Pain and Suffering Damages in NSW CTP Claims
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).
- In New South Wales, pain and suffering damages under Compulsory Third Party (CTP) insurance are assessed based on the
- Motor Accident Injuries Act 2017* and
- SIRA guidelines*. When disputes arise, the Personal Injury Commission (PIC) evaluates claims by considering medical evidence, the nature of injuries, and the impact on the claimant’s life. This article explains what claimants can expect during disputes over pain and suffering damages in Ashfield and beyond.
NSW CTP Rules Behind Pain and Suffering Claims
- Under the
- Motor Accident Injuries Act 2017*, pain and suffering damages are available for injuries meeting the 'threshold injury' criteria. This includes injuries like whiplash, soft tissue damage, or fractures that result in neurological signs. SIRA’s
- Motor Accident Guidelines* outline how these injuries are assessed, requiring medical evidence such as MRI scans, clinical notes, and reports from registered medical practitioners. The PIC may also consider the claimant’s pre-accident lifestyle, current limitations, and the permanence of injuries.
Evidence and Practical Steps for PICs
To dispute a low offer, claimants must provide detailed evidence. This includes:
- Medical records confirming the injury’s severity and duration
- A doctor’s report linking the injury to the accident
- Evidence of how the injury affects daily activities (e.g., work, family, or social life)
- Witness statements or accident reports
SIRA emphasizes that claims must be supported by 'objective evidence' to demonstrate the claimant’s suffering. For example, a claimant with chronic pain may need to show how the injury limits their ability to work or engage in hobbies.
SIRA’s Role in Dispute Resolution
SIRA assesses all CTP claims and resolves disputes through its internal review process. If a claimant disagrees with a decision, they can request a review by submitting new evidence or a written explanation. The PIC may also refer the case to an independent medical expert for further assessment. SIRA’s What You Can Claim page outlines the types of damages available, including compensation for pain, loss of enjoyment, and future care needs.
Common PIC Expectations in Disputes
PICs often expect claimants to:
- Provide clear, documented evidence of their injuries
- Explain how the injury impacts their quality of life
- Cooperate with medical assessments
- Challenge decisions based on incomplete or outdated information
For instance, a claimant who suffered a soft-tissue injury may dispute a low offer by showing that their pain persists beyond the 52-week statutory benefit period. SIRA’s guidelines state that such claims require 'clinical signs' like reduced mobility or chronic pain, not just self-reported symptoms.
Time Limits and When to Seek Advice
CTP claims must be submitted within 52 weeks of the accident, though extensions may apply for serious injuries. If a claimant disagrees with a decision, they should seek legal advice promptly. The PIC’s internal review process typically takes 28 days, but complex cases may take longer. Claimants should also be aware that disputes over pain and suffering damages are often resolved through negotiation rather than litigation.
Next Steps for Claimants
If you’re disputing a pain and suffering claim in Ashfield or elsewhere in NSW, it’s essential to act quickly. Gather all relevant evidence, review SIRA’s guidelines, and consider seeking legal advice to ensure your claim is properly assessed. Every claim depends on its own facts, and the PIC’s expectations can vary based on the injury’s severity and the evidence provided.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.