How NSW CTP Insurers Assess Liability for Pedestrian Crossing Injuries
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).
If you were injured as a pedestrian at a marked crossing in Bega, NSW insurers assess liability by examining traffic laws, evidence, and the specific circumstances of the accident. Under the Motor Accident Injuries Act 2017, insurers must determine whether the driver or pedestrian breached their duty of care. This article explains the factors insurers consider, how the SIRA framework applies, and what evidence supports your claim.
Key Factors in Assessing Liability
NSW insurers evaluate liability by considering:
- Traffic laws: Whether the driver obeyed stop signs, traffic lights, or gave way requirements.
- Pedestrian conduct: Whether you followed crossing rules, such as using a marked crossing and not jaywalking.
- Witness statements: Accounts from bystanders or drivers about what occurred.
- Camera footage: If available, evidence from traffic cameras or dashcams.
- Road conditions: Whether signage was visible or road markings were clear.
For example, if a driver ran a red light at a marked crossing and struck you, the insurer would likely find the driver at fault. Conversely, if you stepped into the road without using a crossing, the insurer might assess shared responsibility.
The Role of SIRA Guidelines
The State Insurance Regulatory Authority (SIRA) provides authoritative guidance on assessing claims. Under the SIRA framework:
- Threshold injuries (such as whiplash or soft tissue damage) are eligible for statutory benefits.
- Serious injuries (like fractures or nerve damage) qualify for additional compensation.
- Fault assessment must consider whether the driver or pedestrian breached their legal duties.
SIRA’s guidelines also clarify that insurers must consider the spinal nerve-root qualification for soft tissue injuries. This means neurological signs, even without radiculopathy, may still qualify as threshold injuries.
Evidence to Support Your Claim
To strengthen your claim, gather:
- Medical records documenting your injuries and treatment.
- Accident reports from the NSW Police or local council.
- Witness contact details and statements.
- Photographs of the crossing, traffic signs, and vehicle damage.
- Income records if you’ve lost wages due to the injury.
If you were hit at a poorly lit crossing or a sign was obscured, this evidence could influence the insurer’s assessment of fault.
Time Limits and Dispute Options
You must notify the at-fault driver’s insurer within 52 weeks of the accident to claim statutory benefits. If your injury is a threshold injury, benefits are generally limited to 52 weeks unless you have a serious injury. For disputes, you can:
- Request a review by the insurer’s internal team.
- Lodge a complaint with SIRA if the insurer refuses a claim.
- Seek independent legal advice if the claim is denied.
When to Seek Advice
If your claim is denied or you’re unsure about liability, consult a solicitor. They can review your evidence, assess the insurer’s reasoning, and advise on disputing a decision. Time limits apply, so act promptly.
Next Steps
CTP entitlements depend on the accident date, injury type, and evidence. To request contact about your circumstances, complete the quick, no obligation enquiry form.