If your child was injured in a motor accident in NSW and your claim is disputed, understanding your options under the Compulsory Third Party (CTP) scheme is critical. This article explains how to resolve disputes over child injury compensation in Bankstown, including SIRA's role, claim submission processes, and steps to challenge decisions.
NSW CTP Rules for Child Injury Claims
Under the Motor Accident Injuries Act 2017, the CTP scheme provides compensation for injuries caused by motor vehicles. For children, claims must be submitted to the State Insurance Regulatory Authority (SIRA) within 52 weeks of the accident. SIRA assesses claims based on medical evidence, injury severity, and the accident's circumstances. Key considerations include:
- Threshold injuries: Soft tissue injuries meeting specific medical criteria (e.g., spinal nerve-root damage) qualify for benefits.
- Weekly income payments: If your child has a long-term injury, you may claim weekly payments for lost income.
- Dispute timelines: You have 52 weeks from the accident date to submit a claim. After this period, benefits may be limited unless the injury meets higher impairment thresholds.
Practical Steps for Parents
When a claim is disputed, parents should:
- Gather medical records showing the injury's impact, including treatment plans and prognosis.
- Document the accident with police reports, witness statements, and photos.
- Submit a formal dispute to SIRA within the 52-week window. SIRA provides a claim form and a checklist of required evidence.
- Request a review if SIRA rejects the claim. You can ask for a written explanation of the decision.
Dispute Resolution Options
If SIRA denies your claim, you have limited options:
- Internal review: SIRA may reassess the claim if new evidence is provided.
- External review: You can request a review by the Personal Injury Commission (PIC), which handles disputes over medical assessments. The PIC will consider whether the injury meets the threshold for benefits.
- Legal challenge: In rare cases, a court may review the claim, but this is uncommon and requires legal representation.
Time Limits and Key Deadlines
- Claim submission: 52 weeks from the accident date.
- Dispute resolution: SIRA must respond within 28 days of receiving a claim. If you request a review, SIRA has 28 days to issue a new decision.
- Medical disputes: If the injury's severity is contested, the PIC must resolve the issue within 28 days of receiving the request.
Hypothetical Example
A 9-year-old child injured in a Bankstown car accident with a fractured arm and concussion. The insurer disputes the claim, arguing the injury is below the threshold. Parents submit medical records showing the child requires ongoing therapy and missed school. SIRA reviews the claim and approves weekly payments for 52 weeks. The parents later challenge the decision, citing a new MRI showing soft tissue damage. SIRA conducts a fresh assessment and adjusts the claim.
When to Seek Advice
Disputes over child injury claims can be complex. If your claim is denied or you're unsure about your options, contact a solicitor specialising in NSW CTP claims. Legal advice can help you navigate SIRA's processes and challenge decisions based on medical evidence.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.