Understanding Hit-and-Run Claims in NSW
If you were injured in a motor accident in New South Wales and the at-fault driver fled the scene or cannot be identified, you may still be entitled to compensation under the state’s Compulsory Third Party (CTP) insurance scheme. The Motor Accident Injuries Act 2017 (MAIA) provides a framework for claims where the responsible vehicle is unknown. You can apply for treatment and care benefits, weekly income payments, and, in some cases, damages for injury. However, the process for resolving disputes, such as a denial of benefits or a disagreement over injury assessment, follows specific pathways governed by the State Insurance Regulatory Authority (SIRA).
How SIRA Manages Unidentified Vehicle Claims
When the vehicle involved in a hit-and-run accident cannot be identified, the CTP insurer (usually the insurer of the vehicle that caused the injury, if known, or the Nominal Defendant if not) is still responsible for assessing and paying claims under the MAIA. SIRA oversees the CTP scheme and ensures claims are processed fairly. If your claim is denied or you disagree with a decision, such as the level of weekly payments, the assessment of injury severity, or the approval of treatment, SIRA provides formal dispute resolution options.
You are not required to identify the at-fault driver to make a claim. The law recognises that in hit-and-run incidents, identification may be impossible. The insurer must assess your claim based on available evidence, including medical reports, accident scene details, and witness statements.
Dispute Resolution Pathways Under SIRA
If you disagree with a decision made by your CTP insurer, you have several formal dispute resolution options under the MAIA and SIRA’s procedures:
- Internal review - You can request your insurer to review their decision. The insurer must respond within 28 days. This step is often the first point of contact and may resolve the issue without external intervention.
- SIRA review - If the internal review does not resolve the dispute, you may apply to SIRA to review the decision. SIRA will assess whether the insurer’s decision was correct under the law and the Motor Accident Injuries Regulation 2017. This process is free and independent.
- Personal Injury Commission (PIC) medical dispute pathway - If the dispute involves a disagreement over your injury assessment, including whole person impairment (WPI) or whether you meet the threshold for damages, you may apply to the PIC. The PIC provides a medical dispute resolution process that includes an independent medical assessment. This pathway is available for disputes about injury severity, treatment recommendations, or impairment rating.
- Formal review or tribunal process - If the dispute remains unresolved, you may apply to the Personal Injury Commission to conduct a formal review. This includes a hearing where you can present evidence, including medical records, employment documentation, and expert testimony.
Evidence That Matters in Hit-and-Run Claims
The strength of your claim depends on the quality and availability of evidence. Key items include:
- Medical records from the time of injury and follow-up treatment
- Police reports, including any that were filed at the scene
- Photographs of the accident scene, vehicle damage, or injury
- Witness contact details and statements
- Records of lost income or reduced capacity to work
- Correspondence with your insurer, including written decisions
Even in hit-and-run cases, a documented medical history and consistent treatment records are critical. SIRA and insurers rely on objective evidence to assess injury and entitlement to benefits.
Time Limits and Procedural Deadlines
There are time limits that apply to dispute resolution under the MAIA. For example, you must apply to SIRA for a review within 60 days of receiving a decision from your insurer. If you miss this deadline, you may still apply, but the review will only proceed if SIRA considers the delay reasonable.
The 60-day rule is a strict procedural requirement. Missing it may prevent access to formal dispute resolution, so it is essential to act promptly.
Hypothetical Example: Dispute Over Injury Assessment
A pedestrian was struck by a vehicle that fled the scene in Sydney. The injury was a soft tissue neck injury with ongoing pain and restricted movement. The insurer approved treatment and care benefits but denied weekly income payments, citing a lack of evidence of income loss. The claimant provided a letter from their employer confirming reduced hours and a medical report detailing functional limitations. The claimant requested an internal review, which was denied. They then applied to SIRA for a review, which was granted. The SIRA review found that the insurer had not properly considered the employment evidence and directed a reinstatement of weekly payments. This example illustrates how formal review pathways can correct initial decisions.
When to Seek Independent Advice
While SIRA provides structured dispute resolution, the process can be complex. You may benefit from independent legal or claims assistance to:
- Interpret insurer decisions
- Prepare a formal review application
- Gather and submit supporting evidence
- Represent you at a PIC medical dispute or formal review
SIRA does not provide legal representation. The dispute process is adversarial, and having a clear understanding of your rights and obligations is essential.
Final Steps and Next Action
Every claim depends on its own facts. The available options may depend on the facts, evidence and applicable law. To request contact about your circumstances, complete the quick, no obligation enquiry form.