How SIRA Evaluates Claims for Pedestrian Crossing Injuries
If you were injured at a pedestrian crossing in Greater Sydney, your claim under the NSW Compulsory Third Party (CTP) scheme depends on the nature of your injury and medical evidence. The Motor Accident Injuries Act 2017 (MAIA) governs claims, and SIRA assesses injuries using the Motor Accident Guidelines. This article explains how claims are evaluated, what benefits are available, and practical steps to take.
Key Factors in Claim Assessment
SIRA determines eligibility based on three factors: the type of injury, fault, and whether the injury meets the threshold for damages. A threshold injury includes soft tissue injuries (like whiplash) and certain psychological injuries, but must involve objective neurological signs. For example, a spinal nerve-root injury with loss of sensation or muscle weakness may qualify for damages, while a minor bruise without lasting effects would only entitle you to treatment and care benefits.
What Benefits Are Available?
If your injury is not serious enough for damages, you may receive:
- Treatment and care benefits to cover medical expenses
- Weekly income payments if you're unable to work
Damages are only available if the injury results in a permanent impairment or serious harm, such as a herniated disc with measurable neurological signs. The 52-week limit applies to weekly payments and treatment benefits if the injury is the only one and does not meet the threshold for damages.
Practical Steps After an Accident
- Seek medical attention immediately. A medical report documenting your injury is essential. For spinal injuries, the report must include objective signs like sensory loss or reflex changes.
- Report the accident to the police if it occurred in a public area. A police report can help establish the circumstances.
- Preserve evidence: Take photos of the crossing, the vehicle, and your injuries. Keep witness contact details and any correspondence with the insurer.
- Notify your CTP insurer as soon as possible. While there’s no strict deadline, delays may affect claim processing.
Common Challenges in Greater Sydney
Urban areas like Sydney’s inner west and North Shore often have complex traffic conditions. SIRA considers whether the pedestrian had the right of way under the Road Rules 2014. For example, a driver may claim the pedestrian crossed against the light, but SIRA will assess whether the pedestrian was in a safe position to cross.
Dispute Resolution Options
If your claim is denied or you disagree with the benefits offered, you can request a review from the insurer. If unresolved, the Civil and Administrative Tribunal (NCAT) can review decisions about benefits, treatment, and damages. However, the 52-week limit for weekly payments only applies if the injury is not serious and does not meet the threshold for damages.
Example: A Case in Inner West Sydney
A 42-year-old woman was struck at a marked crossing on Oxford Street. She sustained a herniated disc with sciatic nerve involvement, confirmed by MRI and a whole person impairment (WPI) assessment showing 12% impairment. The medical report documented loss of sensation and reduced muscle strength. SIRA determined the injury met the threshold for damages, and the claim proceeded to a settlement.
Next Steps
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.