Most people injured on the road face losing their common law rights to sue insurance companies for ongoing medical costs and lost wages under radical changes to the compulsory green slip insurance scheme.
They would also lose their rights to any legal representation to challenge a disputed assessment of their insurance claim.
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Reforms set to leave motorists 'worse off'
Most injured NSW motorists are at risk of losing compensation under government plans to reform the green slip insurance scheme.
Under state government plans to overhaul the compulsory third-party insurance scheme, the minority of motorists who are most seriously injured would retain common law entitlements to lump sum compensation payments and legal representation. Others with less serious injuries would be given limited statutory benefits to income replacement and medical benefits for a maximum of five years.
The vast majority of injured motorists suffer less serious injuries, which can prevent them from returning to work, and will fend for themselves under the planned changes. They will no longer be able to claim for a lump sum payment for future expenses and income loss. They will be cut from the defined benefits scheme after five years.
![Injured motorist Desmond Goulding.](/web/20160910021723im_/http://www.smh.com.au/content/dam/images/g/r/a/i/5/g/image.related.articleLeadwide.620x349.gr8zca.png/1473436194076.jpg)
"Under the new laws, almost no one will have the right to a solicitor. That's disgusting," said injured motorist Desmond Goulding, 64, from the Illawarra.
"How can a normal person go up against insurance companies. That's ludicrous."
A $400 million spike in fraudulent insurance claims in Sydney's western suburbs and inefficiencies which result in just 45¢ in every green slip dollar being returned to injured motorists has spurred wholesale reform of the scheme which covers more than 2 million people.
Danielle De Paoli, from Maurice Blackburn Lawyers, said fraudulent claims had increased the cost of the scheme, but there were other cost-saving alternatives to cutting benefits and redefining the entire CTP scheme.
![In-Young Joyce helps her husband Myung Jin Juong at their home in Epping.](/web/20160910021723im_/http://www.smh.com.au/content/dam/images/g/r/a/i/5/p/image.related.articleLeadwide.620x349.gr8zca.png/1473436194076.jpg)
The Baird government and its new State Insurance Regulatory Authority, which oversees green slip insurance and workers compensation schemes, propose to slash benefits for less seriously injured motorists in the same way benefits to injured workers were cut under workers compensation changes.
![Myung Jin Juong and wife In-Young Joyce at their home in Epping.](/web/20160910021723im_/http://www.smh.com.au/content/dam/images/g/r/a/i/6/2/image.related.articleLeadwide.620x349.gr8zca.png/1473436194076.jpg)
Green slip insurers reaped $2.9 billion in profits over the past 15 years, an average profit margin of 19 per cent per year, while consistently understating expected profits. Insurers warn that without change, they will increase premiums which cost Sydney car owners an average of $614.
A parliamentary review of the compulsory third-party insurance scheme last month noted a call for insurer profits to be monitored "due to the significant and ongoing disparity between prospective and realised profits, which has continuously landed in favour of insurers".
Insurance companies who have donated tens of thousands of dollars to both major political parties in recent years are backing the government's plans to slash benefits to people with less serious injuries that reduce full body function by 10 per cent. Back, neck and leg injuries that require surgery and can prevent people from returning to work are among those that may fall below the threshold.
Mr Goulding, whose injury was assessed below 10 per cent, was cut from his car in June after it was struck by another car.
A neurosurgeon advised he needs surgery to his neck and back, but his CTP insurer has rejected claims for treatment.
"Now I have trouble coping with my life. I'd rather be dead the way I've been treated," Mr Goulding said.
Mr Goulding said his insurer has also refused to grant him more than one session with a psychologist despite medical recommendations for urgent treatment.
In-young Joyce and Myung Jin Juong who live in Epping were involved in a four-car pile-up in September last year. They have more than halved their six-day working week as domestic cleaners as a result of neck and back injuries which fall below the 10 per cent threshold.
A neurosurgeon warned Mr Juong in April this year he risks paralysis without urgent surgical treatment. But Mr Juong has been unable to get approval from his CTP insurer for the operation.
The couple's doctor, Arthur Chesterfield-Evans, a former NSW MP, said he has seen numerous patients facing lengthy delays for insurer approval for medical services.
"What I find is a bunch of insurance companies totally obstructing reasonable treatment to save a quick buck," he said.
"They have given a lot of money to the government and the government is delivering super profits to them."
Gary Ulman, president of the NSW Law Society, said injured motorists with serious injuries below the 10 per cent threshold would be prevented from getting legal representation and will battle with insurers on their own, under the proposals.
"There is going to be an imbalance in power between the individuals and the insurers," he said.
"If someone is injured and is unable to retrain ... they will be spat out of the system after five years and onto welfare.
"The whole system is essentially going to be run by the insurers which means that people who have to negotiate claims on their own may not make claims because it will be a daunting process."
The Baird government appointed State Insurance Regulatory Authority deputy chair Nancy Milne and former Labor Party industrial relations minister John Della Bosca to assess the fairness and affordability of the proposed scheme.
Their report released last week says the insurance industry is calling for an internal insurer dispute resolution process which would allow it to have the final say on disputes with claimants.
NSW Greens MP David Shoebridge, a member of the standing committee on law and justice, which last month reviewed the CTP scheme, said the proposed changes would be particularly unfair on manual workers.
"A nurse or carpenter who relies on a healthy body to do their job can lose their entire career with an injury that is assessed at well below 10 per cent whole person impairment," he said.
"They face losing their right to claim for ongoing wage loss over their entire career and have it replaced with a statutory benefit that will run out after a maximum of three to five years."
Mr Shoebridge said the joint parliamentary committee report highlighted a "grossly disproportionate share of green slip premiums that go to fatten up insurer profits".
"Over the lifetime of the scheme they have taken one dollar in five and the regulator has repeatedly failed to address this," he said.
"John Della Bosca savaged workers compensation benefits 15 years ago and the government clearly sees him as someone they can rely on to do the same with CTP."
Mr Della Bosca implemented cuts to the workers compensation scheme in 2011. Unions portrayed him as the "butcher" of workers compensation.
Government sources say Mr Della Bosca has been recognised for his significant experience in delivering important social reforms including his advocacy and leadership of the NDIS. This was said to be testament to his ability to engage with complex reform.
Mr Shoebridge said he had no doubt Minister for Innovation and Better Regulation Victor Dominello was more committed to addressing problems with the scheme than his predecessor Greg Pearce, whose planned CTP reforms failed.
Mr Dominello said his focus is on delivering a better scheme for injured road users and motorists. He said the government's reforms were supported by social service advocates and will end "the days of insurer super profits and see a significant reduction in premiums".
"It is not fair that only 45¢ in every green slip dollar goes to injured road users, nor is it fair that NSW motorists are being asked to pay the highest premiums in the country," he said.
Insurance companies including Suncorp, Allianz and NRMA have made significant donations to the NSW Liberal Party and Labor Party in recent years.
In 2015/16 Suncorp's financial contributions to political parties included $33,930 to the Liberal National Party and $34,300 to the Labor Party.
Richard Shields, the Insurance Council of Australia's head of government and stakeholder relations, is a former deputy director of party affairs for the NSW Liberal Party. He was also touted earlier this year as a potential rival to conservative senator Concetta Fierravanti-Wells in a factional challenge from the moderate wing of the party.
A spokesman for ICA said the insurance council draws talent from all sides of politics. "These people are highly professional and they work on policy matters with political parties of all persuasions," he said.
Spokesman Campbell Fuller said the NSW CTP scheme was "broken" and in need of reform to create a fairer more affordable scheme to better support the most seriously injured motorists. He said the number of motorists who would need treatment after five years was very small.
"Fraud and exaggerated claims add an estimated $75 to every premium," he said.
"The final design of the scheme has yet to be determined, so it's premature for any stakeholder to make definitive claims about how a reformed scheme may deal with issues such as claims, benefits, profits and disputes.
"The ICA rejects any suggestion of a link between proposed changes to the CTP scheme and political donations by its members. The ICA and its members are committed to transparency in the area of political donations."
A spokeswoman for Suncorp said it works with all governments and political parties to "drive the best outcomes for customers and the wider community".
"To that end, Suncorp is bipartisan and transparent in its engagement with government.
"We agree with the government that the current NSW CTP scheme is broken and in need of reform. We support the proposed reforms to the scheme that tackle rising incidences of fraud involving legally represented claims, while delivering the best health outcomes for motorists and improving affordability."
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