Five FAQs for your motor vehicle accident claim in New South Wales
Published on October 14, 2024 by Michael Greene and Tim Concannon
The Motor Accidents Injuries Act 2017 (MAIA) governs the process for claiming compensation following a motor vehicle accident in New South Wales (NSW). We have developed this short article with five of the common frequently asked questions (FAQs) about bringing a motor vehicle accident claim in NSW.
1. Who is eligible to make a motor vehicle accident claim under the Motor Accidents Injuries Act 2017?
Under the MAIA, anyone injured in a motor vehicle accident in NSW may be eligible to make a claim, regardless of whether they were the driver, passenger, pedestrian, cyclist, or motorcyclist. Even if you were partially or fully at fault for the accident, or no one was at fault you might still be entitled to compensation, although the amount may be reduced based on your level of fault.
In addition to physical injuries, the Act also covers psychological injuries arising from the accident. However, claims for threshold injuries (previously known as minor injuries), such as soft tissue injuries or minor psychological injuries or claims where you were mostly at fault for the accident, are limited to a maximum of 52 weeks of benefits.
It’s important to note that if the accident occurred while working or in the course of your employment, you may also have a concurrent workers’ compensation claim. These cases can be complex, so seeking legal advice early on is crucial.
2. What types of compensation are available under the Act?
The MAIA 2017 provides for two main types of compensation:
- Statutory benefits – these benefits are available to nearly all injured persons, regardless of fault. Statutory benefits include payments for your medical expenses, loss of income, and rehabilitation costs. These benefits are typically available for up to 52 weeks if the injury is classified as a threshold injury. If the injury is more severe, statutory benefits may extend beyond 52 weeks and potentially up to five years.
- Common law damages – if your injury is not considered a threshold injury and you can establish that another party was at fault, you may be entitled to claim common law damages. This type of compensation can cover past and future loss of earnings and non-economic losses (pain and suffering). To qualify for non-economic loss damages your whole-person impairment must be greater than 10%.
3. What is the process for pursuing a motor vehicle accident claim?
The process for lodging a claim under the MAIA involves several key steps:
- Seek medical attention – immediately after the accident, ensure that you receive medical treatment. Your injuries must be documented by a medical professional, as this will form the basis of your claim.
- Report the accident – you must report the accident to the police within 28 days. If the police did not attend the accident scene, you should go to the nearest police station and report it. This report will generate an event number, which is necessary for your claim.
- Complete and submit a claim form – to claim statutory benefits, you must submit an application form with an accompanying medical certificate to the CTP insurer within 28 days of the accident [1]. This form requires detailed information about the accident, your injuries, and any treatment received. If only medical or care expenses are claimed the claim form can be served within 3 months of the accident.
- Insurer assessment – once the insurer receives your claim, they will assess your eligibility for benefits. The insurer may require you to attend medical examinations and provide additional documentation. They usually have 4 weeks within which to make an initial decision whether to commence payments.
- Dispute resolution – if you disagree with the insurer’s decision regarding your claim, you can seek an internal review or escalate the matter to the Personal Injury Commission (PIC).
- Common law damages – a separate claim form should be served on the insurer to commence a damages claim within 3 years, and generally not later than 2 years, after the accident. Separate procedures apply to damages claims including the need to provide full particulars of your claim, attend one or more medico-legal assessments and engage in settlement discussions prior to lodging a damages application in the PIC.
4. How are disputes about motor vehicle accident claims resolved?
Disputes can arise during the claims process, particularly regarding the assessment of liability, the classification of injuries as threshold or non-threshold, or the quantum of benefits. The MAIA provides several avenues for resolving these disputes:
- Internal review – if you disagree with an insurer’s decision, you can request an internal review. This involves a senior officer from the insurer’s internal review unit re-assessing the decision.
- Personal Injury Commission (PIC) – if the internal review does not resolve the dispute, you can escalate the matter to the PIC. The PIC is an independent tribunal deigned to resolve disputes between claimants and insurers. The PIC handles disputes related to liability, treatment costs, weekly payments, impairment, threshold injury disputes and damages assessments.
- Court proceedings – if you remain dissatisfied with the PIC decision, you may “appeal” to the District Court of NSW. However, court proceedings can be costly and time-consuming, so it is best to first exhaust all alternative dispute resolution mechanisms.
5. Are there any time limits for making a motor vehicle accident claim?
Yes, the MAIA imposes strict time limits for lodging a claim [2]. Key deadlines include:
- 28 days to submit a personal injury claim form on the insurer – This is required if you are claiming weekly statutory benefits for loss of income.
- Three months to submit a personal injury claim form for medical benefits – you must submit your Personal Injury Claim Form within three months of the accident if only medical expenses are claimed. If you miss this deadline, you must provide a full and satisfactory explanation for the delay, or your claim may be denied.
- Three years to claim common law damages – if you wish to pursue common law damages, you must serve a common law damages application form within three years of the date of the accident. In some cases, this period may be extended if you were unaware of your injury’s severity or if the delay was due to other exceptional circumstances. It is generally advisable to serve this application form within 2 years of the accident.
- Three years to file PIC damages application – it is invariably advisable to lodge this application with the PIC within 3 years of the accident in order to safeguard your right to “appeal” to the District Court should you be unhappy with the damages decision of the PIC.
It’s essential to act promptly and seek legal advice as soon as possible after an accident to ensure your rights are protected. Navigating the process of making a motor vehicle accident claim can be complex. By understanding your rights, the types of compensation available, and the claims process, you can better manage your recovery and ensure you receive the compensation to which you are entitled.
Please note that this article does not constitute legal advice. If you are seeking professional advice on any legal matters, you can contact Carroll & O’Dea Lawyers on 1800 059 278 or via our Contact Page and one of our lawyers will be able to assist you. If you believe you have a claim, you can also use our fast and simple Personal Injury Claim Check and we will get into touch with you shortly.
[1] Motor Accidents Injuries Act 2017 (NSW) s6.13.
[2] Ibid.
