How Treatment Costs Are Funded for Child Injuries in NSW Motor Accident Claims
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).
If your child was injured in a motor accident in New South Wales, treatment costs are funded through the state’s Compulsory Third Party (CTP) scheme. Under the Motor Accident Injuries Act 2017 (MAIA), claims for injuries to children are handled similarly to adult claims, but with specific considerations for their needs. This article explains how treatment costs are funded, the role of SIRA, and practical steps for parents seeking support.
The Legal Framework for Funding Treatment Costs
The MAIA governs NSW CTP claims, ensuring injured parties receive financial support for medical treatment, income loss, and other expenses. For children, the scheme covers treatment costs such as hospital visits, specialist consultations, physiotherapy, and medical equipment. SIRA (State Insurance Regulatory Authority) administers these claims, assessing the injury’s severity and the child’s specific needs.
Under the MAIA, claims must be made within a reasonable time of the accident, though the exact deadline is not specified in the legislation. SIRA evaluates whether the injury meets the threshold for benefits, which includes injuries requiring medical treatment or resulting in a whole person impairment. For children, the focus is on ensuring their treatment needs are met, even if the injury is minor.
Practical Steps for Funding Treatment Costs
To secure funding for your child’s treatment, you’ll need to provide evidence of the injury and its impact. Key documents include:
- Medical records confirming the injury and treatment plan
- Accident reports or police statements
- Witness statements or photos of the incident
- Income records to assess financial impact
- SIRA’s claim form, completed and submitted promptly
Parents should notify SIRA as soon as possible after the accident to ensure timely processing. Delays may affect the availability of benefits, especially if the injury requires ongoing care.
Time Limits and Dispute Options
The MAIA does not set a strict time limit for making a claim, but delays can complicate the process. For injuries classified as 'threshold injuries' (e.g., soft tissue injuries with specific neurological signs), benefits may be limited after 52 weeks. However, children with complex or long-term needs may qualify for extended support under the scheme.
If your claim is denied, you can request a review with SIRA or seek legal advice. Independent legal counsel can help challenge decisions or negotiate a fair outcome, especially if the injury requires ongoing treatment or has long-term implications.
A Hypothetical Example
Consider a 7-year-old child injured in a car accident with a broken arm and concussion. The claim would cover medical bills, physiotherapy, and any necessary accommodations at school. If the injury is classified as a threshold injury, benefits would generally stop after 52 weeks unless the child’s treatment requires ongoing support beyond that period.
When to Seek Legal Advice
While SIRA handles most claims, complex cases, such as those involving long-term care needs, disputes over injury classification, or overlapping workers’ compensation claims, may require legal assistance. A solicitor can help ensure your child’s treatment costs are fully covered and that all legal requirements are met.
Next Steps
Funding treatment costs for children in NSW CTP claims depends on the injury’s severity, the child’s specific needs, and timely action. Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.