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've suffered dental injuries from an airbag accident in Greater Sydney, understanding how NSW insurers assess liability is critical. Under the Motor Accident Injuries Act 2017 (MAIA), insurers evaluate claims based on the accident's circumstances, the nature of the injury, and whether it meets the scheme's criteria. This article explains the factors insurers consider, how SIRA guidelines apply, and what evidence is needed to support your claim.
Key Factors in Assessing Liability
NSW insurers assess liability by examining:
- The accident's cause: Whether the airbag deployed correctly or malfunctioned, and how that contributed to the injury.
- Injury severity: Dental injuries must meet the 'threshold injury' definition in the Motor Accident Guidelines. This includes fractures, dislodged teeth, or damage requiring professional treatment.
- Fault and contributory negligence: While CTP insurance typically covers claims regardless of fault, insurers may reduce payouts if the injured person contributed to the accident.
SIRA's approach to claims emphasizes objective medical evidence. For example, if an airbag deployed with excessive force, insurers will review medical records to determine if the injury aligns with the threshold injury criteria. They may also consider whether the injury resulted from the accident rather than pre-existing conditions.
Evidence to Support Your Claim
To prove liability, you'll need:
- Medical documentation: Detailed records from a dentist or oral surgeon confirming the injury's cause and treatment. This should include imaging (e.g., X-rays) and a diagnosis linking the injury to the airbag deployment.
- Accident report: Information from the police or a witness about how the accident occurred, including the airbag's condition and deployment.
- Witness statements: Accounts from others who observed the airbag malfunction or the injury.
- Photographs: Images of the airbag, vehicle damage, and any visible dental injuries.
Time Limits and Dispute Options
Claims must be made within 52 weeks of the accident if you're seeking statutory benefits like weekly payments or treatment costs. After this period, you may still pursue a common law damages claim, but insurers will assess whether the injury meets the threshold injury criteria.
If your claim is disputed, you can request a review by the NSW Civil and Administrative Tribunal (NCAT) or seek mediation through SIRA. It's important to act quickly, as delays can weaken your case.
When to Seek Legal Advice
While this article provides general guidance, each claim is unique. For example, if your dental injury resulted from a faulty airbag design or a manufacturer's defect, you may need to explore additional legal avenues. Always consult a legal professional to ensure your claim is assessed against the full scope of NSW CTP laws.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.