Understanding Pregnancy Injuries in NSW CTP Claims
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 in a motor vehicle accident in NSW while pregnant, you may be entitled to compensation through the Compulsory Third Party (CTP) insurance scheme. This includes injuries that affect you, your unborn child, or both. The Personal Injury Commission (PIC) assesses claims based on the Motor Accident Injuries Act 2017 and the Motor Accident Injuries Regulation 2017. The PIC’s role is to determine whether your injuries are compensable, what benefits you are entitled to, and whether a dispute arises over the nature or extent of the injury.
In Albury, as elsewhere in NSW, the PIC does not assume that pregnancy injuries are automatically compensable. Instead, it evaluates whether the injury was caused by the accident and whether it meets the legal thresholds for compensation. This includes assessing whether the injury is a threshold injury, whether it resulted in a whole person impairment, and whether it has caused a loss of income or reasonable treatment and care needs.
What the PIC Considers in Disputes Over Pregnancy Injuries
When a claim involving a pregnancy injury is disputed, the PIC will rely on medical evidence and legal criteria under the Motor Accident Injuries Act 2017. The PIC expects claimants to provide clear documentation showing that the injury occurred as a direct result of the motor vehicle accident. This includes:
- A detailed medical record from your treating practitioner, including notes on the onset of symptoms and any diagnostic imaging (such as MRI or ultrasound) performed after the accident.
- A formal assessment of whole person impairment (WPI) by a qualified medical assessor, if applicable.
- Evidence that the injury has caused a loss of income, or that you have incurred reasonable and necessary treatment and care costs.
The PIC also considers whether the injury was pre-existing or exacerbated by the accident. For example, if you had a history of back pain or pelvic instability, the PIC will assess whether the accident worsened that condition. The PIC does not accept claims based solely on a pregnancy diagnosis following an accident. The injury must be objectively demonstrated to have been caused or significantly aggravated by the crash.
Practical Steps to Support Your Claim
To strengthen your claim and reduce the risk of a dispute, you should:
- Seek medical attention immediately after the accident, even if symptoms are mild. Delayed treatment may be used to challenge the causal link between the accident and your injury.
- Keep a daily record of symptoms, including pain levels, mobility limitations, and any impact on daily activities.
- Preserve all correspondence with your insurer, including any letters disputing your claim.
- Collect and retain copies of all medical reports, treatment invoices, and proof of lost income.
If you were injured while carrying a child, the PIC may also assess whether the injury affected the pregnancy outcome. For example, if you suffered a fall or impact that led to preterm labour or fetal distress, the PIC will consider whether that was a direct result of the accident. In such cases, a fetal assessment by a specialist obstetrician may be required.
Dispute Resolution and Internal Review
If the PIC issues a decision that you disagree with, you have the right to request an internal review. This must be done within 28 days of receiving the decision. The review will be conducted by a different PIC officer and may result in a change to the original decision. You must submit all new or updated evidence during this process.
If the internal review does not resolve the dispute, you may apply to the Personal Injury Commission (PIC) for a formal review. This process allows you to present your case before a tribunal member. You may also request a medical dispute assessment if there is a disagreement about the nature or extent of your injury. The medical dispute process is governed by the Motor Accident Injuries Regulation 2017 and requires a second opinion from a specialist medical assessor.
The PIC will only change its decision if new evidence is provided that was not available during the initial assessment. The review process can take several months, so it is advisable to act promptly.
Hypothetical Example: A Claim in Albury
A 32-year-old woman was a passenger in a car that was struck from behind in Albury on 15 May 2026. She was 24 weeks pregnant at the time. She experienced sudden back pain and abdominal tightness immediately after the crash. She was taken to a local hospital, where an ultrasound showed no immediate fetal distress, but she was monitored for 48 hours. She later developed sciatica and was diagnosed with a lumbar disc herniation. Her treating doctor confirmed that the injury was caused by the impact.
She submitted her claim to the CTP insurer. The PIC initially accepted her claim for treatment and care benefits and weekly income payments. However, it later disputed her claim for damages, arguing that her injury was a threshold injury and that she had not met the 52-week threshold for damages under the Motor Accident Injuries Act 2017. She requested an internal review, submitted MRI results and a WPI assessment, and was later granted damages after the review confirmed her injury met the criteria.
When to Seek Independent Advice
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.