Understanding the Motor Accident Injuries Act 2017 in regional NSW
The Motor Accident Injuries Act 2017 (MAIA) is the current legal framework that governs compensation for personal injury resulting from motor vehicle accidents in New South Wales. This includes regional areas such as Wagga Wagga, Tamworth, Coffs Harbour, and the Northern Rivers. To be eligible under the MAIA, you must have suffered personal injury as a result of a motor vehicle accident that occurred on or after 1 December 2017. The Act provides statutory benefits including treatment and care, weekly income payments, and, in some cases, damages. Eligibility depends on the nature of the injury, the circumstances of the accident, and whether the injury meets the threshold for damages. This article explains the core eligibility criteria under the MAIA for people in regional NSW.
Who is covered under the scheme?
The MAIA covers drivers, passengers, pedestrians, cyclists, and motorcyclists who sustain injury in a motor vehicle accident. Coverage extends to injuries sustained in a car park, driveway, or private property if the vehicle was being used in a way that constitutes a motor vehicle accident under the law. For example, if a pedestrian is struck by a car while crossing a road in a rural town, or a cyclist is hit by a vehicle on a country road, they may be eligible for benefits under the MAIA. The scheme applies regardless of fault, but eligibility for damages depends on whether the injury meets the threshold for serious injury.
What injuries qualify for benefits?
Under the MAIA, you may be entitled to treatment and care benefits, weekly income payments, and, if applicable, damages. These benefits are available if you have suffered personal injury as a result of a motor vehicle accident. The type of benefit depends on the nature and severity of the injury. For example, if you sustained a whiplash injury from a low-speed collision, you may be eligible for treatment and care benefits and weekly income payments if you are unable to work. However, if your only injuries are classified as threshold injuries, the right to claim damages is limited.
Threshold injuries and the 52-week rule
A threshold injury under the MAIA includes soft tissue injuries such as whiplash, as well as certain types of spinal nerve-root injuries. However, a spinal nerve-root injury that causes neurological signs other than radiculopathy may still be considered a threshold injury. Radiculopathy, which includes symptoms like numbness, tingling, or weakness in a limb, must be confirmed by clinical signs and imaging to qualify as a threshold injury. If your only injuries are threshold injuries, you are generally entitled to treatment and care benefits and weekly income payments for up to 52 weeks from the date of the accident. After 52 weeks, these benefits may cease unless a medical practitioner certifies that the injury is not resolving and that ongoing treatment is required.
When damages may be claimed
Damages are only available if your injury meets the threshold for serious injury. This means the injury must be more than minor and must have a significant impact on your life. The MAIA sets out specific criteria for serious injury, including permanent impairment, severe pain, or a substantial loss of function. If your injury meets this threshold, you may be able to claim damages for pain and suffering, loss of enjoyment of life, and future care needs. However, if your only injuries are threshold injuries, you cannot claim damages under the MAIA. This rule applies equally in regional NSW as it does in metropolitan areas.
Practical steps and evidence to support a claim
To establish eligibility under the MAIA, you should take the following steps as soon as possible after the accident:
- Seek medical attention and keep all medical records, including treatment notes, diagnostic imaging, and assessments from medical practitioners.
- Report the accident to the police if it involved a motor vehicle and resulted in injury, even if it occurred in a remote area.
- Gather witness contact details, photographs of the scene, and any available video footage.
- Notify the insurer of the at-fault vehicle as soon as possible. You can do this through the insurer’s claims portal or by contacting them directly.
- Keep records of any lost income, travel expenses for medical appointments, and out-of-pocket costs related to the injury.
These records are essential to support your claim for statutory benefits. The insurer will assess your claim based on the evidence provided, including medical reports and accident details.
Time limits and dispute options
There are time limits for making a claim under the MAIA. You must notify the insurer of the at-fault vehicle within three years of the accident. However, it is advisable to notify them as soon as possible to avoid delays. If your claim is denied or you disagree with the insurer’s assessment, you may request a review. If the review does not resolve the dispute, you may apply to the Civil and Administrative Tribunal (NCAT) for a determination. In regional areas, access to legal advice and medical assessments may be limited, so it is important to act promptly to preserve your rights.
Hypothetical example: A regional motor accident
A 45-year-old farmer in the Central West region of NSW was struck by a vehicle while crossing a country road on foot. He sustained a soft tissue injury to his neck and back. He sought medical treatment within a week and was diagnosed with whiplash. His injury was confirmed as a threshold injury under the Motor Accident Guidelines. He received treatment and care benefits for 52 weeks. After that period, his medical practitioner submitted a report stating that his symptoms had not resolved and that ongoing treatment was necessary. He was then able to continue receiving treatment and care benefits beyond 52 weeks under the MAIA’s provisions for non-resolving injuries.
Next steps
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.