If you were injured in a multi-vehicle pile-up in Greater Sydney, SIRA funds eligible treatment costs under NSW CTP laws. This article explains how SIRA covers medical expenses, what costs are included, and steps to take after an accident.
SIRA's Role in Funding Treatment Costs
Under the Motor Accident Injuries Act 2017 (MAIA), SIRA administers CTP claims in NSW. After a multi-vehicle pile-up, the injured party may claim treatment costs from the at-fault driver’s insurer, provided the injury meets the 'threshold injury' criteria. Threshold injuries include soft tissue injuries like whiplash, fractures, and certain neurological conditions. SIRA covers costs such as medical consultations, scans, physiotherapy, and medications, but only if they are directly related to the accident.
Covered Treatment Expenses
SIRA typically funds:
- Medical examinations and specialist consultations
- Diagnostic imaging (e.g., X-rays, MRIs)
- Physiotherapy and occupational therapy
- Medications prescribed for accident-related injuries
- Travel expenses to medical appointments
Costs not covered include:
- Pre-existing conditions or injuries
- Cosmetic treatments unrelated to the accident
- Expenses after 52 weeks if only threshold injuries are involved (unless the injury results in long-term impairment)
Practical Steps for Claimants
- Seek immediate medical attention: Document all treatment received, as this is critical for claiming costs. Inform your doctor about the accident and its connection to your injuries.
- Keep detailed records: Save all medical bills, appointment confirmations, and correspondence with SIRA or the insurer. This includes records of how the accident affected your daily activities.
- Notify the at-fault driver’s insurer: Complete the required claim forms and provide evidence of the accident, such as police reports, witness statements, and photographs of the damage.
- Submit a 'Notice of Claim': Under the Motor Accident Injuries Regulation 2017, you must notify the insurer of your intention to claim within 52 weeks of the accident. Failure to do so may result in the loss of certain benefits.
Time Limits and Dispute Resolution
You have 52 weeks from the accident date to claim weekly income benefits under the scheme. However, treatment costs may be claimed beyond this period if the injury results in a whole person impairment (WPI) of 10% or more. If your claim is disputed, SIRA may refer the matter to a medical expert for assessment. Disputes over treatment costs are resolved based on medical evidence, not fault.
When to Seek Legal Advice
While SIRA handles most claims, complex cases involving multiple insurers, long-term injuries, or disputes over coverage may require legal assistance. A solicitor can help with:
- Determining whether your injury meets the threshold criteria
- Contesting a decision to deny coverage
- Calculating compensation for long-term treatment needs
Next Steps
Time limits and procedural requirements vary depending on the accident date and injury type. To request contact about your circumstances, complete the quick, no obligation enquiry form.