Minor Injury Definition and Funding Treatment Costs in NSW CTP Claims
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).
- Under New South Wales law, a minor injury in a Compulsory Third Party (CTP) motor accident claim is defined by the
- Motor Accident Guidelines* and the
- Motor Accident Injuries Act 2017*. SIRA (State Insurance Regulatory Authority) outlines that minor injuries typically include soft-tissue injuries like whiplash, sprains, or strains, as well as certain psychological injuries. These injuries must meet specific clinical criteria to qualify for funding under the CTP scheme.
How Treatment Costs Are Funded
If your injury is classified as minor, treatment costs may be funded through two main mechanisms:
- Weekly income benefits, You receive a weekly payment to cover lost income due to the injury.
- Treatment and care benefits, This covers medical expenses, physiotherapy, and other treatment costs.
For example, if you require physiotherapy for a minor soft-tissue injury, the CTP insurer may cover the cost of sessions, provided the treatment is documented and approved by a medical practitioner.
Key Considerations for Auburn Residents
While SIRA’s guidelines apply statewide, residents of Auburn should note that:
- Medical records must clearly link treatment to the accident.
- Accident location (e.g., a car park or road) affects how the injury is classified.
- Time limits apply, weekly benefits typically stop after 52 weeks if only threshold injuries are involved.
Practical Steps to Take
To ensure your treatment costs are funded:
- Seek medical attention immediately after the accident.
- Document all treatment (e.g., physiotherapy notes, scans).
- Notify your insurer about the injury and treatment costs.
- Keep records of income loss if you’re unable to work.
When to Seek Legal Advice
Consult a legal professional if:
- Your injury exceeds the threshold for minor injuries.
- You face disputes over the classification of your injury.
- You need help navigating the 52-week benefit limit.
Time Limits and Disputes
Under the Motor Accident Injuries Act 2017, you must notify the insurer within 52 weeks of the accident. If you fail to do so, you may lose entitlement to certain benefits. Disputes over injury classification or funding decisions can be escalated to the NSW Civil and Administrative Tribunal (NCAT) for review.
Example Scenario
Imagine a driver in Auburn sustains a minor soft-tissue injury in a car accident. Their doctor documents the injury as a sprained wrist with no neurological signs. The insurer approves weekly benefits and covers physiotherapy costs. However, after 52 weeks, the insurer stops payments, assuming the injury is a threshold injury. The driver may need to seek legal advice to challenge this decision or explore additional claims.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.