Domestic Duties Care Costs in NSW CTP Claims
Where a person's only injuries resulting from the accident are threshold injuries, weekly benefits and treatment and care generally cease after 52 weeks (ss 3.11 and 3.28).
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 injured in a motor accident in NSW and need help with household tasks like cooking, cleaning or shopping, you may be eligible for domestic duties care costs under the Compulsory Third Party (CTP) scheme. These costs cover support for daily living when injuries limit your ability to perform these tasks. Disputes over the amount or eligibility of these claims are common, but there are formal processes to resolve them.
NSW CTP Rules Behind Domestic Duties Claims
Under the Motor Accident Injuries Act 2017, domestic duties care costs are considered a 'support' claim under the CTP scheme. SIRA (State Insurance Regulatory Authority) guidelines state that you can claim for assistance with household tasks if your injuries prevent you from performing them. This includes:
- Preparing meals
- Cleaning and laundry
- Shopping and errands
- Child or pet care
To qualify, your injuries must meet the 'threshold injury' definition under the Motor Accident Guidelines. This typically requires a medical assessment showing your condition limits daily functioning. SIRA also specifies that claims must be made within 52 weeks of the accident unless there's a valid reason for delay.
Practical Steps and Evidence for Disputes
If your claim for domestic duties care costs is disputed, you'll need to provide:
- Medical evidence showing your injuries limit daily tasks
- Records of care provider invoices or receipts
- A care plan from a registered nurse or occupational therapist
- Proof of income loss due to inability to perform household duties
SIRA recommends keeping detailed records of all expenses and communications with insurers. If your claim is denied, you can request a review by submitting a written objection within 28 days of the decision.
Time Limits and Dispute Resolution Options
CTP claims must generally be made within 52 weeks of the accident. However, disputes over domestic duties care costs can extend beyond this period if:
- You were unable to claim due to medical treatment
- You received a medical opinion delaying your claim
To resolve disputes, you can:
- Internal review: Submit a written objection to SIRA within 28 days of a decision
- Mediation: Use the NSW Civil and Administrative Tribunal (NCAT) for disputes over claim amounts
- Legal review: Seek independent legal advice if you believe your claim was unfairly denied
SIRA's internal review process allows for reconsideration of claims based on new evidence. However, it's important to note that a challenge does not guarantee a changed decision. The Personal Injury Commission (PIC) can also review medical disputes related to care needs.
When to Seek Legal Advice
Disputes over domestic duties care costs often require legal expertise, especially if:
- Your claim is denied without explanation
- You need to challenge a medical assessment
- You're unsure if your injuries meet the threshold injury definition
A solicitor can help you:
- Prepare a strong claim package
- Challenge incorrect medical opinions
- Navigate SIRA's review process
If you're in Ashfield, consider contacting a local solicitor with experience in CTP claims. They can help you understand your options and ensure your claim meets all legal requirements.
Next Steps
CTP claims involving domestic duties care costs can be complex, especially when disputes arise. Understanding your rights under the Motor Accident Injuries Act 2017 and SIRA guidelines is essential. If you're in Ashfield and need help resolving a dispute, complete the quick, no obligation enquiry form to request contact about your circumstances.