience in dealing with investigators. Other reasons for engaging a lawyer include:

1. A lawyer will understand the complexity of the CTP claim process and will gather information and evidence on your behalf to protect your entitlements.
2. Lawyers understand the difference between particulars of a claim and evidence. There is an obligation to provide particulars, or details about the claim. There is however, no obligation to provide evidence to an insurer unless you intend to rely upon it. An investigator will attempt to obtain as much information and evidence as possible during an interview, so a lack of understanding regarding what you’re obligated to provide can be fatal to your claim.
3. A lawyer will understand how the facts of your case impact your claim viability. As such, they will ask additional questions relevant to protecting your interests. An investigator on the other hand will limit their questions to those that protect an insurer’s interests or will ask questions in a leading manner to obtain a particular response.
4. If engaging with an investigator is beneficial to your case, a lawyer will obtain your instructions and provide specific answers in writing so that your responses cannot be misinterpreted. This means an investigator engaged by the insurer can work to your benefit, not theirs. 

THE KEY POINTS TO REMEMBER

1. You do not need to speak with an insurance company investigator provided you act in good faith and provide relevant information to the insurer about your CTP claim.
2. Investigators represent insurance companies and will always protect the interest of the insurance company. 
3. Engaging a lawyer at the start of your CTP claim, like those at Advantage Legal is the safest action you can take so you and your entitlements will be protected.