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).
If you've suffered burn injuries from a vehicle fire in New South Wales, you may be eligible for funding to cover treatment costs under the Compulsory Third Party (CTP) insurance scheme. This article explains how the NSW CTP rules apply to burn injuries, what treatment costs are covered, and the practical steps to claim funding. It also outlines time limits and legal boundaries for making such claims.
What Treatment Costs Are Covered for Burn Injuries?
Under the Motor Accident Injuries Act 2017 (MAIA), CTP insurance covers treatment costs for injuries caused by motor vehicle accidents, including burn injuries. This includes medical treatments like skin grafts, physiotherapy, and specialist consultations. It also covers hospital stays, medications, and equipment such as burn dressings. However, the scope of coverage depends on the injury being classified as a 'threshold injury' under the Motor Accident Guidelines. Severe burns that require extensive treatment are more likely to qualify for ongoing funding.
How to Claim Funding for Burn Injury Treatment
To claim funding, you must notify the at-fault driver’s CTP insurer within 52 weeks of the accident. This deadline applies to all claims for treatment costs, including those for burn injuries. You’ll need to provide medical evidence confirming the burn injury and its connection to the accident. This includes medical records, treatment plans, and receipts for expenses. SIRA (State Insurance Regulatory Authority) oversees the claims process and provides guidance on what constitutes a valid claim.
Practical Steps for Burn Injury Claims
- Seek immediate medical attention to document the injury and its severity.
- Collect evidence of the accident, such as police reports, witness statements, and photographs of the fire damage.
- Contact the CTP insurer to report the claim within 52 weeks.
- Submit medical records to support the treatment costs.
- Monitor your claim and request updates if the insurer delays processing.
Time Limits and Legal Boundaries
CTP claims for treatment costs must be made within 52 weeks of the accident. If the injury is classified as a 'threshold injury' (e.g., a burn requiring skin grafts), benefits are generally limited to 52 weeks unless the injury results in long-term impairment. For example, a burn injury causing permanent scarring or mobility issues may qualify for ongoing funding. However, claims for non-threshold injuries (e.g., minor burns) are typically limited to the 52-week period. Always consult a legal professional to confirm your injury’s classification.
Hypothetical Example
Consider a driver who suffered second-degree burns from a vehicle fire. Medical records show the injury required multiple skin grafts and ongoing physiotherapy. Under the CTP scheme, the insurer would cover the cost of these treatments, provided the claim is made within 52 weeks. If the burn leads to chronic pain or reduced mobility, the claim may extend beyond 52 weeks depending on the injury’s severity.
When to Seek Legal Advice
While the CTP scheme provides a clear pathway for funding treatment costs, disputes can arise over claim eligibility, medical assessments, or insurer delays. For example, an insurer may dispute the link between the burn injury and the accident, or challenge the necessity of certain treatments. In such cases, legal advice can help ensure your rights are protected. Always act promptly, as time limits apply to all aspects of the claim.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.