Transitional Claims Under the MAI Act
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).
Transitional claims under the Motor Accident Injuries (MAI) Act 2017 apply to motor accidents occurring before 12 December 2017. These claims bridge the gap between the old Compulsory Third Party (CTP) scheme and the new MAI Act framework. Unlike standard CTP claims, transitional claims are limited to injuries meeting the 'threshold injury' criteria under the Motor Accident Guidelines. This distinction is critical: injuries below this threshold are not eligible for benefits under the new scheme.
How SIRA Guidelines Apply in Newcastle and Hunter
The State Insurance Regulatory Authority (SIRA) provides the official framework for assessing transitional claims. For example, a cyclist in Newcastle who sustained a soft-tissue injury in 2020 (pre-2017) would qualify for transitional benefits if their injury meets the threshold criteria. SIRA's guidelines specify that spinal nerve-root injuries with neurological signs, such as reduced reflexes or muscle weakness, may still fall within the soft-tissue definition, even if radiculopathy (nerve root irritation) is not present.
Practical Steps for Pursuing Transitional Claims
To pursue a transitional claim, claimants must:
- Obtain medical records confirming the injury meets the threshold criteria
- Gather evidence of the accident, including police reports or witness statements
- Submit a claim to the at-fault driver's insurer within the 52-week statutory period
- Document income loss and treatment costs if seeking weekly benefits
In the Hunter region, a pedestrian involved in a 2019 car accident who required physiotherapy would need to provide medical evidence showing their injury meets the threshold. SIRA's online tool for assessing injury severity can help determine eligibility.
Key Legal Boundaries to Understand
Transitional claims have strict limitations:
- Only injuries meeting the threshold injury definition are eligible
- Weekly benefits and treatment benefits stop after 52 weeks unless the injury is classified as a 'major injury' under the MAI Act
- Claims must be submitted within the statutory time limits, which vary depending on the injury type
For example, a driver in Newcastle who sustained a minor whiplash injury in 2021 would not qualify for transitional benefits, as such injuries fall below the threshold. However, if the injury involved a fractured rib or ligament tear, it might qualify.
When to Seek Legal Advice
Transitional claims require careful assessment of both the injury and the accident date. Claimants should consult a solicitor if:
- The injury's severity is unclear
- The accident occurred before and after the 2017 law change
- The claimant is unsure if their injury meets the threshold criteria
Legal professionals can help navigate the distinction between transitional claims and standard CTP claims, ensuring claimants understand their options under the new MAI Act.
Example Illustrating the Process
Consider a motorcyclist in the Hunter region who was involved in a 2020 accident. Their medical records show a torn ligament and bruised ribs, both injuries meeting the threshold criteria under SIRA's guidelines. This claimant would be eligible for transitional benefits, including treatment and care payments and weekly income support. However, after 52 weeks, benefits would stop unless the injury is reclassified as a major injury.
Next Steps
Transitional claims require precise understanding of both the injury and the applicable legal framework. If you're unsure whether your claim falls under the MAI Act transitional provisions, seek professional advice. Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.