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).
Military personnel injured in motor accidents in New South Wales must follow specific procedures to access compensation under the Compulsory Third Party (CTP) insurance scheme. Common mistakes include delaying medical treatment, failing to report the accident to the insurer within a reasonable time, not preserving evidence such as photos or witness details, and assuming that fault is irrelevant for all benefits. These errors can affect eligibility for treatment and care benefits, weekly income payments, or a claim for damages. The current legal framework is governed by the Motor Accident Injuries Act 2017 (MAIA), which applies to all motor accidents occurring on or after 1 December 2017, including those involving defence personnel.
Under the MAIA, CTP compensation is available regardless of fault for certain benefits, including treatment and care, and weekly income payments. However, to claim damages for pain and suffering or loss of enjoyment of life, a person must meet the threshold for a serious injury. This threshold includes injuries such as a spinal nerve-root injury with neurological signs, or a permanent impairment of 10% or more. A common mistake among military personnel is assuming that all injuries qualify for damages, when in fact only serious injuries do. For injuries that fall below the threshold, benefits are limited and may end after 52 weeks if they are the only injuries sustained.
Military personnel often face unique challenges, such as being on active duty, deployed, or stationed in remote areas. These circumstances may delay reporting the accident or seeking medical attention. It is essential to notify the insurer as soon as possible, ideally within 28 days, to avoid disputes over claim validity. Failure to do so may result in a delay or denial of benefits, particularly for weekly payments. The insurer must be informed in writing, and a claim form should be completed through the SIRA portal or via a nominated claims assessor.
Evidence that supports a CTP claim includes medical records detailing the injury and treatment, a police report if one was filed, photographs of the vehicle damage and accident scene, witness contact details, and records of income loss. Military personnel should keep copies of all correspondence with the insurer, including emails and letters. A common oversight is not documenting the impact of the injury on daily duties or training, which may affect the assessment of future income loss.
Another frequent mistake is not understanding the difference between statutory benefits and a common law damages claim. Statutory benefits like treatment and care, and weekly payments, are available under the MAIA regardless of fault. A damages claim, however, requires proving fault and meeting the threshold for a serious injury. Military personnel may also be subject to separate arrangements under the Defence Injury Compensation Scheme (DICS), but this does not prevent a CTP claim under NSW law. It is possible to claim under both schemes, but the CTP claim must still comply with NSW requirements.
If a claim is disputed or a benefit is denied, the next step is to request a review from the insurer. If unresolved, a formal dispute can be made to the State Insurance Regulatory Authority (SIRA). The process is governed by the Motor Accident Injuries Regulation 2017 and the Motor Accident Injuries Guidelines. Military personnel should seek advice from a legal professional or a claims support organisation if they face a dispute, as the procedures can be complex.
A realistic example: A Defence member was injured in a car accident while returning from a training exercise in Wagga Wagga. They delayed reporting the accident to the insurer for three months due to operational duties. The insurer initially refused to process the claim on the grounds of late notification. However, the member provided a medical certificate showing treatment began within 14 days of the accident and a log of operational tasks that prevented immediate reporting. SIRA later confirmed the claim was valid because the delay was not due to negligence and the injury was assessed as a threshold injury.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.