How the NSW CTP Scheme Handles Partial Fault Claims
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).
In New South Wales, the Compulsory Third Party (CTP) scheme covers injuries from motor vehicle accidents, even when multiple parties share fault. Under the Motor Accident Injuries Act 2017, claims involving partial fault are resolved through a structured process that prioritises mediation and avoids litigation where possible. On the Central Coast, claimants must understand how shared liability is assessed and the steps to challenge decisions without breaching time limits.
Dispute Resolution Options for Shared Liability Claims
When a claim involves more than one party contributing to the accident, the first step is to contact the relevant insurer. SIRA (State Insurance Regulatory Authority) oversees the CTP scheme and facilitates mediation to resolve disputes. Claimants can request a mediation session to discuss liability and compensation without involving the court. If mediation fails, the claimant may need to escalate the matter through the Personal Injury Commission (PIC) or seek legal advice.
Practical Steps and Evidence to Gather
To support a partial fault claim, claimants must provide evidence of the accident, such as police reports, witness statements, and medical records. SIRA requires detailed documentation of injuries and treatment to assess eligibility for benefits like weekly income payments or treatment and care benefits. For shared liability cases, evidence of each party’s contribution to the accident is critical. For example, if a driver and cyclist both contributed to the crash, the claimant must demonstrate how each party’s actions led to the injury.
Time Limits and When to Seek Advice
CTP claims must be submitted within 52 weeks of the accident if the injury is classified as a 'threshold injury' under the Motor Accident Guidelines. For more severe injuries, the 52-week limit applies to benefits but does not prevent a claimant from pursuing a damages claim. If a claimant disagrees with a decision, they must act quickly: disputes over liability must be resolved before the 52-week period expires. Seeking legal advice early ensures claimants understand their options and avoid missing critical deadlines.
A Hypothetical Example
Consider a scenario where a driver on the Central Coast collides with a cyclist who was riding against traffic. Both parties contributed to the accident: the driver ran a stop sign, while the cyclist failed to yield. Under the CTP scheme, the claimant must prove how each party’s actions caused the injury. SIRA would assess the fault split and determine the proportion of benefits each party must pay. If the claimant disputes the fault allocation, they can request a mediation session with SIRA before escalating the matter.
Internal Review and Medical Disputes
If a claimant disagrees with a decision, they can request an internal review by the insurer or the PIC. The PIC’s medical dispute pathway allows claimants to challenge assessments of injury severity or treatment necessity. However, it’s important to note that a challenge does not guarantee a changed decision. Claimants must provide new evidence or demonstrate errors in the initial assessment to succeed.
Next Steps
CTP claims involving partial fault require careful navigation of the NSW scheme. On the Central Coast, claimants should prioritise gathering evidence, engaging with SIRA early, and seeking legal advice if disputes arise. Time limits and procedural requirements mean acting promptly is essential. For tailored guidance, complete the quick, no obligation enquiry form to request contact about your circumstances.