Understanding CTP Claims for Pillion Passengers in NSW
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).
A pillion passenger injured in a motorcycle accident in Greater Sydney may be entitled to compensation under the NSW Compulsory Third Party (CTP) insurance scheme. This entitlement arises under the Motor Accident Injuries Act 2017 (MAIA), which governs all CTP claims in NSW. The scheme provides financial support for medical treatment, lost income, and damages for pain and suffering, regardless of who was at fault in the accident. SIRA (the State Insurance Regulatory Authority) oversees the CTP claims process and ensures that claims are assessed according to the law and the Motor Accident Guidelines.
What Claims Are Available for Pillion Passenger Injuries?
Pillion passengers are eligible to claim under the CTP scheme if they sustained injuries as a result of a motor vehicle accident involving a motorcycle. The types of benefits available include:
- Treatment and care benefits for medical and allied health services
- Weekly income payments if the injury prevents return to work
- A lump sum payment for permanent impairment (if applicable)
- A claim for damages if the injury meets the threshold for a serious injury
SIRA confirms that pillion passengers are not excluded from CTP coverage simply because they were not operating the vehicle. The law recognises that passengers on motorcycles are at risk of injury and are entitled to the same rights as drivers or other passengers in a motor vehicle.
How SIRA Assesses Compensation for Pillion Passenger Injuries
SIRA uses a structured process to assess claims for pillion passengers. The assessment is based on the Motor Accident Guidelines, which set out the criteria for determining the value of benefits and damages. Key factors include:
- The nature and severity of the injuries
- The impact on the ability to work and perform daily activities
- The need for ongoing medical treatment
- The extent of any permanent impairment
For claims seeking damages, a threshold injury must be established. This means the injury must be serious enough to qualify under the MAIA, such as a permanent impairment of 10% or more, or a permanent loss of a body function. SIRA does not assess damages for minor or soft-tissue injuries unless they meet this threshold.
Practical Steps and Evidence That Matter
To support a claim, pillion passengers should take the following steps as soon as possible:
- Seek medical attention and keep all records of treatment
- Report the accident to the police if it involved a motor vehicle and resulted in injury
- Notify the CTP insurer of the claim within a reasonable time
- Gather and preserve evidence such as:
- Photographs of the accident scene, vehicle damage and visible injuries
- Witness contact details and statements
- Medical reports, including assessments of impairment
- Records of lost income or reduced work hours
- Correspondence with insurers or medical providers
SIRA advises that early reporting and documentation significantly improve the chances of a successful claim. Delays in notifying the insurer may affect the ability to claim weekly payments or treatment benefits.
Time Limits and Dispute Options
There is no fixed deadline for making a CTP claim in NSW, but delays may affect the availability of benefits. SIRA notes that claims should be made as soon as possible after the accident, particularly if weekly income payments are needed.
If a claim is rejected or a benefit amount is disputed, the claimant may request a review from the insurer. If the dispute remains unresolved, the claimant can apply to the Civil and Administrative Tribunal (NCAT) for a determination. SIRA provides guidance on the review and appeal process through its website and claim support services.
A Hypothetical Example: Applying the Rules in Practice
A 32-year-old pillion passenger in Sydney was injured in a collision on the M4 motorway when the motorcycle they were riding on was struck from behind by a car. The passenger sustained a whiplash injury and a minor fracture to the right wrist. Medical records confirmed a 12% whole person impairment, and the injury prevented return to work for 18 weeks. The claimant reported the accident to police, obtained medical treatment, and notified the CTP insurer within three weeks. SIRA would assess this claim based on the Motor Accident Guidelines, including the impairment rating and duration of lost income. The claimant would be entitled to treatment and care benefits, weekly income payments for the 18-week period, and a lump sum for impairment. Because the impairment exceeds 10%, the claimant may also be eligible to claim damages for pain and suffering, subject to the threshold requirements.
Next Steps for Pillion Passengers in NSW
Every claim depends on its own facts. The availability of benefits and the amount of compensation depend on the nature of the injury, the evidence supporting it, and the timing of the claim. SIRA’s process ensures that claims are assessed fairly and consistently across Greater Sydney and the rest of NSW. However, the legal and procedural details can be complex, and individual circumstances vary.
To request contact about your circumstances, complete the quick, no obligation enquiry form.