How SIRA Funds Treatment Costs for MAC Act Legacy Claims in Armidale NSW
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 sustained an injury in a motor vehicle accident before 1 January 2017, you may be eligible for treatment cost funding under the legacy Motor Accident Claims (MAC) Act. SIRA (State Insurance Regulatory Authority) administers these claims, but the rules differ from current Compulsory Third Party (CTP) claims. Understanding the legal boundaries and evidence requirements is critical.
Under the MAC Act, treatment costs are funded through a combination of weekly benefits and lump-sum payments. SIRA assesses whether your injury qualifies as a 'threshold injury' under the Motor Accident Guidelines. If your injury meets this threshold, you may receive weekly payments for treatment-related expenses, including physiotherapy, specialist consultations, and medical equipment.
Key Differences Between MAC Act and Current CTP Claims
The MAC Act framework is distinct from the current Motor Accident Injuries Act 2017. Legacy claims are subject to the 52-week statutory benefit period, after which weekly payments stop unless your injury meets the 'whole person impairment' threshold. Current CTP claims, however, have different rules for long-term treatment funding.
For example, if your injury resulted in a 10% whole person impairment under the current scheme, you may receive ongoing weekly benefits. Under the MAC Act, such injuries are not eligible for weekly payments but may qualify for a lump-sum settlement. This distinction is crucial when determining your funding options.
Evidence Required for Treatment Cost Funding
To claim treatment cost funding under the MAC Act, you must provide:
- Medical records confirming your injury and treatment
- Itemised bills for medical services
- Evidence linking your injury to the accident (e.g., police report, witness statements)
- Proof of income to assess your financial need for treatment funding
SIRA may also request a medical report from a specialist to determine your injury's severity. If your injury does not meet the threshold, you may need to pursue a common law damages claim separately.
Time Limits and Dispute Resolution
MAC Act claims must be submitted within 52 weeks of the accident, unless you have a valid reason for delay. If your claim is denied, you can request a review by SIRA or seek independent legal advice. Note that the 52-week period applies to weekly benefits, not lump-sum payments.
A hypothetical example: Sarah sustained a soft-tissue injury in a 2015 car accident. Under the MAC Act, she received weekly payments for 52 weeks. After this period, SIRA determined her injury did not meet the threshold for ongoing benefits. Sarah then pursued a common law claim to cover additional treatment costs.
When to Seek Legal Advice
Legacy MAC Act claims have unique rules that differ from current CTP claims. If your injury occurred before 2017 and you're unsure about your funding options, consult a solicitor specialising in motor accident claims. They can help you navigate SIRA's assessment process and ensure your claim meets all legal requirements.
Next Steps
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.