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 caring for a loved one injured by a drunk driver in Albury, NSW, you may be eligible for compensation through the NSW Compulsory Third Party (CTP) scheme. This article explains how caregivers and families can claim support, what documentation is needed, and how to manage care responsibilities while navigating the claims process.
What Compensation Is Available for Caregivers?
Under the NSW CTP scheme, families of injured victims can claim for care-related expenses. This includes weekly income payments for the injured person and treatment benefits for medical care. Caregivers may also claim for out-of-pocket costs like transportation to medical appointments or home modifications needed for care.
The Motor Accident Injuries Act 2017 outlines that weekly benefits cover 75% of the injured person’s pre-accident income, while treatment benefits pay for medical expenses. Families must demonstrate the injured person’s injury meets the 'threshold injury' criteria, which includes injuries like whiplash or soft-tissue damage. Spinal nerve-root injuries with neurological signs may also qualify.
How SIRA Assesses Caregiver Claims in Albury
The State Insurance Regulatory Authority (SIRA) administers NSW CTP claims. When assessing family care claims, SIRA considers:
- Medical evidence confirming the injury's severity
- Proof of the injured person’s pre-accident income
- Documentation of care-related expenses
- Statements from healthcare professionals about the injury’s impact on daily living
Caregivers should work closely with the injured person’s treating medical team to ensure all required evidence is submitted. SIRA may request additional information if the claim appears incomplete.
Key Documentation for Family Care Claims
To support your claim, gather:
- Accident reports from police or witnesses
- Medical records showing the injury’s connection to the accident
- Proof of the injured person’s income (e.g., payslips)
- Receipts for care-related expenses
- Witness statements detailing the accident
For example, if your loved one requires 20 hours of weekly care, you’ll need to document this with a care plan from a healthcare professional. SIRA may also require a 'care and support needs assessment' to determine the level of assistance needed.
Navigating CTP Claims While Managing Care
Caregivers often face time constraints, but prompt action is critical. Notify the at-fault driver’s insurer within 52 weeks of the accident to avoid missing statutory benefits. While weekly benefits are available for up to 52 weeks, long-term care needs may require additional support beyond the CTP scheme.
Disputes can arise if SIRA questions the injury’s severity or the care’s necessity. In such cases, seeking legal advice early can help challenge decisions. Remember, the injured person’s care team must provide evidence that the injury meets the threshold for benefits.
When to Seek Legal Advice
If your claim is denied or you’re unsure about your options, contact a legal professional. A solicitor can help dispute SIRA decisions, negotiate better outcomes, or advise on additional support beyond the CTP scheme.
Next Steps for Families in Albury
Caregivers should act quickly to preserve their right to claim. Document everything related to the injury and care, and notify the insurer within the 52-week deadline. For personalized guidance, complete the quick, no obligation enquiry form to discuss your circumstances.