Common Mistakes in CTP Claims Under the Motor Accident Injuries Act 2017
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).
The Motor Accident Injuries Act 2017 governs statutory benefits for injuries caused by motor vehicle accidents in NSW. On the Central Coast, claimants often make errors that delay or reduce compensation. Understanding these mistakes helps injured people avoid pitfalls.
Key Mistakes to Avoid
1. Failing to Document Injuries Promptly Claimants must report injuries to medical professionals within 24 hours of the accident. Delays can lead to disputes over the injury’s connection to the accident. For example, a pedestrian who delays seeking treatment for whiplash may struggle to prove the injury’s onset date.
2. Missing the 52-Week Benefit Limit Under s 4.4 of the Act, weekly benefits and treatment payments stop after 52 weeks if injuries are limited to threshold injuries. A cyclist with soft-tissue injuries who doesn’t seek medical review by week 52 may lose access to ongoing support.
3. Not Following Insurer Procedures SIRA’s guidelines require claimants to notify insurers within 28 days of the accident. A driver who waits weeks to contact their insurer may face delays in processing claims.
4. Misunderstanding Threshold Injury Definitions The Act defines threshold injuries as those requiring medical treatment. A car occupant with a minor sprain (not meeting clinical criteria) may not qualify for benefits, even if they feel unwell.
Practical Steps to Avoid Mistakes
- Seek immediate medical attention to establish a clear injury timeline.
- Keep detailed records of treatment, including medical notes, invoices, and correspondence.
- Notify your insurer within 28 days of the accident.
- Review your claim with a legal professional before submitting it to ensure compliance with the Act.
Legal Protections and Dispute Resolution
The Act provides protections against unreasonable delays by insurers. If a claimant believes their benefits are unfairly limited, they can request a review through SIRA. For example, a Central Coast resident denied weekly payments after 52 weeks may challenge the decision by providing additional medical evidence.
When to Seek Legal Advice
Complex cases, such as disputes over contributory fault or overlapping workers’ compensation claims, require specialist guidance. A solicitor can help claimants navigate the 52-week limit, threshold injury assessments, and insurer negotiations.
Next Steps
CTP claims depend on accurate documentation, timely action, and understanding the Motor Accident Injuries Act 2017. To request contact about your circumstances, complete the quick, no obligation enquiry form.