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).
Domestic duties support is a key benefit under NSW Compulsory Third Party (CTP) claims, covering household tasks like cooking, cleaning and personal care when injuries prevent daily functioning. This article explains how insurers assess these costs, what evidence is needed, and how rehabilitation planning affects claims. It focuses on the NSW CTP scheme's approach to domestic support, distinguishing it from other claim categories.
How domestic duties care costs work under NSW CTP
Under the Motor Accident Injuries Act 2017, domestic duties support is part of the 'treatment and care' benefits available to injured road users. This includes assistance with household tasks like meal preparation, laundry, and personal hygiene when injuries prevent the person from performing these tasks independently. The NSW government's SIRA (State Insurance Regulatory Authority) outlines that domestic duties support is calculated based on the injured person's needs, not the cost of hiring a carer.
Insurers assess domestic duties care costs by evaluating medical evidence showing the injury limits daily functioning. For example, if a car accident leaves someone unable to cook meals due to hand injuries, they may be entitled to support with meal preparation. The amount of support is determined by the severity of the injury and the duration of the limitation, not by the market rate for domestic help.
Documentation needed to support domestic duties claims
To claim domestic duties support, claimants must provide evidence of their injury's impact on daily life. This typically includes:
- Medical records confirming the injury and its effect on daily functioning
- A rehabilitation plan from a treating medical practitioner
- Evidence of the specific domestic tasks the injury prevents (e.g., inability to clean due to mobility issues)
- Any correspondence with insurers about the claim
SIRA's guidelines state that domestic duties support is not limited to a fixed schedule. Instead, it is assessed on a case-by-case basis, with the focus on the injured person's actual needs. For instance, a pedestrian injured in a car park may need support with shopping if their injuries prevent them from walking to the supermarket.
How rehabilitation planning affects domestic duties assessments
Rehabilitation planning plays a critical role in determining the scope of domestic duties support. A medical practitioner's report must outline the injured person's recovery plan and how long the injury will affect their ability to perform household tasks. For example, if a cyclist's knee injury requires 12 months of physiotherapy, the domestic duties support may be extended beyond the typical 52-week limit for threshold injuries.
SIRA's approach is to align domestic duties support with the injured person's rehabilitation timeline. If the medical evidence shows that the injury will permanently limit daily functioning, the support may continue beyond the 52-week statutory cap. However, if the injury is a 'threshold injury' (as defined under the Motor Accident Guidelines), benefits may be limited after 52 weeks unless the injury results in a whole person impairment of 10% or more.
When to seek legal advice for domestic duties claims
Domestic duties support is a statutory benefit under the NSW CTP scheme, but claimants may need to dispute an insurer's decision to limit or deny support. For example, if an insurer refuses to cover meal preparation costs despite medical evidence showing the injury prevents the person from cooking, legal advice may be needed to challenge the decision.
While CTP insurers must pay for treatment and care, they are not legally required to cover all domestic help expenses unless the injury directly prevents the person from performing those tasks. Claimants should also be aware that the 52-week limit applies only to injuries that do not meet the whole person impairment threshold.
Practical steps for claimants
- Obtain a medical report detailing how the injury affects daily functioning
- Keep records of domestic tasks you are unable to perform due to the injury
- Follow your rehabilitation plan and update insurers about your progress
- Contact SIRA or a legal advisor if you receive a notice of disagreement with your claim
Domestic duties support is a vital part of the NSW CTP scheme, but claimants must act promptly to ensure their needs are properly assessed. If you're unsure whether your circumstances qualify, completing the quick, no obligation enquiry form can help you get tailored advice about your situation.