How SIRA Assesses Burn Injuries in CTP Claims
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).
In New South Wales, the State Insurance Regulatory Authority (SIRA) administers Compulsory Third Party (CTP) claims for injuries caused by motor vehicle accidents. Burn injuries from vehicle fires are treated under the same framework as other injuries, but SIRA has specific criteria for assessing the severity and impact of such injuries.
When a burn injury occurs in a vehicle fire, SIRA evaluates the claim based on medical evidence, the nature of the injury, and its effect on the injured person’s daily life. Thermal burns from flames and chemical burns from fire-related substances are both considered. The assessment focuses on whether the injury meets the 'threshold injury' definition under the Motor Accident Injuries Act 2017, which requires a minimum level of impairment to qualify for benefits.
Evidence Required for Burn Injury Claims
To support a burn injury claim, claimants must provide:
- Medical records from a specialist, including burn severity classifications (e.g., first, second, or third-degree burns)
- Accident reports detailing the fire's cause and circumstances
- Witness statements or photographs of the incident
- Evidence of treatment such as hospital records, specialist consultations, or therapy sessions
- Income records if the injury affects earning capacity
SIRA may also request independent medical opinions to verify the injury's impact. For example, a burn injury requiring skin grafts or long-term rehabilitation would likely meet the threshold for benefits.
Regional Considerations for Illawarra and South Coast
While SIRA applies the same legal framework across NSW, claimants in Illawarra and the South Coast may face unique challenges. These regions have fewer specialist burn treatment facilities compared to metropolitan areas, which could affect the availability of medical evidence. Claimants should ensure they receive treatment from accredited medical practitioners and retain all documentation.
SIRA also considers the location of the accident when assessing claims. For instance, a vehicle fire on a remote road may involve different emergency response times compared to urban areas, which could influence the injury's progression.
Time Limits and Dispute Resolution
CTP claims must be submitted within 52 weeks of the accident for benefits related to 'threshold injuries.' However, this timeline does not apply to claims involving whole person impairment (WPI) or long-term care needs. If a burn injury results in permanent scarring or functional limitations, the claim may extend beyond 52 weeks.
Disputes over burn injury assessments can be resolved through SIRA's Dispute Resolution Process, which includes mediation and formal reviews. Claimants should seek legal advice if they believe their injury meets the threshold but is being denied.
When to Seek Legal Advice
Burn injuries from vehicle fires can have complex medical and legal implications. For example, a chemical burn from a leaking fuel tank may require specialist input to determine its connection to the accident. Legal professionals can help claimants:
- Navigate SIRA's assessment criteria
- Challenge denied claims based on incomplete evidence
- Pursue additional compensation for pain, suffering, or loss of enjoyment
If your burn injury resulted from a vehicle fire, contact a legal professional to ensure your claim reflects the full impact of your injury.
Next Steps
CTP claims involving burn injuries depend on accurate medical assessments and timely submission of evidence. While SIRA provides a standard framework, regional factors like access to specialist care may influence outcomes. Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.