Pregnancy-Related Injuries and the 2017 CTP Reforms
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).
If you were injured during pregnancy in a motor vehicle accident in NSW, the 2017 reforms to the Compulsory Third Party (CTP) scheme significantly changed how claims are assessed. The reforms introduced clearer guidelines for evaluating injuries to mothers and fetuses, with a focus on clinical evidence and specific injury thresholds. This article explains how these changes affect claims in the Illawarra and South Coast regions.
How SIRA Assesses Pregnancy Injuries
The State Insurance Regulatory Authority (SIRA) administers NSW CTP claims and evaluates injuries based on the Motor Accident Guidelines. For pregnancy-related injuries, SIRA considers:
- Maternal injuries: Whether the mother’s injury meets the 'threshold injury' definition under the Motor Accident Injuries Act 2017. This includes injuries like abdominal trauma, spinal nerve-root damage, or complications such as preterm labour.
- Fetal injuries: SIRA assesses whether the fetus sustained a 'threshold injury' as defined in the guidelines. This could include conditions like cerebral palsy, brain damage, or limb abnormalities.
The 2017 reforms clarified that injuries to the mother and fetus are treated separately but are both subject to the same injury thresholds. For example, a mother with a spinal nerve-root injury (even without radiculopathy) may qualify for benefits, provided there are neurological signs.
Regional Considerations for Illawarra and South Coast
While SIRA applies uniform rules across NSW, claimants in the Illawarra and South Coast regions should note that:
- Local claim handlers may have varying interpretations of complex cases, especially where maternal and fetal injuries overlap.
- Access to medical specialists in these regions may influence the speed of claim assessments, as SIRA relies on expert opinions to determine injury severity.
- Regional trauma centres (e.g., Wollongong Hospital) are key sources of evidence for claims involving pregnancy-related injuries.
Practical Steps for Claimants
To support a pregnancy injury claim, gather:
- Medical records documenting the injury, including ultrasound reports, MRI scans, and specialist opinions.
- Accident details such as police reports, witness statements, and vehicle damage assessments.
- Evidence of impact on daily life, such as medical leave, reduced income, or increased healthcare costs.
SIRA typically requires a clinical assessment by a registered medical practitioner to confirm the injury meets the threshold. For example, a pregnant woman with abdominal trauma may need a gynaecologist’s report to establish a link between the accident and the injury.
Time Limits and Dispute Options
CTP claims must be submitted within 52 weeks of the accident for most benefits. However, claims involving pregnancy-related injuries may require extended timelines if:
- The injury’s full impact is not immediately apparent (e.g., fetal development issues).
- Additional medical testing is needed to confirm the injury’s severity.
If your claim is disputed, you may:
- Request a review through SIRA’s internal appeals process.
- Seek independent medical opinion to challenge the assessment.
When to Seek Legal Advice
While SIRA handles most claims, complex cases involving pregnancy injuries may require a solicitor to:
- Navigate fault and contributory negligence considerations.
- Challenge threshold injury determinations.
- Ensure full compensation for both maternal and fetal injuries.
Next Steps
The 2017 reforms have made pregnancy injury claims more structured, but each case depends on its unique facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.