Motor Accident Injuries Act 2019

The following people may apply to an insurer for internal review of an internally reviewable decision the insurer has made about an application for defined benefits:

an applicant for defined benefits;

if an applicant for defined benefits is a person with a legal disability—the applicant’s guardian;

if the dependant of a person who died as a result of the motor accident is a person with a legal disability—the dependant’s guardian;

the personal representative of a person who died as a result of the motor accident.

An application for internal review must be made within 28 days after—

the date of the internally reviewable decision; or

if the insurer has not made the internally reviewable decision within the time required under this Act—the end of the time required for making the decision.

However, an application for internal review may be made after the 28 days (a late application) if—

the applicant satisfies the insurer that they have a full and satisfactory explanation for the delay; and

the MAI guidelines provide for a late application to be made within a longer period; and

the late application is made within the longer period.

For subsection (3) (a), a full and satisfactory explanation by an applicant for a delay is a full account of the conduct, including the actions, knowledge and belief of the applicant, beginning on the date of the internally reviewable decision until the date of providing the explanation.

The explanation is not a satisfactory explanation unless a reasonable person in the circumstances explained by the applicant would have been justified in delaying the application.