NSW clarifies medical disputes and legacy roles in CTP law

Revision bill focuses on technical corrections and transitions

NSW clarifies medical disputes and legacy roles in CTP law

Workers Compensation

By Roxanne Libatique

New statute law changes affecting the New South Wales motor accident and insurance governance framework have commenced, with the Statute Law (Miscellaneous Provisions) Act (No 2) 2025 taking effect on Feb. 18. For insurers and intermediaries with NSW exposure, the amendments change key definitions and processes in compulsory third party (CTP) and related schemes and sit alongside broader workers’ compensation reforms that have recently passed the state parliament.

Act changes medical dispute definition and technical references

A key element of the Statute Law (Miscellaneous Provisions) Act (No 2) 2025 is an amendment to section 7.17 of the Motor Accident Injuries Act 2017, revising the definition of “medical dispute” to confirm that it extends to disputes determined through merit review processes. For CTP insurers, dispute resolution providers, and legal representatives, the clarification addresses ambiguity over whether matters decided by way of merit review fall within the same statutory category as other medical disputes. The change is likely to affect how disputes are framed, which pathways are selected, and how decisions are described in claims management and litigation. The Act also updates wording in legacy motor accident legislation. Section 62(1)(b) of the Motor Accidents Compensation Act 1999 is amended to replace a reference to the “President” with a reference to the “Commission,” aligning the provision with the current institutional structure for dispute resolution and scheme oversight.

Governance amendment sets out health and related services guideline process 

The statute law package also amends the State Insurance and Care Governance Act 2015. A change to section 26E introduces an express requirement that the Guidelines for the Provision of Relevant Services (Health and Related Services) may be published in the Government Gazette and specifies the date on which they commence. For workers’ compensation and care scheme insurers, third‑party claims managers, and treatment providers, the amendment sets out the formal mechanism for issuing these guidelines and clarifies their commencement dates. This allows scheme participants to align contract terms, clinical service arrangements, and benefit assessment processes with updated guidelines as they are gazetted.

Statute Law Revision program underpins the amendments 

The new act forms part of the Statute Law Revision (SLR) program administered by the NSW government. Under this program, a Statute Law (Miscellaneous Provisions) Bill is prepared for both the Budget and Spring sittings of parliament each year. The program is used for non‑controversial matters and incremental legislative adjustments, rather than substantial policy change. Bills under the program generally include:

  • Minor amendments proposed by government agencies
  • Technical or “pure” revision work proposed by the Parliamentary Counsel
  • Repeals of obsolete or unnecessary legislation, with any remaining operative provisions relocated where required
  • Associated savings and transitional provisions

Read next: NSW moves forward with workers’ compensation overhaul

Proposals that increase sentences of imprisonment, significantly raise monetary penalties, affect private rights, impose retrospective liabilities, address contentious subject matter, or require broad whole‑of‑government negotiation are usually treated as unsuitable for inclusion. Large or complex amendment packages are also directed to stand‑alone bills outside the SLR process.

Submission process and timing for agencies

NSW government agencies seeking amendments under the program must obtain ministerial approval and submit proposals to the Parliamentary Counsel with a short briefing note, typically limited to one page per proposal. The note is expected to:

  • Explain why the change is being sought and by whom
  • Describe the proposal in non‑technical language and how it addresses the identified issue 
  • Outline the implications of the proposal

If an act is administered jointly, approval from all responsible ministers is required before a proposal can be progressed. Proposals are assessed first by the Parliamentary Counsel and then by senior legal staff within the Department of Premier and Cabinet. Items considered unsuitable for the SLR program are excluded from the bill and may need to proceed through separate legislative processes. To match parliamentary timetables, proposals received by the second Friday in February are considered for inclusion in the Budget sitting statute law bill, while those received by the fourth Friday in July are considered for the Spring sitting bill. In election years, approval for Budget‑sitting inclusions can be obtained from the incoming portfolio minister after the new government is sworn in. Proposals submitted after the cut‑off dates may be carried forward to later statute law bills.

Workers’ compensation reforms adjust premiums and benefits 

Separately, NSW has passed reforms described by the government as intended to “repair the NSW workers compensation system,” with consequences for premiums, benefit design, and return‑to‑work arrangements. The reform package, developed from a compromise advanced by lower‑house crossbench members in 2025, was endorsed by the Legislative Assembly after passing the Legislative Council. Key elements include:

  • A legislated 18‑month restriction on average premium increases
  • Retention of Whole Person Impairment (WPI) thresholds moved by the lower‑house crossbench
  • A new “Return to Work” intensive program providing an additional year of medical benefits and income replacement
  • New powers enabling the Treasurer to lower the WPI threshold where this is considered to be in the public interest
  • A replacement program for Business Connect
  • Changes to terminology relating to the reasonable management action defence

Read next: NSW parliament approves workers’ compensation reform package

Government projections indicated that, without the reforms, employers with no claims history were facing premium increases of at least 36% over three years. The package follows engagement with business groups, unions, and community and not‑for‑profit organisations.

Implications for insurers and intermediaries 

Areas of focus for insurance professionals are likely to include:

  • Updating internal definitions, dispute‑handling protocols, and documentation to reflect the revised “medical dispute” definition in the Motor Accident Injuries Act
  • Monitoring gazettal and commencement dates for updated health and related services guidelines issued under the State Insurance and Care Governance Act
  • Assessing the effects of the 18‑month restriction on average premium increases on workers’ compensation pricing, margins, and participation decisions
  • Reviewing claims, rehabilitation, and return‑to‑work practices in light of the new intensive program and possible future changes to WPI thresholds

Insurers and intermediaries will be watching how these measures affect claim costs, employer premiums, and scheme outcomes in the NSW market over the medium term.

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