Where a person's only injuries resulting from the accident are threshold injuries, weekly benefits and treatment and care generally cease after 52 weeks (ss 3.11 and 3.28).
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).
Multi-vehicle pile-ups in NSW can leave families grappling with both medical and financial challenges. Under the NSW Compulsory Third Party (CTP) scheme, caregiver-related costs may be covered if they are directly linked to the injured person’s recovery. This article explains what family support expenses are eligible, how insurers assess needs, and the evidence required to claim support under the Motor Accident Injuries Act 2017.
What Caregiver Costs Are Covered in CTP Claims?
NSW CTP claims cover out-of-pocket expenses incurred by family caregivers, such as travel costs, home modifications, or equipment purchases, where these are necessary due to the injured person’s inability to perform daily tasks. For example, if a family member must rearrange their home to accommodate a spouse’s mobility needs after a multi-vehicle crash, those costs may be recoverable.
The Motor Accident Guidelines specify that claims must demonstrate a direct connection between the injury and the caregiver’s expenses. This includes evidence that the injured person’s condition requires ongoing support, such as medical reports confirming limited mobility or cognitive impairments.
How CTP Insurers Assess Family Support Needs
Insurers evaluate support needs by reviewing medical documentation, witness statements, and evidence of dependency. For instance, if a child requires round-the-clock care due to a severe brain injury from a pile-up, the insurer will assess whether the family’s financial strain is tied to the accident.
SIRA (State Insurance Regulatory Authority) advises that claims must show the caregiver’s expenses are ‘reasonably necessary’ and not excessive. This means families should keep detailed records of all costs, including receipts for home modifications or travel logs for visiting the injured person.
Practical Steps and Evidence for Caregiver Claims
To support a CTP claim for family-related costs, gather:
- Medical records confirming the injured person’s condition
- Evidence of dependency, such as a doctor’s note stating the need for daily assistance
- Receipts for home modifications, travel expenses, or equipment purchases
- Witness statements from family members or friends detailing the caregiving role
Families should also notify the at-fault driver’s insurer promptly, as delays can affect eligibility for certain benefits.
Time Limits and Dispute Resolution
CTP claims must be submitted within 52 weeks of the accident if the injury is classified as a ‘threshold injury’ under the Motor Accident Injuries Act 2017. For more severe injuries, claims can be made at any time, but insurers may challenge the necessity of caregiver expenses.
If disputes arise, families can request a review by the NSW Civil and Administrative Tribunal (NCAT) or seek independent medical opinions. It is crucial to act quickly, as time limits apply to all CTP-related claims.
When to Seek Legal Advice
Families should consult a solicitor if they face disputes over caregiver costs, need help navigating SIRA guidelines, or suspect their claim is being undervalued. Legal professionals can also assist with negotiating fair compensation for long-term care needs.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.