Permanent Impairment Threshold and Time Limits for 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).
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).
Under New South Wales law, a claim for permanent impairment under the Compulsory Third Party (CTP) scheme requires a whole person impairment of at least 10%. This threshold is defined by the Motor Accident Guidelines and assessed by the State Insurance Regulatory Authority (SIRA). If your injury results in a 10% or greater impairment, you may be eligible for compensation. However, time limits apply.
Key Legal Framework for CTP Claims
The Motor Accident Injuries Act 2017 governs CTP claims. Section 4.4 of the Act specifies that claims for injuries must be made within 52 weeks of the accident date. This applies to all CTP claims, including those for permanent impairment. If your injury is a 'threshold injury' (10% or more), you must file your claim within this period. After 52 weeks, benefits for threshold injuries stop, but permanent impairment claims are not automatically excluded.
How SIRA Assesses Permanent Impairment Claims
SIRA uses the Motor Accident Guidelines to evaluate injuries. A medical report from a registered medical practitioner is essential. The assessment considers factors like the nature of the injury, medical evidence, and how the impairment affects daily life. For example, a 12% whole person impairment would qualify, while a 5% injury would not. The Illawarra and South Coast regions follow the same SIRA guidelines as other NSW areas.
Practical Steps for Claiming Permanent Impairment
- Seek medical attention: Document your injury with a medical report. This is critical for proving the 10% threshold.
- Gather evidence: Collect accident details, witness statements, and medical records.
- Notify the insurer: Contact the at-fault driver’s CTP insurer within 52 weeks.
- Submit a claim: Use the SIRA online portal or contact their claims team. Delaying could jeopardize your right to claim.
Hypothetical Example
Imagine a car accident in the Illawarra region causes a knee injury. A medical report states a 12% whole person impairment. This meets the 10% threshold, so you can claim. However, if the report states only a 7% impairment, you cannot. The 52-week deadline applies regardless of the injury type.
When to Seek Legal Advice
If your claim is denied, or if you’re unsure about your eligibility, consult a solicitor. Time limits are strict, and SIRA assessments can be complex. Legal advice ensures you meet all requirements and understand your options.
Next Steps
CTP claims depend on the accident date, injury type, and evidence. To request contact about your circumstances, complete the quick, no obligation enquiry form.