Understanding Partial Fault in NSW CTP Claims
In a motor accident in New South Wales, shared liability means more than one party contributed to the crash. Under the Motor Accident Injuries Act 2017, this does not prevent you from claiming compensation for injuries, treatment and rehabilitation. However, your entitlement to weekly income payments and treatment and care benefits may be adjusted according to your share of fault. The amount you receive is calculated by applying the percentage of fault assigned to you to the total benefit available. This applies across all regions in NSW, including Newcastle and the Hunter, where the State Insurance Regulatory Authority (SIRA) oversees claim administration.
How Shared Liability Affects Treatment and Rehabilitation Planning
When fault is shared, the insurer responsible for your claim, usually the insurer of the vehicle that caused the accident, must still provide treatment and care benefits. These include access to medical treatment, rehabilitation services, and support for returning to work. The rehabilitation plan must be developed in collaboration with your medical practitioners and the insurer, and must reflect your injury, functional capacity, and recovery goals. The plan must be documented and updated as your condition changes. SIRA’s Motor Accident Guidelines require that rehabilitation planning be individualised and evidence-based, regardless of fault allocation.
SIRA’s Role in Coordinating Care in Regional NSW
SIRA is responsible for ensuring that treatment and care benefits are provided in a timely and coordinated way across NSW, including in regional areas such as Newcastle and the Hunter. Insurers must report on the progress of rehabilitation plans to SIRA, and SIRA may review claims where treatment is delayed or where there is a dispute about the need for services. In regional areas, access to specialists and allied health providers may vary, so the insurer must work with you to identify appropriate services, including arranging transport if needed. The insurer must also ensure that any rehabilitation plan is reviewed at least every 12 weeks, or sooner if your condition changes.
What Evidence Supports a Rehabilitation Plan?
A strong rehabilitation plan is built on documented medical evidence. This includes reports from your treating medical practitioner, assessments of your functional capacity, and records of your progress in therapy. You should keep copies of all correspondence with your insurer, notes from appointments, and any letters from your employer about work capacity. Photographs of the accident scene, witness statements, and a police report (if available) may also help establish the circumstances of the crash, particularly if fault is disputed. In the Hunter region, some claimants have successfully used local transport and community health service records to demonstrate reasonable access to care.
Time Limits and Dispute Resolution
There is a 3-year time limit from the date of the motor accident to make a claim for compensation under the Motor Accident Injuries Act 2017. This includes claims for treatment and care benefits, even if fault is shared. If your insurer refuses to fund a rehabilitation service, you may request a review through SIRA’s dispute resolution process. You can also apply for an independent review by the NSW Civil and Administrative Tribunal (NCAT) if the dispute is not resolved. These processes are available across NSW, including in Newcastle and the Hunter, and must be initiated within the 3-year period.
Hypothetical Example: Shared Fault in a Hunter Region Accident
A 42-year-old cyclist was struck by a car while crossing a road in Maitland, NSW. The driver admitted to not seeing the cyclist due to poor lighting. The police report noted the cyclist was not wearing a helmet and was riding against traffic. SIRA’s assessment assigned 30% fault to the cyclist and 70% to the driver. The insurer approved a rehabilitation plan including physiotherapy, psychological support, and a gradual return to work. The plan was reviewed every 12 weeks, and the cyclist received treatment and care benefits for 18 months. The 30% fault deduction applied to weekly payments but did not reduce access to treatment. The plan was updated after a follow-up assessment showed improved mobility.
When to Seek Independent Advice
If you are unsure how fault will affect your treatment or rehabilitation, or if your insurer refuses to fund a service you believe is necessary, you should seek independent advice. A legal or claims professional can help you understand your rights under the Motor Accident Injuries Act 2017 and SIRA’s guidelines. They can also assist in preparing a submission to SIRA or NCAT if a dispute arises. This is particularly important in regional areas where access to specialist care may be limited.
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