Sparke Helmore's MAD (Motor Accidents Division) - Special Edition - New Motor Accident Guidelines

Welcome to this special edition of Sparke Helmore’s MAD publication, a snapshot of the key changes in the newly released Motor Accident Guidelines (version 10) (the Guidelines).

On 15 September 2025, the State Insurance Regulatory Authority (SIRA) published version 10 of the Guidelines, replacing version 9.3.

Exclusions

For claims brought under the Motor Accidents Compensation Act 1999 (the Act), which applies to motor accidents between 5 October 1999 to 30 November 2017, the existing Guidelines continue to have effect.

Generally, for claims involving motor accidents before 1 April 2023, clauses 4.36, 4.3, 4.40 and 4.41 of the superseding Guidelines do not apply. Instead, clauses 4.36, 4.39, 4.40, 4.41, 5.1(c), 5.15 and 5.16 of version 9 apply to those motor accidents as relevant.

Additionally, for CTP policies that came into effect between 15 January 2024 and midnight 14 January 2025, Part 1 of the superseding Guidelines do not apply. Instead, Part 1 version 9.2 continues to apply.

We have summarised changes likely to affect the practice of insurers and solicitors below.

Other changes have been made but are less relevant to everyday implementation, including for example the removal of clause 4.6(f) relating to COVID-19 pandemic implications. A full summary of changes can be accessed here.

Changes implemented in version 10

1. Communication with claimants

   1. Amendment of clause 9 and addition of clause 4.9A – if the insurer has a reasonable belief that communication or provision of information to a claimant may pose a serious threat to the life or health of the claimant or any other person, the insurer must inform the claimant that the specific information may contain distressing information or images. The claimant must be provided with a reasonable opportunity to authorise a friend to receive that specific information about the claim instead of, or in addition to, the claimant.

2. Changes to statutory benefits liability notices

   1. Amendment of clause 4.34(a) – a clear explanation is required of liability decisions.
   2. Removal of clause 4.34(c) – an insurer is no longer required to provide detailed reasons when accepting liability, however the reasons must be sufficient to comply with clause 4.34(a).
   3. Amendments of clause 4.35:
      1. Only new documentation need be annexed to a liability notice, but all relevant information must be listed. An insurer is no longer required to provide the claimant with copies of all documents by default (previously 4.35(b)).
      2. Insurers must apply discretion in identifying and withholding potentially traumatising information or images if a claim for statutory benefits is related to a death or psychological injury.
   4. Amendment to clause 4.36(c) – streamlining processes for combined notices. The amended approach does not dictate the format of the Combined Liability Notice so long as the required information is included and, where relevant, clearly distinguishes between pre-52 weeks and post-52 weeks.

3. Weekly payment decisions

   1. Removal of clause 4.45 specifying the applicability of requirements for rules for weekly payment decisions.
   2. Amendment of clauses 4.44 and 4.45 – within 10 business days after a decision to accept liability for statutory benefits, an insurer must provide a written notice regarding the calculation of pre-accident weekly earnings so that people with a claim have a general understanding of how and why an insurer has made its determination as to the amount of weekly benefits that are payable, and what factors and information insurers have considered. The review avenues must also be clearly set out for the claimant.
   3. Clause 4.49 – an insurer must consider the claimant’s financial position when considering the means of recovering an overpayment (compared to should in version 9.3).

4. Non-compliance with rehabilitation or provision of fitness for work evidence

   1. Amendment of clause 4.61 – an insurer now can only suspend weekly benefits pursuant to ss 3.15(7), 3.17(2) or 6.5(3) of the Act. Strict legislation compliance is required.
   2. Amendment of clause 4.62 – requirements of insurer to contact claimant and advise of review/dispute avenues.  

5. Changes to damages liability notices

   1. Amendment of clause 4.126 – only new documentation need be annexed to a liability notice, but all relevant information must be listed. An insurer is no longer required to provide the claimant with copies of all documents by default.

6. Permanent Impairment decisions

   1. Addition of clause 4.129A in response to Atwal v Insurance Australia Limited trading as NRMA Insurance [2025] NSWSC 143. See our MAD case note here. To summarise, if the insurer in possession of an IME report that indicates a claimant’s WPI is greater than 10% but it considers that further information is required in order to concede an entitlement to non-economic loss, the insurer must seek the required information promptly and advise the claimant of what information is being sought and the reasons why the information is relevant to its decision.

It should be noted that an internal review application is now a ‘request’ in the Guidelines. This wording has been adopted and required amendment of clauses 4.45 and otherwise.