Burn Injuries and CTP Coverage on the Central Coast
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 on the Central Coast, the NSW Compulsory Third Party (CTP) scheme may cover your treatment and rehabilitation costs. Under the Motor Accident Injuries Act 2017, CTP insurers must pay for medical treatment, including specialist care, therapy, and rehabilitation, regardless of fault. This applies to thermal and chemical burns caused by vehicle fires or collisions. However, the amount and type of support depend on the injury's severity and medical evidence.
Key CTP Rules for Burn Injuries
The CTP scheme covers all treatment costs for injuries resulting from a motor vehicle accident, including burns. This includes:
- Emergency care and hospital treatment
- Specialist consultations (e.g., dermatologists, plastic surgeons)
- Rehabilitation services like physiotherapy or occupational therapy
- Equipment such as pressure garments or mobility aids
SIRA (State Insurance Regulatory Authority) assesses claims based on the Motor Accident Guidelines. For burn injuries, medical evidence must show the injury meets the 'threshold injury' definition under the Act. This includes injuries requiring medical treatment beyond first aid, such as second-degree burns or scarring.
Practical Steps for Treatment Planning
To ensure your treatment and rehabilitation are covered:
- Seek immediate medical attention and document all treatment records
- Obtain a detailed medical report outlining the injury's impact
- Keep records of all expenses, including out-of-pocket costs
- Consult with a specialist to create a rehabilitation plan
For vehicle fires, evidence like:
- Fire department reports
- Witness statements
- Vehicle inspection reports
- Photos of the fire scene
may strengthen your claim. SIRA requires a clear link between the accident and your injury.
Time Limits and Dispute Resolution
CTP claims must be submitted within 52 weeks of the accident, unless an extension is granted. After 52 weeks, benefits for 'threshold injuries' typically stop, though ongoing rehabilitation may still qualify. If your claim is disputed, SIRA provides a formal review process. You may also seek legal advice if:
- The insurer refuses to cover necessary treatment
- There's a disagreement about the injury's severity
- You need assistance with rehabilitation planning
Example Scenario
Consider a Central Coast resident who suffered second-degree burns in a vehicle fire. Their treatment included skin grafts and 12 weeks of physiotherapy. SIRA would assess the claim by:
- Reviewing medical records confirming the burn's severity
- Evaluating the impact on daily activities
- Confirming the injury meets the threshold injury definition
- Calculating benefits based on the injury's effect on the person's life
When to Seek Advice
CTP claims involving burn injuries require careful documentation. Contact a legal professional if:
- You're unsure if your injury qualifies
- Your treatment costs exceed initial estimates
- You need help creating a rehabilitation plan
- You face a dispute with the insurer
Next Steps
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.