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've suffered a pregnancy-related injury in a car accident in Bankstown, NSW, understanding how to claim compensation under the Compulsory Third Party (CTP) scheme is critical. Common mistakes during the claims process can lead to denied benefits or reduced payouts. This article explains how to avoid these errors, based on NSW law and SIRA guidelines.
Key Legal Rules for Pregnancy Injuries
Under NSW CTP rules, injuries to a pregnant woman and her fetus are treated as a single claim. SIRA’s guidelines state that maternal and fetal injuries must be documented in medical records to qualify for benefits. For example, if a car accident causes a spinal nerve-root injury with neurological signs (even without radiculopathy), it may still fall under the soft-tissue threshold injury definition. However, pregnancy-related injuries are assessed separately and must meet the 'only injuries' criteria outlined in the Motor Accident Injuries Act 2017, s 4.4. This means claims must demonstrate that the injury directly resulted from the accident and was not pre-existing.
Practical Steps to Avoid Errors
- Document fetal injuries: Medical records must clearly show how the accident caused harm to the fetus, such as placental abruption or fetal distress. Failing to record these details can weaken the claim.
- Preserve evidence: Gather accident reports, witness statements, and photographs of the scene. If the injury required emergency care, ensure hospital records note the connection between the accident and the pregnancy-related harm.
- Notify the insurer: Contact the at-fault driver’s CTP insurer within 52 weeks of the accident. While there’s no strict deadline, delays can jeopardize claims for treatment and care benefits.
Time Limits and Dispute Options
Claims for pregnancy-related injuries must be made within 52 weeks of the accident if they involve only threshold injuries (e.g., soft-tissue injuries). If the injury exceeds the threshold, the 52-week limit does not apply, but benefits may still be restricted. If your claim is disputed, SIRA’s dispute resolution process allows for independent medical assessments. However, delays in submitting evidence or failing to meet SIRA’s documentation standards often lead to rejected claims.
When to Seek Advice
Common mistakes include assuming that all pregnancy injuries qualify for benefits or failing to address pre-existing conditions. For example, a claimant who did not document fetal heart rate abnormalities after an accident may lose compensation for fetal distress. A solicitor can help ensure medical records clearly link the injury to the accident and that all SIRA requirements are met.
Example of a Common Error
Consider a claimant who suffered a car accident and later experienced fetal complications. If the medical team did not record the connection between the accident and the injury, the claim may be denied. Proper documentation, such as a statement from the obstetrician, is essential to avoid this error.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.