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).
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 your child was injured in a motor accident in rural or remote NSW, understanding what the Personal Injury Commission (PIC) expects during disputes is critical. The NSW Compulsory Third Party (CTP) scheme governs claims, but rural areas present unique challenges. This article explains the evidence needed, how PIC assesses disputes, and SIRA’s specific rules for child injury claims in regional NSW.
NSW CTP Rules Behind Child Injury Claims
Under the Motor Accident Injuries Act 2017, CTP claims cover injuries caused by motor vehicles, including child injuries. However, rural disputes often hinge on proving the injury meets the 'threshold injury' definition. SIRA’s guidelines state that injuries must involve 'significant physical or psychological harm' and require medical evidence. For children, this includes documentation of developmental delays, emotional trauma, or long-term health impacts.
Practical Steps and Evidence That Usually Matter
To support a child injury claim, families must gather specific evidence: medical records detailing the injury’s severity, accident reports, witness statements, and photographs of the scene. In rural areas, access to specialists may delay diagnosis, so PIC will scrutinise whether the injury was reasonably identifiable at the time. For example, if a child’s concussion was not diagnosed immediately, the claimant must show the injury was not obvious and required specialist assessment.
Time Limits, Disputes and When to Seek Advice
Claims must be submitted within 52 weeks of the accident, but disputes can arise even after this period. If PIC challenges the injury’s severity, they may request additional medical evidence or refer the case to an internal review. Families should seek legal advice if PIC disputes the injury’s classification, especially if the child’s condition worsens over time. Rural claimants may face delays in accessing medical experts, so early engagement with a solicitor is advisable.
How PIC Handles Child Injury Disputes
PIC assesses disputes by evaluating whether the injury meets the 'threshold injury' criteria under the Motor Accident Guidelines. For children, this often involves specialist assessments, such as paediatric neurologist reports or psychological evaluations. In rural areas, PIC may require evidence that the injury was not reasonably identifiable without specialist input. For instance, if a child’s injury required a MRI scan not available locally, the claimant must prove the necessity of the test.
SIRA’s Specific Rules for Child Claims in Regional NSW
SIRA’s guidelines state that child injury claims in rural areas must demonstrate a 'clear link' between the accident and the injury. This includes evidence of the child’s pre-accident health and any pre-existing conditions. PIC may also consider the impact of the injury on the child’s education, family life, or long-term development. Families should ensure all evidence is submitted promptly, as delays can weaken the claim.
A Hypothetical Example
Consider a 7-year-old child injured in a car accident in a remote NSW town. The child develops a concussion but is not diagnosed immediately. The claimant must show that the injury was not obvious and required specialist assessment. If PIC disputes the injury, the claimant must provide medical records proving the delay in diagnosis and the injury’s impact on the child’s cognitive function.
When to Seek Legal Advice
Disputes over child injury claims often require legal intervention. Families should consult a solicitor if PIC challenges the injury’s classification, disputes the need for ongoing treatment, or questions the child’s long-term prognosis. Legal advice is also essential if the claimant faces delays in accessing medical specialists or if the injury involves complex psychological effects.
Next Steps
CTP entitlements depend on the accident date, injury type, and evidence submitted. To request contact about your circumstances, complete the quick, no obligation enquiry form.