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).
When a motor vehicle accident involves a hit-and-run with an unidentified driver, NSW insurers assess liability under the Motor Accident Injuries Act 2017 (MAIA) and SIRA guidelines. This article explains how insurers evaluate claims, the evidence required, and the limitations of compensation in such cases.
How NSW Insurers Assess Liability in Hit-and-Run Claims
NSW insurers determine liability for hit-and-run claims by applying the principles of the MAIA and SIRA’s Motor Accident Claims Guidelines. Since the at-fault driver is unidentified, insurers rely on the no-fault compensation model of the CTP scheme. This means injured parties are entitled to statutory benefits regardless of fault, but insurers must assess whether the claim falls within the scope of the scheme.
Key factors insurers evaluate include:
- Nature of the accident: Whether the incident occurred on a public road, car park, or private property (as location affects legal classification).
- Evidence of injury: Medical records confirming injuries consistent with the accident, such as soft-tissue injuries or threshold injuries (as defined by SIRA).
- Police reports: Documentation from the NSW Police Force detailing the incident, including witness statements and vehicle descriptions.
- Witness accounts: Statements from bystanders or other drivers who observed the accident.
Insurers may also consider the 'unidentified vehicle' provisions under the MAIA, which allow claims to proceed even when the responsible driver cannot be located. However, claims are limited to injuries covered by the CTP scheme, such as treatment and care benefits, weekly income payments, and compensation for permanent impairments.
Evidence Required for Unidentified Vehicle Claims
To support a claim against an unidentified vehicle, claimants must provide:
- Medical evidence: Detailed records from a medical practitioner confirming injuries and their connection to the accident.
- Accident report: A formal report from the NSW Police Force or a registered claims adjuster.
- Witness statements: Written or recorded accounts from witnesses who saw the incident.
- Photographic evidence: Images of the accident scene, vehicle damage, or injuries.
- Income records: Proof of lost wages or reduced earning capacity if claiming weekly income payments.
SIRA guidelines emphasize that insurers must act reasonably when assessing claims involving unidentified vehicles. Claimants should ensure all evidence is submitted promptly to avoid delays in processing.
Time Limits and Dispute Resolution
Under the MAIA, claimants have three years from the date of the accident to pursue compensation. However, certain benefits, such as weekly income payments, are limited to 52 weeks if the injuries are classified as 'threshold injuries' (injuries requiring treatment but not resulting in permanent impairment).
If an insurer disputes a claim, claimants may:
- Request a review by the insurer’s internal claims team.
- Lodge a complaint with the NSW Civil and Administrative Tribunal (NCAT) if the dispute involves a disagreement over the assessment of injuries or benefits.
- Seek independent legal advice to challenge the insurer’s decision.
Practical Example: How an Unidentified Vehicle Claim Works
Consider a scenario where a pedestrian is struck by a car that flees the scene. The injured person provides a police report confirming the incident, medical records showing soft-tissue injuries, and witness statements identifying the vehicle’s make and model. The insurer assesses the claim under the CTP scheme, approves treatment benefits, and limits weekly payments to 52 weeks as the injuries are classified as threshold injuries.
When to Seek Legal Advice
While SIRA provides a framework for claims, individual circumstances may require legal review. For example, if an insurer refuses to pay for injuries that clearly meet the threshold injury definition, or if there are disputes over the classification of injuries, claimants should consult a solicitor. Legal advice is also essential if a claimant believes an insurer has acted unreasonably or failed to comply with the MAIA.
Next Steps for Claimants
Understanding how insurers assess liability in hit-and-run claims is critical for securing compensation. If you’ve been involved in an accident with an unidentified vehicle, gather all relevant evidence and submit it to the at-fault driver’s insurer. Remember, every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.