If you were pregnant and injured in a car accident in Ashfield, NSW, understanding how insurers assess your claim is critical. Under the NSW Compulsory Third Party (CTP) scheme, insurers must evaluate claims involving pregnancy-related injuries based on specific legal rules. This article explains how insurers determine liability, what evidence matters, and how claims for maternal and fetal injuries are handled under the Motor Accident Injuries Act 2017.
How CTP Insurers Evaluate Pregnancy-Related Claims
NSW CTP insurers assess claims by determining whether the injury meets the scheme’s definition of a 'threshold injury' or qualifies for damages. For pregnancy injuries, this involves:
- Medical evidence confirming injury to the mother or fetus, such as ultrasound reports or specialist notes
- Clinical impact on maternal health, including complications like preterm labor or fetal distress
- Causal link between the accident and the injury, established through medical opinion
Insurers must consider both the mother’s and fetus’s injuries under the scheme’s 'injuries to the mother and fetus' provisions. SIRA guidelines emphasize that injuries must be 'directly caused by the accident' and meet specific clinical criteria.
Key Factors for Pregnancy Injury Claims
When assessing pregnancy-related claims, insurers focus on:
- Nature of the injury - whether it’s a soft tissue injury, spinal nerve-root injury, or more severe condition
- Medical documentation - detailed records from obstetricians, maternal-fetal medicine specialists, and midwives
- Impact on daily life - evidence of reduced mobility, pain, or medical treatment required
- Fetal health - specialist reports confirming fetal injury or complications like intrauterine growth restriction
For example, if a car accident caused a pregnant woman to experience radiculopathy (nerve root irritation) with clinical signs, this would qualify under the Motor Accident Guidelines. Insurers must also consider if the injury meets the 'only injuries' threshold for statutory benefits.
Practical Steps for Claimants
To support your claim, gather:
- Medical records from obstetricians and maternal-fetal specialists
- Accident reports from NSW Police or the Transport for NSW incident log
- Witness statements from other drivers or pedestrians
- Photographs of the vehicle damage and injury-related symptoms
If you’re unsure about your evidence, contact SIRA’s claims helpline for guidance. Time limits apply - you must notify the at-fault driver’s insurer within 90 days of the accident.
Disputes and When to Seek Advice
If your claim is disputed, you may need to:
- Request a review of the insurer’s assessment
- Seek independent medical opinions
- Consider mediation through the NSW Civil and Administrative Tribunal (NCAT)
Consult a solicitor if the insurer refuses to pay for maternal or fetal injuries, or if you need help navigating the CTP scheme’s specific rules for pregnancy claims.
Next Steps
CTP claims involving pregnancy injuries require careful documentation and understanding of both maternal and fetal health impacts. While insurers must assess claims under the Motor Accident Injuries Act 2017, the process can be complex. Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.