Entitlement to Compensation After a Fatal Motor Accident
In New South Wales, a person who dies in a motor accident may leave dependants entitled to compensation under the Compulsory Third Party (CTP) insurance scheme. This claim is not dependent on proving fault and is governed by the Motor Accident Injuries Act 2017 and the Motor Accident Injuries Regulation 2017. The main purpose is to provide financial support to those who relied on the deceased for financial or domestic assistance. The value of the claim is determined by assessing the deceased’s capacity to contribute before the accident, using medical and financial evidence.
Medical Evidence Required for a Fatal Claim
Medical evidence in a fatal motor accident claim is not used to assess injuries sustained during the accident, as the deceased is no longer alive. Instead, it is used to establish the deceased’s functional capacity and ability to provide financial or domestic support in the period before death. SIRA requires medical records from the 12 months prior to the accident, including records from general practitioners, specialists, hospitals, and any treatment for chronic conditions.
The evidence must show whether the deceased was employed, self-employed, or engaged in domestic duties, and whether any health issues limited their capacity to perform these roles. A medical report from a qualified practitioner is often required. This report must be based on objective clinical findings and address the deceased’s ability to work, perform household tasks, and provide financial support. The report must be completed by a doctor who has treated the deceased or has access to their full medical records.
How SIRA Assesses the Value of a Claim
SIRA evaluates the medical evidence to determine the deceased’s capacity to contribute to the household and to assess any loss of future income. The assessment focuses on whether the deceased was actively supporting dependants financially or through domestic services. The value of the claim is based on the deceased’s actual contributions, not on hypothetical or future potential.
SIRA may consider evidence of pre-existing conditions, ongoing treatment, and functional limitations. If the deceased was receiving a disability pension, a Centrelink statement or Department of Veterans’ Affairs record may be relevant. The assessment does not consider the nature of the injury that caused death, but rather the deceased’s health and functional status in the months leading up to the accident.
Preparing for a Medical Assessment
Families should begin preparing for a medical assessment by gathering all available medical records related to the deceased. This includes GP notes, specialist letters, medication lists, hospital admission records, and any documentation of disability assessments. These records must be organised and provided to the CTP insurer or to a medical assessor appointed by SIRA.
It is important to preserve any correspondence with healthcare providers, including letters confirming the deceased’s treatment, disability status, or inability to work due to illness. Evidence of financial contributions, such as payslips, tax returns, business records, or household budget documents, should also be collected. These materials help establish the value of the financial support the deceased provided.
Time Limits and Procedural Requirements
A claim for compensation following a fatal motor accident must be made within three years of the date of death. This time limit is strict and cannot be extended unless a court grants leave. The claim must be submitted through the CTP insurer or via SIRA’s online claims portal. Failure to meet the deadline may result in the claim being barred.
If a medical assessment is required, the insurer or SIRA will notify the claimant of the appointment date, location, and required documentation. It is essential to attend the assessment and bring all requested records. The assessment is not a test of the deceased’s condition but a formal review of their health and functional capacity prior to death.
Disputes and Seeking Independent Advice
If a claim is denied or the offered compensation is considered inadequate, the claimant may request a review from the insurer or apply to SIRA for a determination. A dispute may arise if the medical evidence is incomplete, inconsistent, or if the insurer disputes the deceased’s capacity to contribute.
In such cases, it is advisable to seek independent legal advice. A solicitor can assist in obtaining a second medical opinion, challenging a report, or representing the claimant in a review or dispute resolution process.
Next Steps
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.