If your child was injured in a motor accident in NSW, understanding how to resolve disputes over compensation is critical. The NSW Compulsory Third Party (CTP) scheme provides specific pathways for child injury claims, but navigating these requires awareness of SIRA's processes and key legal distinctions. This article explains how to challenge decisions, what evidence matters and how child-specific claims differ from general CTP disputes.
How SIRA handles child injury claims
SIRA (State Insurance Regulatory Authority) manages CTP claims in NSW, including those involving children. For child injuries, SIRA considers factors like the child's age, medical needs and long-term impacts differently than adult claims. Claims must be submitted within 52 weeks of the accident for treatment and care benefits, but disputes over injury severity or compensation amounts can extend beyond this period. SIRA's guidelines state that children under 12 are presumed to have a higher risk of long-term effects, which may influence benefit calculations.
Dispute resolution options for child injury claims
If you disagree with SIRA's decision on a child injury claim, you have specific options:
- Internal review: Request a reassessment of the claim by SIRA within 28 days of receiving the decision. This process considers new evidence or clarifies misunderstandings.
- Medical dispute pathway: If the injury's severity is contested, you can request a medical review through the Personal Injury Commission (PIC). This involves independent medical experts assessing the child's condition against the Motor Accident Guidelines.
- External review: After exhausting internal options, you may apply to the NSW Civil and Administrative Tribunal (NCAT) for a review of SIRA's decision. This is a formal process requiring detailed evidence.
Key differences for child injury claims
Child injury claims differ from general CTP disputes in three ways:
- Lower threshold for benefits: SIRA considers injuries like whiplash or soft tissue damage as 'threshold injuries' for children, even if they wouldn't qualify for an adult. This means children may receive treatment and care benefits for longer periods.
- Specialised medical evidence: Claims involving children often require paediatric specialists to assess long-term impacts. SIRA's guidelines note that children's injuries may have 'cumulative effects' not immediately apparent.
- Extended time limits: While 52 weeks is the standard for treatment benefits, disputes over injury severity can extend this period. For example, a child with a spinal nerve-root injury (as defined in the Motor Accident Guidelines) may qualify for ongoing benefits beyond 52 weeks.
Practical steps for resolving disputes
To challenge a decision, gather:
- Medical records showing the child's condition and treatment
- Accident reports and witness statements
- Evidence of financial impact (e.g. lost income for a parent)
- Any correspondence with SIRA
If you're unsure how to proceed, note that SIRA's internal review process must be completed before external options like NCAT are available. Disputes over injury severity often require medical evidence showing the child's condition meets the 'threshold injury' definition under the Motor Accident Injuries Act 2017.
When to seek legal advice
Disputes over child injury claims can be complex. A solicitor can help:
- Navigate SIRA's internal review process
- Prepare for medical dispute pathways
- Challenge decisions at NCAT
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.