How SIRA assesses pre-existing injury aggravation in NSW CTP claims
If a motor accident worsens a pre-existing injury, the New South Wales Compensation and Insurance Regulatory Authority (SIRA) has specific rules to determine whether you are entitled to compensation. This is a common issue in CTP claims, especially in Greater Sydney, where many people have existing medical conditions that may be affected by a crash.
SIRA evaluates whether the injury was aggravated by the accident, not whether the injury existed before. This means that if your condition worsened after the crash, you may still be eligible for compensation, depending on the evidence.
What SIRA looks for in claims involving pre-existing injuries
SIRA assesses claims by considering the following:
- Medical evidence, You must provide medical records that show your injury worsened after the accident. This includes reports from your doctor or specialist.
- Timing of the injury, SIRA will look at when the injury was first diagnosed and whether the accident caused a significant change in your condition.
- Causal link, You must prove that the accident caused or contributed to the worsening of your injury. This is often done through expert medical opinion.
- Pre-existing injury documentation, You must provide evidence that you had the injury before the accident, such as medical records or a diagnosis.
Practical steps to support your claim
If you believe your pre-existing injury has been aggravated by a motor accident, take the following steps:
- Seek medical attention immediately, Make sure your doctor documents the worsening of your condition after the accident.
- Keep detailed records, Gather all medical records, accident reports, witness statements, and any correspondence with your insurer.
- Notify your insurer, Inform your insurer about the pre-existing injury and the accident as soon as possible.
- Consider expert opinion, In some cases, SIRA may require a specialist to provide an opinion on whether the injury was aggravated by the accident.
Time limits and when to seek advice
CTP claims in NSW have strict time limits. You must notify your insurer within 90 days of the accident, and you must submit your claim within 6 months of the accident. If you fail to meet these deadlines, your claim may be rejected.
If your claim is denied or you are unsure whether you qualify, it is important to seek legal advice. A solicitor can help you understand your options and ensure your claim is submitted correctly.
When to seek independent advice
If your claim is denied or you are unsure whether your pre-existing injury was aggravated by the accident, it is important to seek independent legal advice. A solicitor can help you understand your options and ensure your claim is submitted correctly.
How to request contact about your circumstances
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.