Children injured in motor accidents face unique challenges in recovering their daily routines. Under New South Wales' Compulsory Third Party (CTP) scheme, claims must demonstrate how injuries impact essential activities like school, play, and family life. This article explains what daily activities are considered, how insurers assess limitations, and practical steps families should take to support claims.
What Daily Activities Are Assessed in Child Injury Claims?
NSW CTP insurers evaluate how injuries affect a child's ability to perform routine tasks. This includes:
- Attending school regularly
- Participating in hobbies or extracurricular activities
- Engaging in family routines like meals or bedtime
- Performing basic self-care tasks like dressing or toileting
The Motor Accident Guidelines (MAGs) define 'daily activities' as 'the ability to perform the activities of daily living' (MAG 2023, p. 12). Insurers consider both physical and emotional impacts, such as anxiety affecting school attendance.
How CTP Claims Account for Daily Activity Limitations
CTP claims cover:
- Medical treatment costs for injuries impacting daily activities
- Weekly income benefits if the child cannot attend school regularly
- Out-of-pocket expenses for therapies like physiotherapy
- Special equipment needed for daily tasks
Insurers use the 'only injuries' test: if a child's injuries are threshold injuries (soft tissue injuries meeting specific neurological criteria), benefits may stop after 52 weeks unless long-term impacts are proven (Motor Accident Injuries Act 2017 s 4.4).
Evidence to Support Daily Activity Claims
Families should gather:
- Medical records showing injury diagnosis and treatment
- School reports documenting absences or learning difficulties
- Therapist notes about activity limitations
- Witness statements from teachers or family members
- Photos of the accident scene (if relevant)
A hypothetical example: A 10-year-old with back pain from a car accident misses 30% of school. Medical evidence showing pain during physical education and school records showing absences would support a claim for weekly benefits.
Time Limits and Dispute Resolution
CTP insurers must respond to claims within 28 days (SIRA, 2023). If benefits are denied, families can:
- Request a review in writing within 28 days
- Lodge a complaint with the NSW Civil and Administrative Tribunal (NCAT)
- Seek legal advice if disputes escalate
Insurers may dispute claims if they argue the child's condition has improved. Medical experts are often required to assess long-term impacts on daily activities.
When to Seek Legal Advice
Families should consult a solicitor if:
- The child's condition worsens after the initial 52-week period
- Insurers refuse to consider long-term impacts
- There are disputes about the extent of daily activity limitations
- The child requires specialist equipment or home modifications
Next Steps for Families
Understanding how CTP laws apply to children is critical. While this article provides general guidance, each claim depends on its own facts. Time limits apply, and evidence must be gathered promptly. For tailored advice, complete the quick, no obligation enquiry form to request contact about your circumstances.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.