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 or a loved one has been injured in a motor vehicle accident on the Illawarra or South Coast, understanding how family care needs are handled under NSW CTP laws is critical. NSW Compulsory Third Party (CTP) insurance covers care and support costs for injured road users, but the process requires specific documentation and awareness of time limits. This article explains how family support considerations are integrated into CTP claims, what evidence insurers require, and when to seek legal guidance.
How NSW CTP claims cover family care needs
Under the Motor Accident Injuries Act 2017, CTP insurers must cover care and support costs for injured road users. This includes both paid and unpaid care, such as assistance with daily living tasks, medical appointments, or household responsibilities. SIRA guidelines clarify that family members providing care are entitled to claim for their time and expenses, provided they meet the scheme’s criteria.
The key is to demonstrate that the care was necessary due to the injury. For example, if a child requires overnight supervision after a serious accident, this would qualify as a care need. SIRA’s What You Can Claim page confirms that family support is a recognized claim type, but it must be documented with evidence such as care records, witness statements, or medical reports.
Practical steps to support family care claims
To ensure your family care needs are considered, take these early steps:
- Document the care provided: Keep a record of hours spent on care tasks, expenses incurred, and any changes in the injured person’s condition.
- Obtain medical confirmation: A doctor’s note confirming the injury’s impact on daily living is essential. This may include details about mobility limitations or cognitive impairments.
- Notify the insurer: Inform your CTP insurer about the care needs within the required timeframe. Delays may affect eligibility for certain benefits.
- Seek witness evidence: Family members or friends who can attest to the care needs may provide valuable support.
A hypothetical example: After a collision on the South Coast, a cyclist requires 24-hour care for two weeks. Their sibling documents the care hours, provides receipts for meals and transport, and contacts the insurer. This evidence helps establish the care need under CTP rules.
Time limits and dispute resolution
CTP claims have strict deadlines. For example, weekly income benefits are generally limited to 52 weeks if the injury is classified as a threshold injury (per s 4.4 of the Motor Accident Injuries Act 2017). If your claim involves long-term care, ensure you understand how the injury’s severity affects benefit duration.
Disputes over family care claims can be resolved through SIRA’s internal review process. If an insurer rejects a claim, you may request a review or seek mediation. It’s important to act promptly, as delays can reduce the amount of support available.
When to seek legal advice
While many family care claims can be managed through SIRA, complex cases may require legal assistance. A solicitor can help navigate issues such as:
- Determining the correct claim type for unpaid family care
- Challenging an insurer’s refusal to cover certain needs
- Ensuring all documentation meets CTP scheme requirements
If you’re unsure about your options, contact a legal professional to review your circumstances.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.