Transitional Claims Under the MAI Act in 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 were injured in a motor accident before 1 December 2017, your claim may fall under the transitional rules of the Motor Accident Insurance (MAI) Act 2018. SIRA (State Insurance Regulatory Authority) provides guidance on how these rules apply to claims that span the old and new CTP schemes. This article explains the key features of transitional claims, how SIRA interprets the rules, and practical steps to take.
What Are Transitional Claims?
Transitional claims apply to motor accidents occurring on or after 1 January 2017, where the injury was sustained before 1 December 2017. These claims are governed by the MAI Act 2018, which replaced the old Motor Accidents Compensation Act 1999 (MACA). SIRA explains that transitional claims are treated differently depending on when the injury occurred and whether it meets the threshold for compensation under the new scheme.
Under the MAI Act, claims for injuries sustained before 1 December 2017 are subject to a 'threshold injury' test. This means the injury must meet specific clinical criteria outlined in the Motor Accident Guidelines to qualify for benefits. SIRA clarifies that the threshold injury rules apply to all claims, regardless of when the accident occurred.
How SIRA Applies the Transitional Rules
SIRA provides detailed guidance on how transitional claims are assessed. For example, if your injury occurred before 1 December 2017 but your claim is made after that date, you may be eligible for benefits under the MAI Act. However, the type of benefits you receive depends on the nature of your injury and when it was sustained.
SIRA also outlines that claims for injuries occurring on or after 1 December 2017 are subject to the new MAI Act rules, which include stricter thresholds for compensation. This means that even if your injury occurred after the scheme change, you must meet the new clinical criteria to qualify for benefits.
Practical Steps for Transitional Claims
If you are pursuing a transitional claim, it is important to gather the following evidence:
- Medical records confirming your injury and its date of occurrence
- Police reports or accident reports
- Witness statements
- Evidence of income loss or medical expenses
You should also contact your treating medical practitioner to ensure your injury meets the threshold criteria under the MAI Act. SIRA recommends seeking medical attention as soon as possible after an accident to ensure your claim is properly documented.
Time Limits and Dispute Options
Under the MAI Act, there are strict time limits for making a claim. Generally, you must notify your insurer within 90 days of the accident. If you fail to meet this deadline, you may lose your right to claim benefits. SIRA advises that you act quickly to ensure your claim is processed in a timely manner.
If you believe your claim has been unfairly assessed, you can request a review by SIRA. You may also seek independent legal advice to help you understand your options.
When to Seek Legal Advice
Transitional claims can be challenging to navigate, especially when the injury occurred before and after the scheme change. If you are unsure whether your claim falls under the transitional rules, it is advisable to seek legal advice. A solicitor can help you understand your rights and ensure your claim is processed correctly.
Next Steps
Understanding transitional claims under the MAI Act is essential for anyone injured in a motor accident in NSW. SIRA provides clear guidance on how these claims are assessed, but the rules can be complex. If you have questions about your claim or need assistance with the process, it is important to seek professional advice. Every claim depends on its own facts, and the outcome may vary depending on the circumstances of your case. To request contact about your circumstances, complete the quick, no obligation enquiry form.