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).
Children struck by vehicles in driveways face unique challenges in NSW CTP claims. Insurers assess recovery progress based on medical evidence and daily activity reports. Families in Auburn should understand how SIRA evaluates return-to-activities claims under the Motor Accident Injuries Act 2017.
How NSW CTP Insurers Assess Return to Daily Activities
NSW CTP insurers evaluate a child's recovery by examining medical records, treatment plans, and evidence of daily activity restoration. Key factors include:
- Medical documentation showing progress toward pre-accident functioning
- School attendance records and participation in activities
- Statements from teachers, therapists, or caregivers
- Rehabilitation plans and milestones
Insurers use the Motor Accident Guidelines to determine if injuries meet threshold criteria. For example, a child with a minor soft tissue injury may need a return-to-school plan documented by a paediatrician.
SIRA Guidelines for Child Injury Claims
SIRA's guidelines emphasize that children's recovery timelines differ from adults. Important considerations include:
- Age-appropriate activity benchmarks
- Developmental milestones for pre-school and school-age children
- Impact of injury on cognitive, physical, and emotional development
- Need for specialist assessments (e.g., neuropsychological testing)
Families should request copies of the Motor Accident Guidelines to understand how their child's case is evaluated. SIRA requires evidence showing a direct link between the accident and the child's current functional limitations.
Practical Steps for Families
To support a CTP claim for a child's return to daily activities:
- Obtain medical records detailing treatment and recovery progress
- Document the child's participation in school, play, and family activities
- Gather witness statements about changes in behavior or function
- Request a rehabilitation plan from the treating physician
- Preserve all correspondence with insurers and medical professionals
A hypothetical example: A 7-year-old struck by a car in a driveway shows improved coordination but struggles with attention. Medical records showing therapy progress and school reports noting focus improvements would support a claim for treatment benefits.
Time Limits and Dispute Resolution
CTP benefits for threshold injuries (e.g., soft tissue injuries) generally stop after 52 weeks under s 4.4 of the Motor Accident Injuries Act 2017. Families should:
- Monitor the 52-week timeline for treatment benefits
- Request written explanations for benefit reductions
- Seek legal advice if disputes arise about injury severity or recovery progress
Disputes can be resolved through SIRA's internal review process or by engaging a legal professional. Families should act promptly to ensure all evidence is submitted within statutory deadlines.
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