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 are a military personnel injured in a motor accident in New South Wales, understanding how to resolve disputes over your Compulsory Third Party (CTP) claim is critical. The NSW government’s State Insurance Regulatory Authority (SIRA) oversees CTP claims, but military personnel may face unique challenges. This article explains how SIRA handles disputes for service members, outlines specific resolution options, and highlights key differences between military and standard CTP claims.
How SIRA Handles Disputes for Military Personnel
SIRA manages all CTP claims under the Motor Accident Injuries Act 2017 (MAIA). For military personnel, disputes often arise over claim eligibility, injury assessments, or compensation amounts. SIRA’s dispute resolution process mirrors standard CTP procedures but includes additional considerations for service-related injuries.
The first step is to submit a formal written objection to the initial decision. This must be done within 28 days of receiving the decision, as outlined on SIRA’s Making a motor accident claim page. If the objection is denied, you may request a review by a senior SIRA officer or escalate to the Personal Injury Commission (PIC) for a medical dispute review.
Specific Dispute Resolution Options for Defence Personnel
Military personnel claims differ from standard CTP claims in two key ways: service-related injuries and unique evidence requirements. For example, a service member’s injury may be linked to both the motor accident and pre-existing military duties, requiring a nuanced assessment.
SIRA allows for a medical dispute review if there is disagreement over the severity of injuries. This process involves a specialist medical report from a registered medical practitioner, as detailed on SIRA’s What you can claim page. The PIC may also request additional evidence, such as military medical records or service-specific injury reports.
Key Differences Between Military and Standard CTP Claims
While most CTP claims follow the same process, military personnel claims require additional documentation. For instance, SIRA may require proof of service-related injury or evidence that the injury was aggravated by military duties. This can affect eligibility for certain benefits, such as weekly income payments or treatment and care benefits.
Another distinction is the internal review timeline. Standard CTP claims have a 28-day objection period, but military claims may require extended timelines for medical assessments. SIRA’s guidelines state that disputes involving service-related injuries are prioritized for review, though this does not guarantee a changed decision.
Practical Steps for Military Personnel Claims
If you are a service member with a CTP claim dispute, take these steps:
- Gather all medical records related to the motor accident and your military service.
- Document any service-specific injuries that may link the accident to your duties.
- Submit a written objection to SIRA’s initial decision within 28 days.
- Request a medical dispute review if your objection is denied.
- Seek independent legal advice if the dispute escalates to the Personal Injury Commission.
Example Scenario: A Military Personnel Claim Dispute
Consider a scenario where a soldier sustains a soft-tissue injury in a car accident. SIRA initially denies a claim for weekly income payments, citing the injury as a “threshold injury” under the MAIA. The service member challenges this by providing military medical records showing the injury was aggravated by physical training duties. SIRA then refers the dispute to a medical review, which determines the injury meets the threshold criteria. This example illustrates how service-specific evidence can alter claim outcomes.
When to Seek Legal Advice
Disputes over CTP claims can be complex, especially for military personnel. While SIRA provides a structured process, navigating it requires attention to detail. If your claim involves service-related injuries or you face repeated rejections, consider consulting a solicitor with experience in CTP claims. Legal advice can help ensure all evidence is properly submitted and that your rights under the MAIA are protected.
Next Steps for Claimants
If your CTP claim dispute involves military service injuries, act quickly. Time limits apply to objections and reviews, and delays can jeopardize your entitlements. For personalized guidance on your circumstances, complete the quick, no obligation enquiry form to request contact about your case.