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're struggling to return to daily activities after a motor accident in Greater Sydney, delays in insurer decisions could impact your compensation. Under NSW CTP laws, insurers must assess claims promptly, but delays can affect how benefits are calculated. This article explains how delayed decisions impact claimants, what evidence matters, and when to seek legal advice.
How Delays in CTP Claims Affect Daily Activities
NSW CTP claims are governed by the Motor Accident Injuries Act 2017. Insurers must assess claims within 52 weeks of the accident, as outlined in SIRA’s guidelines. Delays beyond this period may affect your ability to claim weekly benefits or treatment costs, as the Act limits statutory payments after 52 weeks. For example, if you’re unable to work due to injuries and the insurer delays approving your claim, you may miss out on income support during the critical recovery period.
SIRA’s What you can claim page clarifies that weekly benefits cover lost income, but only if the insurer confirms your injuries meet the threshold injury criteria. Delays in processing can prevent claimants from accessing these payments, especially if they need to return to daily activities like work, shopping, or caring for family.
Practical Steps for Claimants in Greater Sydney
To manage delays, document your daily activities and how injuries prevent you from performing them. Keep records of:
- Medical reports showing how injuries affect your mobility or capacity
- Evidence of attempted communication with the insurer (emails, letters)
- Proof of income or expenses related to daily activities (e.g., transport costs, home modifications)
SIRA’s Making a motor accident claim guide recommends submitting a detailed claim form within 52 weeks. If the insurer delays, you may need to escalate the matter through SIRA’s dispute resolution process.
Time Limits and When to Seek Advice
NSW CTP claims must be submitted within 52 weeks of the accident. If the insurer delays beyond this period, you may lose access to weekly benefits, as the Act limits statutory payments after 52 weeks. Delays in assessing injuries can also affect how you claim treatment costs or income support.
If you face repeated delays, contact SIRA’s dispute resolution team or seek legal advice. A solicitor can help you challenge the insurer’s decision or request a review of your claim’s processing time.
Example: How Delays Impact a Claimant
Consider a claimant in Sydney who broke their wrist in a car accident. The insurer delayed approving their claim for 12 weeks, during which the claimant couldn’t work and had to pay for groceries and transport. By the time the insurer processed the claim, the 52-week period had expired, and the claimant lost access to weekly benefits. This highlights how delays can directly affect your ability to return to daily activities and claim compensation.
Next Steps
If you’re facing delays in your CTP claim, act quickly. Document your injuries, communicate with the insurer, and seek legal advice if you believe the delay is unreasonable. Every claim depends on its own facts, and the right steps can help you access the support you need.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.