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've been injured in a motor accident in New South Wales, the Motor Accident Injuries Act 2017 (MAIA) governs your statutory benefits. The first 7 days after an accident are critical for securing your claim. This guide explains the legal steps to take, including medical documentation, notifying insurers, and meeting SIRA requirements. Time limits apply, and failing to act promptly may affect your entitlements. Continue reading to understand your rights and what to do next.
Immediate Steps After a Motor Accident Injury
Under the MAIA, injured road users must take specific actions within the first 7 days to preserve their claim. First, seek medical attention immediately. A doctor’s report is essential to establish the nature and severity of your injuries. Delaying medical care may lead to disputes about the injury’s connection to the accident.
Next, document the accident scene. Take photographs of your injuries, the vehicle damage, and any road conditions. Gather witness details and note the time, location, and weather. This evidence supports your claim and helps SIRA assess your case.
You must notify the at-fault driver’s insurer within 7 days. If the driver flees the scene, contact the NSW Police and report the incident. Failing to notify the insurer on time may result in the loss of statutory benefits, as the MAIA requires prompt communication.
SIRA’s Role in Determining Claim Requirements
The State Insurance Regulatory Authority (SIRA) administers the CTP scheme under the MAIA. SIRA sets the criteria for what you can claim, including weekly income payments, treatment and care benefits, and compensation for permanent impairment. To qualify, your injury must meet the threshold injury definition in the Motor Accident Guidelines.
SIRA also determines the 52-week statutory benefit period. If your injuries are limited to threshold injuries, weekly payments and treatment benefits generally stop after 52 weeks. However, if your injury results in a whole person impairment (WPI) of 10% or more, you may be eligible for ongoing compensation.
Time Limits and Dispute Resolution
The MAIA imposes strict deadlines. You must notify the insurer within 7 days and submit a claim form within 14 days of the accident. If you fail to meet these deadlines, you may lose your right to statutory benefits. For claims involving permanent impairment, you have 12 months from the date of injury to apply for a WPI assessment.
Disputes over claim eligibility or benefit amounts can be resolved through SIRA’s dispute resolution process. If you believe your claim is being undervalued, you may request a review or seek independent legal advice. However, the MAIA does not guarantee a specific outcome, each case is assessed based on its facts.
Example: A Hypothetical Scenario
Consider a cyclist injured in a car accident in Sydney. They seek medical attention, receive a diagnosis of a soft-tissue injury, and notify the insurer within 7 days. SIRA determines the injury meets the threshold definition and approves weekly payments. However, if the cyclist delays medical treatment and fails to notify the insurer, SIRA may dispute the claim’s validity.
When to Seek Legal Advice
While the MAIA provides a statutory framework, complex cases may require legal assistance. For example, if you’ve suffered a serious injury with long-term consequences, or if the insurer disputes your claim, a solicitor can help navigate the process. Legal advice is also essential if you’re unsure about your eligibility for ongoing benefits or compensation.
Next Steps
The steps outlined in this guide apply to claims under the MAIA. However, each case is unique. If you’re unsure about your rights or need help with your claim, complete the quick, no obligation enquiry form to request contact about your circumstances. Every claim depends on its own facts.