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).
When a learner driver is involved in an accident during supervised practice, families and caregivers may need to claim compensation for additional expenses. Under New South Wales' Compulsory Third Party (CTP) scheme, caregiver-related costs can be included in claims if they meet specific criteria. This article explains what expenses are covered, how to document caregiver needs, and how SIRA assesses these claims.
What Caregiver Expenses Are Covered in NSW CTP Claims?
The NSW CTP scheme covers medical treatment, income loss, and reasonable out-of-pocket expenses for injuries caused by motor vehicle accidents. Caregiver-related costs fall under 'out-of-pocket expenses' if they are directly linked to the injured person's recovery. Eligible expenses include:
- Lost income for family members who must reduce work hours or take time off to care for the injured person.
- Travel costs for caregivers attending medical appointments or transporting the injured person.
- Home modifications or equipment needed to support the injured person's recovery.
- Mental health support for caregivers experiencing stress or trauma.
SIRA (State Insurance Regulatory Authority) assesses these claims based on the injured person's medical needs and the caregiver's documented role. For example, if a child requires 24-hour care after a learner driver accident, the family may claim for lost wages and transportation costs.
How to Document Caregiver Needs for CTP Claims
To support a caregiver claim, families must provide clear evidence of the injured person's medical needs and the caregiver's involvement. Key documentation includes:
- Medical records showing the injury's severity and recovery timeline.
- Proof of income loss for caregivers, such as payslips or employer statements.
- Witness statements from family members or healthcare professionals confirming the caregiver's role.
- Expense receipts for travel, home modifications, or mental health services.
- Accident reports detailing the incident and the learner driver's involvement.
SIRA requires claims to demonstrate a direct connection between the injury and the caregiver's expenses. For instance, if a family member must leave work to care for an injured learner driver, they must show how the accident caused this disruption.
SIRA's Approach to Assessing Family-Related Claims
SIRA evaluates caregiver claims by considering the injured person's 'whole person impairment' and the impact on their family. Under the Motor Accident Injuries Act 2017, claims must show that the injury meets the 'threshold injury' criteria, which includes neurological signs or significant functional limitations.
For example, if a learner driver sustains a soft-tissue injury (like a whiplash) that requires ongoing care, SIRA will assess whether the caregiver's expenses are reasonable and necessary. The authority also considers the injured person's pre-accident lifestyle and how the injury affects their family's daily activities.
A hypothetical example: After a learner driver crashes during a supervised drive, a family member must take time off work to care for the injured driver. The family claims lost wages and travel costs for medical appointments. SIRA would review medical records to confirm the injury's severity and verify the caregiver's expenses.
Time Limits and When to Seek Advice
CTP claims must be submitted within 52 weeks of the accident if the injury is classified as a 'threshold injury.' For non-threshold injuries, claims must be made within 10 years. Families should act quickly to gather evidence and submit claims before these deadlines.
Disputes may arise if SIRA rejects a claim or if the injured person's condition worsens after the initial assessment. In such cases, families should seek legal advice to challenge the decision or explore additional compensation.
Next Steps for Families and Caregivers
If your family is caring for an injured learner driver, start by documenting all expenses and medical details. Contact SIRA directly to submit a claim, and consider seeking legal advice if your claim is denied. Every claim depends on its own facts, and the right support can help families navigate the process.