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).
After a cyclist dooring incident, families may need to claim compensation for caregiver costs under NSW's Compulsory Third Party (CTP) scheme. This article explains how to claim for care and support, what evidence is needed, and how SIRA assesses these costs. Families should understand that caregiver claims are part of broader CTP entitlements, and documentation is key to securing support.
What Caregiver Costs Can Be Claimed After a Cyclist Dooring Incident
Under the Motor Accident Injuries Act 2017, families can claim for costs incurred while providing care to an injured cyclist. This includes expenses like:
- Medical equipment or home modifications
- Lost income if a family member had to stop work to care for the injured person
- Travel costs for medical appointments
- Temporary accommodation if the injured person requires overnight care
SIRA guidelines state that claims must cover 'reasonable and necessary' expenses directly related to the injury. For example, if a parent had to take time off work to care for their child injured in a dooring incident, the lost income could be claimed as part of the CTP benefits.
How SIRA Assesses Caregiver Costs in Cyclist Dooring Claims
SIRA evaluates caregiver claims based on documented evidence of the injury's impact. Key factors include:
- The injured person's medical condition and recovery timeline
- The necessity of ongoing care (e.g., assistance with daily living tasks)
- The cost of care compared to standard market rates
For instance, if a cyclist requires assistance with mobility for 12 months, the family may claim for the cost of hiring a carer or the income lost by a family member taking on this role. SIRA may also consider the availability of government-funded care programs to determine the claim's viability.
Practical Steps for Families Claiming Caregiver Costs
To support a CTP claim for caregiver costs, families should:
- Document all care-related expenses with receipts, invoices, and records
- Keep a care log detailing hours spent providing care and the nature of assistance
- Provide proof of income loss (e.g., payslips, employer statements)
- Submit medical reports confirming the injury's severity and care needs
Families should also notify their insurer within 52 weeks of the accident to avoid missing time limits for certain benefits. If the injured person's condition worsens or new care needs arise, a revised claim may be submitted.
Time Limits and Dispute Resolution
CTP claims must be made within 52 weeks of the accident for most benefits, though some claims (like those involving long-term care) may have extended deadlines. If a family disputes an insurer's decision, they can request a review through SIRA or seek independent legal advice. It's important to note that SIRA's assessment of 'reasonable and necessary' costs is central to determining the claim's success.
When to Seek Legal Advice
Families should consult a legal professional if:
- The injured person's condition is unclear or requires ongoing medical review
- The insurer denies a claim or offers an unsatisfactory settlement
- There are disputes about the extent of care needed
A lawyer can help ensure all evidence is properly submitted and that the family understands their rights under the CTP scheme.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.