How contributory negligence affects treatment cost funding in NSW CTP claims
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 you were injured in a motor accident in New South Wales and are seeking treatment funding through the Compulsory Third Party (CTP) scheme, your claim may be impacted by contributory negligence. Under NSW law, if you were partly at fault for the accident, your entitlement to treatment costs may be reduced. This article explains how contributory negligence works in CTP claims, what treatment costs are covered, and how to navigate funding disputes.
NSW CTP rules on contributory negligence
The Motor Accident Injuries Act 2017 governs CTP claims in NSW. Section 4.4 of this Act states that if your injuries resulted from your own fault, your compensation may be reduced. For example, if you were speeding and contributed to the accident, your claim for treatment costs may be adjusted. SIRA (State Insurance Regulatory Authority) applies these rules consistently, using the Motor Accident Guidelines to assess fault.
Contributory negligence does not automatically disqualify you from receiving treatment funding. Instead, it reduces the amount you can claim. SIRA calculates your entitlement based on the proportion of fault attributed to you and the other party. If your fault is minor, your treatment costs may still be fully funded.
What treatment costs are covered under NSW CTP?
Under the CTP scheme, you may claim treatment costs for injuries resulting from the accident. This includes medical bills, physiotherapy, and specialist consultations. However, contributory negligence may reduce the amount available. For instance, if your fault is 20%, your treatment funding could be reduced by 20%.
SIRA also covers weekly income loss benefits and treatment and care benefits. If your injuries meet the 'threshold injury' criteria (as defined in the Motor Accident Guidelines), you may receive weekly payments. However, contributory negligence may affect the duration of these benefits.
Practical steps to support your claim
To ensure your treatment costs are funded, gather evidence such as:
- Medical records showing your injuries and treatment
- Accident reports and witness statements
- Proof of income to support weekly benefit claims
- Documentation of any contributory fault (e.g., traffic camera footage, police reports)
SIRA requires these records to assess your claim. If your contributory fault is disputed, you may need to provide additional evidence to support your case.
Time limits and when to seek advice
You have 52 weeks from the date of your injury to claim weekly benefits under the CTP scheme. After this period, benefits are generally limited unless your injuries are classified as 'whole person impairment' (a permanent disability). If your claim involves contributory negligence, it's crucial to seek legal advice before the 52-week deadline.
Disputes over contributory fault can be resolved by requesting a review from SIRA. However, the process can be complex, and claimants often benefit from legal guidance to ensure their treatment costs are fairly funded.
Example: How contributory negligence affects funding
Consider a scenario where a driver collides with another vehicle. If the injured driver was speeding (contributory fault of 30%) and the other driver was negligent (70%), SIRA would reduce the treatment funding by 30%. This means the injured party would receive 70% of the full treatment cost. The exact calculation depends on the fault percentage determined by SIRA.
Next steps
If your claim involves contributory negligence, time is critical. Contact LegalAdvice.com.au to discuss your circumstances. Our team can help you understand your entitlements, gather necessary evidence, and navigate the CTP scheme.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.