Understanding MAI Act Transitional Claims in Greater Sydney
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 were injured in a motor accident in Greater Sydney before 1 December 2017, but are still seeking compensation under the Motor Accident Injuries Act 2017 (MAIA), you may be making a transitional claim. These claims are governed by the MAIA, but the accident occurred under the old Motor Accidents Compensation Act 1999 (MACA) framework. The transition between these two laws creates specific legal and procedural requirements that, if misunderstood, can result in delays, reduced entitlements or claim rejection.
The key distinction is that while the MAIA now sets out the current rules for compensation, claims arising from pre-2017 accidents may still be subject to the old law’s provisions in certain respects. This means that not all aspects of the MAIA apply automatically to older claims. For example, eligibility for damages, thresholds for injury, and time limits for claims may differ depending on when the accident occurred and whether the claim was initiated under the old or new framework.
Legal Boundaries and Key Differences in Transitional Claims
Transitional claims in Greater Sydney must be assessed under the MAIA, but the injury and claim history must be examined against the law that applied at the time of the accident. The MAIA introduced new thresholds for injury, including the concept of a threshold injury, which limits entitlement to damages. However, for accidents occurring before 1 December 2017, the threshold for damages was higher and based on a more restrictive definition of permanent impairment.
A common mistake is assuming that the MAIA’s lower threshold for damages (such as a 10% whole person impairment) applies to pre-2017 accidents. It does not. The old MACA threshold of 15% whole person impairment still applies to claims from before 1 December 2017, unless a claim was formally commenced under the MAIA before that date. This distinction is critical and often misunderstood.
Another frequent error is failing to properly identify the insurer responsible. For pre-2017 accidents, the CTP insurer is determined by the vehicle’s registration and the insurer that held the green slip at the time of the accident. If the green slip was held by a different insurer than the one currently managing claims, this can delay processing. In Greater Sydney, where vehicle use and insurer turnover are high, this issue frequently arises.
Practical Steps and Evidence That Matter
To ensure your transitional claim is processed correctly, gather and preserve the following evidence:
- A copy of the police accident report, if one was filed
- Medical records from the time of the accident and any subsequent treatment
- A record of all weekly income payments received, if applicable
- Details of any treatment and care benefits received under the old scheme
- Correspondence with insurers, including any claim forms submitted
- Photographs of the accident scene, vehicle damage, and visible injuries
Failure to provide complete medical evidence showing the nature and duration of injuries can result in a claim being rejected or limited. The Motor Accident Injuries Regulation 2017 requires that medical evidence demonstrate a causal link between the accident and the injury. For transitional claims, this evidence must also show that the injury persisted beyond the initial recovery period, as required under the old law.
A common mistake is assuming that a medical certificate from a general practitioner is sufficient. For claims involving permanent impairment, a specialist assessment is required, and the report must be completed by a medical practitioner registered under the MAIA’s approved panel. This requirement applies even to pre-2017 claims, as the MAIA now governs the assessment process.
Time Limits, Disputes and When to Seek Advice
Time limits for making a claim under the MAIA are strict. For transitional claims, the deadline to commence a claim is generally 3 years from the date of the accident. However, if the claim was not formally started under the old MACA scheme, the 3-year limit under the MAIA still applies. Missing this deadline can result in a claim being barred.
A frequent error is relying on a claim that was started under the old law but not formally transferred to the MAIA framework. If a claim was initiated under MACA but not updated to the MAIA process by 1 December 2017, it may not be eligible for the new benefits, including treatment and care benefits under the MAIA’s 52-week rule.
If your claim is disputed or denied, you may apply to the State Insurance Regulatory Authority (SIRA) for a review. However, the review process is not automatic and requires a formal application. The most common grounds for dispute are the assessment of impairment, the level of weekly payments, or the denial of damages due to a failure to meet the threshold.
A realistic example: A pedestrian in Sydney’s inner west was struck by a car in 2016. They received treatment for a back injury and were off work for 10 weeks. No claim was made under MACA at the time. In 2025, they sought compensation under the MAIA. The insurer rejected the claim on the basis that the injury did not meet the 10% threshold. However, because the accident occurred before 1 December 2017, the 15% threshold under MACA still applies. The claimant was able to submit a specialist assessment showing 16% whole person impairment and was successful in obtaining damages.
Next Steps and When to Seek Help
The legal framework for transitional claims in Greater Sydney is complex and fact-specific. Entitlements depend on the accident date, injury type, claim history, and whether the claim was formally initiated under the old or new law. Missteps in documentation, timing, or assessment can significantly reduce or eliminate compensation.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.