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 a facial scarring injury in a motor accident in NSW, you may be eligible for compensation through the Compulsory Third Party (CTP) scheme. However, many claimants make errors that could reduce their entitlements. This guide explains common mistakes to avoid when pursuing a CTP claim for facial scarring injuries, based on NSW law and SIRA guidelines.
Key CTP Rules for Facial Scarring Claims
Under the Motor Accident Injuries Act 2017, facial scarring injuries are assessed based on their impact on your daily life and appearance. SIRA (State Insurance Regulatory Authority) evaluates claims by considering:
- Medical evidence confirming the scarring injury
- How the injury affects your ability to work, socialise or perform daily tasks
- Whether the scarring meets the 'threshold injury' definition under the Motor Accident Guidelines
A common mistake is assuming all facial injuries qualify as threshold injuries. SIRA requires specific clinical signs, such as visible scarring that impacts appearance or function, to qualify for benefits. For example, a minor cut with minimal scarring may not meet the threshold, while a severe laceration causing noticeable scarring likely will.
Practical Steps to Avoid Errors
To ensure your claim is processed correctly:
- Seek immediate medical attention to document the injury. A GP or specialist report is essential.
- Preserve evidence like photographs of the scarring, accident reports, and witness statements.
- Notify your insurer within 52 weeks of the accident. Delays may reduce your entitlement to weekly benefits.
- Understand that 'threshold injuries' are limited to 52 weeks of benefits. After this period, you may need to pursue a separate common law claim for ongoing scarring.
When to Seek Legal Advice
Disputes often arise over the severity of scarring or whether it meets the threshold. A solicitor can help:
- Challenge an insurer's refusal to pay benefits
- Navigate the 52-week statutory limit for threshold injuries
- Pursue additional compensation for cosmetic treatment costs
If your claim involves complex scarring or disputes, consult a lawyer before missing key deadlines. The CTP scheme has strict time limits, and errors in documenting your injury can lead to reduced compensation.
Example: Missing the 52-Week Deadline
Consider a claimant who suffered a facial laceration in a car accident. They receive weekly benefits for 52 weeks under the CTP scheme. After this period, the insurer stops payments, assuming the injury no longer meets the threshold. However, the claimant may still have a valid common law claim for ongoing scarring, which requires separate legal action.
Next Steps
CTP claims for facial scarring depend on accurate documentation, timely action, and understanding the difference between statutory benefits and common law damages. If your claim involves disputes, time limits, or complex scarring, seek legal advice before missing critical deadlines.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.