Where a person's only injuries resulting from the accident are threshold injuries, weekly benefits and treatment and care generally cease after 52 weeks (ss 3.11 and 3.28).
A threshold injury under the Motor Accident Injuries Act 2017 (NSW) includes a soft tissue injury and a psychological or psychiatric injury that is not a recognised psychiatric illness (adjustment disorder and acute stress disorder are the usual examples; s 1.6 and Motor Accident Guidelines Part 5).
Amputation injuries following a motor vehicle accident in NSW may entitle injured persons to compensation covering caregiver and family support costs under the Compulsory Third Party (CTP) scheme. This article explains how NSW CTP insurers assess claims involving limb loss, including the types of family-related expenses covered, time limits for claiming care costs, and practical steps for Bathurst residents.
What Caregiver Costs Are Covered in CTP Amputation Claims?
Under the Motor Accident Injuries Act 2017, CTP insurers must cover reasonable expenses related to the injured person’s care and recovery. For amputation claims, this includes:
- Prosthetic devices and their maintenance
- Home modifications to accommodate mobility needs
- Caregiver support costs, such as wages for full-time assistance
- Travel expenses for medical appointments
SIRA guidelines state that claims must demonstrate a direct link between the injury and the caregiver-related cost. For example, if an amputation requires 24/7 care, the insurer must cover the cost of a live-in carer.
How SIRA Evaluates Family Impact on Amputation Claims
SIRA assesses the effect of amputation on family responsibilities by considering:
- The injured person’s pre-accident role in household duties
- Changes in the family’s financial and emotional capacity
- Evidence of increased caregiving demands, such as medical reports or witness statements
In a hypothetical case, a mother of two who loses her leg in a Bathurst car crash may claim additional costs for modifying the family home and hiring a carer to assist with childcare. SIRA would evaluate whether these expenses are reasonable and necessary.
Time Limits for Claiming Caregiver Expenses
CTP claims must be submitted within 52 weeks of the accident for most benefits. However, claims for ongoing care costs (e.g., long-term prosthetic use) can extend beyond this period if:
- The injury is classified as a 'threshold injury' under the Motor Accident Guidelines
- The claimant provides evidence of continuous care requirements
Caregiver-related claims must be submitted within 52 weeks of the accident unless the insurer agrees to an extension. Delays may reduce the amount recoverable.
Practical Steps for Bathurst Residents
- Document all caregiving costs with receipts and invoices
- Obtain medical reports confirming the need for family support
- Submit claims to the at-fault driver’s CTP insurer within 52 weeks
- Seek independent advice if the insurer disputes the claim
When to Seek Legal Advice
Families should consult a solicitor if:
- The insurer refuses to cover reasonable care costs
- The claimant faces financial hardship due to caregiving responsibilities
- The injury involves complex medical treatment requiring specialist input
CTP claims involving amputation require careful documentation of both the injury and its impact on family life. Bathurst residents should act promptly to preserve their right to claim support costs under the NSW scheme.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.