Pursuant to the Motor Accident Injuries Act 2017 (“MAI Act”), notice must be given to the relevant insurer when making a claim for statutory benefits. A common question that arises, is, who is the relevant insurer?
If you are making a claim for statutory benefits, or a common law claim, following a motor vehicle accident, the process for making a claim begins by notifying all of the defendants, that is, the compulsory third party insurer for any of the vehicles involved, that may have been negligent in causing the accident.
Who is the relevant insurer?
Making a claim for statutory benefits has been complicated by the introduction of the term “relevant insurer” in the MAI Act.
Under the MAI Act, section 6.12(1) states a claim for statutory benefits is made by giving notice to the relevant insurer and under section 3.2(1), the relevant insurer is the one who pays those benefits.
Since the introduction of the new scheme, section 3.2 of the MAI Act provides an explanation of the relevant insurer, as follows:
in if the motor accident concerned involved only one motor vehicle with motor accident insurance cover the insurer of the motor vehicle, or
if the motor accident concerned involved more than 1one motor vehicle, the insurer of the at fault motor vehicle, or
in any other case the Nominal Defendant.
Who to make a claim against?
Having regard to the concept of relevant insurer under the MAI Act, when making a claim for statutory benefits, a claim may be made against one insurer. It is then for the insurer to accept the claim that it is the relevant insurer for the purposes of managing the claim, paying the statutory benefits or disputing the claim brought against it.
The insurer will make the assessment if they are deemed to be the relevant insurer in accordance with section 3.2 of the MAI Act. They will do this by considering the factual circumstances of the accident and make enquires with the claimant if any other vehicles were involved in the accident or contributed to it.
What if there is a dispute regarding the relevant insurer?
If there is a dispute regarding the relevant insurer, or if there is a delay in making such a determination, the matter can be referred to the Dispute Resolution Services under section 3.3(2). The matter then becomes a miscellaneous claims assessment matter and the outcome of that assessment is binding on the insurers.
Pursuant to Clause 4.28 of the Motor Accident Guidelines, a claimant is excused if they have given notice of a statutory benefit claim to the wrong insurer. The purpose of this clause is to encourage and have the correct insurers cooperate, so that the claimant’s entitlements are not adversely affected. This is also to assist self-represented claimants who are not aware of the provisions of the Act.
*Disclaimer: This is intended as general information only and not to be construed as legal advice. The above information is subject to changes over time. You should always seek professional advice before taking any course of action.*
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