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).
When multiple vehicles are involved in a crash, injured parties must navigate complex claims under NSW's Compulsory Third Party (CTP) scheme. This article explains what Personal Injury Claimants (PICs) can expect when disputes arise over compensation for multi-vehicle pile-up accidents in the Newcastle and Hunter regions. Key factors include evidence requirements, SIRA's dispute resolution process, and practical steps to maximise outcomes.
NSW CTP rules for multi-vehicle pile-ups
Under the Motor Accident Injuries Act 2017, all NSW drivers must hold CTP insurance covering injuries caused by their vehicle. In multi-vehicle pile-ups, each insurer is legally obligated to cover injuries caused by their insured vehicle. However, disputes often arise when injuries are caused by multiple parties or when insurers disagree on the extent of injuries.
SIRA (State Insurance Regulatory Authority) oversees claims under the CTP scheme. For multi-vehicle accidents, PICs must notify all involved insurers and provide evidence linking injuries to each vehicle. SIRA's guidelines state that compensation is based on the injury's cause, not the number of vehicles involved. This means a PIC may receive benefits from multiple insurers if injuries are caused by more than one vehicle.
Evidence and documentation for disputes
PICs must provide clear evidence to support their claim. Key documents include:
- Medical records confirming injuries and their connection to the accident
- Police reports detailing the crash and fault allocation
- Witness statements from drivers, pedestrians, or cyclists
- Photographs of the accident scene and vehicle damage
- Medical opinions linking injuries to the accident
In disputes, insurers may request additional evidence. For example, if a PIC claims a soft-tissue injury (threshold injury), SIRA's guidelines require medical evidence showing spinal nerve-root damage or radiculopathy. Without this, benefits may be limited after 52 weeks under the Act.
SIRA's role in resolving compensation disputes
When insurers disagree on compensation amounts, PICs can apply to SIRA for a review. SIRA considers:
- The nature and severity of injuries
- Medical evidence confirming injury causation
- The fault of each vehicle involved
- The impact of injuries on the PIC's daily life
SIRA's decision is binding unless the PIC appeals to the NSW Civil and Administrative Tribunal (NCAT). It's important to note that SIRA does not guarantee a specific outcome. For example, a PIC claiming a 20% whole person impairment (WPI) may receive weekly income payments, but the amount depends on the injury's impact and the insurer's assessment.
Practical steps for PICs in pile-up disputes
- Notify all insurers involved in the accident within 28 days of the incident. Delays may affect benefit eligibility.
- Coordinate with multiple insurers. Each insurer has its own claims process, so PICs should keep records of all communications.
- Seek medical attention promptly. Delayed treatment may affect the ability to claim benefits for threshold injuries.
- Request a medical report from a registered medical practitioner. This is critical for disputes over injury severity.
- Consider a SIRA review if insurers disagree on compensation. Applications must be submitted within 28 days of the insurer's final decision.
Example: Dispute over multiple injuries
Consider a scenario where a PIC was injured in a pile-up involving three vehicles. One insurer disputes the claim for a soft-tissue injury, arguing it's a threshold injury. Under SIRA's guidelines, the PIC must provide evidence of spinal nerve-root damage or radiculopathy. If the medical report confirms a threshold injury, benefits will stop after 52 weeks. However, if the injury meets the whole person impairment threshold, the PIC may receive ongoing weekly payments.
Time limits and when to seek advice
PICs must act quickly. Under the Motor Accident Injuries Act 2017, claims must be submitted within 28 days of the accident. Delays may result in lost benefits, especially for injuries that fall below the threshold. If a PIC is unsure about their claim's validity, they should consult a solicitor experienced in CTP disputes. Legal advice is particularly important when:
- Injuries involve multiple insurers
- The PIC is unsure if their injury meets the threshold injury definition
- Disputes over the extent of injuries arise
Next steps for PICs
If you've been injured in a multi-vehicle pile-up and are facing disputes with insurers, it's essential to understand your rights under NSW law. While SIRA provides a framework for resolving claims, the process can be complex. By gathering the right evidence and seeking professional advice, PICs can maximise their chances of receiving fair compensation.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.