If you were injured in a cyclist dooring incident in New South Wales, you may be entitled to treatment costs covered by the state’s Compulsory Third Party (CTP) scheme. Under the Motor Accident Injuries Act 2017 (MAIA), CTP insurers fund medical expenses for injuries caused by motor vehicles, including dooring accidents. This article explains how treatment costs are funded, what medical expenses are covered, and steps to take after a dooring incident.
How CTP Funding Works for Cyclist Injuries
NSW’s CTP scheme, administered by the State Insurance Regulatory Authority (SIRA), provides statutory benefits for injuries caused by motor vehicles. For cyclist dooring incidents, treatment costs are funded under the same rules as other road accidents. This includes medical bills, physiotherapy, and specialist consultations. However, the type of funding depends on the injury’s severity and whether it meets the threshold injury criteria under the Motor Accident Guidelines.
Covered Medical Expenses
CTP insurers cover treatment costs for injuries resulting from a motor vehicle accident, including:
- Emergency care and hospital treatment
- Specialist medical reports and scans
- Physiotherapy and rehabilitation
- Medication prescribed for injury-related pain
- Ongoing treatment for soft tissue injuries (e.g., whiplash, muscle strains)
Not all expenses are covered. For example, routine dental care or unrelated medical treatments are excluded. SIRA’s guidelines specify that only injuries directly caused by the accident are eligible for funding.
Practical Steps for Cyclists
After a dooring incident, cyclists should:
- Seek immediate medical attention to document injuries
- Collect evidence: take photos of the scene, note vehicle details, and get witness statements
- Notify the at-fault driver’s CTP insurer within 52 weeks of the accident (this is the statutory deadline for claiming benefits)
- Keep all medical records and correspondence with insurers
If you’re unsure whether your injury qualifies, contact SIRA directly. The 52-week time limit applies to all CTP claims, including treatment cost disputes.
Time Limits and Disputes
CTP insurers must respond to claims within 28 days of receiving a completed claim form. If you dispute a decision, you can request a review through SIRA. For injuries that don’t meet the threshold criteria, weekly benefits may stop after 52 weeks, though some treatment costs may still be funded depending on the injury’s nature.
When to Seek Legal Advice
While CTP claims are usually handled directly with insurers, legal advice may be needed if:
- The insurer denies a claim without explanation
- You receive a letter stating your injury doesn’t qualify
- You need help navigating the 52-week time limit
- You’ve suffered long-term injuries requiring ongoing treatment
Legal professionals can help ensure you receive all eligible benefits, including treatment costs, under the MAIA.
Example Scenario
Consider a cyclist who was doored and suffered a broken arm. Under CTP rules, the insurer would cover hospital treatment, X-rays, and physiotherapy. However, if the injury was classified as a ‘threshold injury’ (e.g., soft tissue damage without fractures), weekly benefits might stop after 52 weeks, though some treatment costs could still be funded.
Next Steps
CTP entitlements depend on the accident date, injury type, and claim timing. To request contact about your circumstances, complete the quick, no obligation enquiry form.