Military personnel injured in motor accidents in New South Wales may be entitled to compensation through the Compulsory Third Party (CTP) insurance scheme. This claim process is governed by the Motor Accident Injuries Act 2017 and administered by the State Insurance Regulatory Authority (SIRA). For Defence personnel, the process involves specific considerations, particularly when preparing for medical assessments required under the CTP scheme. These assessments are used to determine the nature and extent of injuries, including any pre-existing or service-related conditions, and to assess eligibility for benefits such as treatment and care, weekly income payments, or damages.
The CTP scheme in NSW provides statutory benefits regardless of fault, but entitlements depend on the type and severity of injuries sustained. If a person’s only injuries are considered threshold injuries under the Motor Accident Injuries Act 2017, benefits are generally limited to 52 weeks of treatment and care and weekly income payments. A threshold injury includes soft tissue injuries, but only if they meet the criteria set out in the Motor Accident Guidelines, including the presence of neurological signs in the case of spinal nerve-root injuries. For Defence personnel, injuries may have a service-related component, which may affect how the injury is assessed and whether it is considered to have arisen from the accident.
To prepare for a medical assessment, Defence personnel should gather and retain all relevant documentation. This includes medical records from both civilian and Defence Health services, a detailed account of the accident, and any correspondence with the Department of Defence or Veterans Affairs. Where an injury has both civilian and service-related elements, SIRA will assess whether the injury arose from the motor accident and whether any pre-existing condition contributed to the current impairment.
Medical assessments under the CTP scheme are conducted by independent medical practitioners appointed by SIRA. These assessments are not routine medical reviews but formal evaluations used to determine eligibility for benefits and, where applicable, the level of whole person impairment (WPI). For Defence personnel, it is advisable to bring a summary of any prior injuries, treatment history, and service medical records to the assessment. This helps the assessor distinguish between injuries that may have been exacerbated by the accident and those that were present before.
Key evidence that may support a claim includes:
- A completed police accident report or incident report from a Defence base, if applicable.
- Photographs of the vehicle damage, scene, and any visible injuries taken shortly after the accident.
- Witness statements, particularly from other service members or civilian bystanders.
- Medical reports from treating practitioners, including those from Defence Health.
- Pay slips or employment records showing loss of income due to injury.
- A written record of symptoms and functional limitations since the accident.
Time limits apply. A claim must generally be made within three years of the accident date. If a claim is not made within this period, it may not be accepted unless there are exceptional circumstances. In some cases, a claim may be made after the three-year period if it is established that the injury was not apparent at the time and only became evident later.
If a medical assessment results in a finding that does not reflect the full impact of the injury, or if the assessment is not conducted in a way that accounts for service-related factors, a review or dispute may be possible. The claimant may request a review of the assessment by SIRA, or seek a second opinion from a different medical practitioner. In some cases, a claim may proceed to a formal dispute resolution process, including a hearing before a tribunal.
A hypothetical example: A Defence member was injured in a car accident while returning from a training exercise in Wagga Wagga. The injury involved a herniated disc, which was initially treated under Defence Health. The CTP insurer requested a medical assessment to determine whether the injury was caused by the accident. The claimant brought a summary of prior back issues from a 2018 service medical review, along with a current MRI report and a statement from their treating physiotherapist. This documentation helped clarify that the disc injury was new and related to the accident, not a pre-existing condition.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.