Dental Injuries and NSW CTP Claims After 2017 Reforms
If you suffered a dental injury in a motor vehicle accident in NSW, the way your claim is assessed has changed significantly since 1 December 2017. The reforms to the Compulsory Third Party (CTP) scheme now govern claims for dental injuries, including broken teeth, jaw fractures, and soft tissue damage. This article explains how the 2017 changes affect your entitlement to treatment costs, compensation for permanent injury, and the process for claiming under the new Motor Accident Injuries Act 2017 (MAIA).
How NSW CTP Laws Assess Dental Injuries
Under the current scheme, dental injuries are evaluated based on two main factors: treatment costs and impairment level. The New South Wales Motor Accident Claims Authority (SIRA) provides detailed guidelines to determine what is covered.
- Treatment Costs: SIRA covers all reasonable and necessary dental treatment directly related to the injury, including fillings, root canals, and orthodontic work. For example, if an airbag caused a fractured tooth requiring a crown, the cost of the crown would be covered.
- Impairment Thresholds: If your injury meets the 'threshold injury' definition in the Motor Accident Guidelines, you may be eligible for ongoing weekly payments. This typically applies to injuries like jaw fractures or soft tissue damage that affect daily activities. However, injuries below this threshold (e.g., a chipped tooth with no functional impact) are generally limited to treatment costs only.
The 2017 reforms introduced stricter rules for determining which injuries qualify for ongoing payments. For instance, a 2022 SIRA update clarified that injuries requiring only minor dental work (e.g., a single filling) are unlikely to meet the threshold unless they cause significant long-term impairment.
Practical Steps and Evidence for Dental Injury Claims
To support your claim, you must provide:
- Medical Evidence: A dentist’s report confirming the injury’s cause and treatment needs. For example, a report stating that an airbag deployment caused a fractured tooth requiring a crown.
- Accident Details: Police reports, witness statements, or dashcam footage showing how the injury occurred.
- Treatment Records: Receipts, invoices, and records of all dental work performed after the accident.
- Income Evidence: If your injury affects your ability to work, provide pay slips or employment records.
It’s crucial to notify your insurer within 52 weeks of the accident. After this period, claims for treatment costs may be limited unless the injury meets the threshold for ongoing payments.
When to Seek Legal Advice
The 2017 reforms introduced complex rules about which injuries qualify for compensation. For example, a 2023 case showed that a claimant who suffered a jaw fracture and required orthodontic treatment was denied ongoing payments because the injury did not meet the 'threshold injury' criteria. Legal advice can help ensure your claim is assessed correctly under the new scheme.
If your dental injury involves a broken tooth, jaw fracture, or soft tissue damage, contact a solicitor specialising in NSW CTP claims. They can help you understand whether your injury meets the threshold for ongoing payments or if you’re limited to treatment costs only.
Next Steps
CTP claims depend on the date of your accident, the nature of your injury, and the evidence you provide. To request contact about your circumstances, complete the quick, no obligation enquiry form.