What the PIC Can Expect in Roundabout Collision Disputes
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).
If you've been injured in a roundabout collision in NSW, understanding what the Personal Injury Claimant (PIC) can expect from CTP insurers is critical. The PIC must demonstrate that the accident caused injuries, and that the insurer’s assessment of liability or compensation is unreasonable. In disputes, the PIC must provide clear evidence of the accident’s circumstances, injuries, and how the insurer’s decision conflicts with SIRA guidelines.
NSW CTP Rules Behind Roundabout Claims
Under the Motor Accident Injuries Act 2017, CTP insurers must cover injuries caused by motor vehicle accidents, including those at roundabouts. SIRA’s guidelines state that liability is determined by whether the accident occurred in a motor vehicle context, regardless of fault. However, disputes often arise when insurers challenge the severity of injuries or the link between the accident and the claim.
Key factors include:
- Evidence of the accident: Police reports, witness statements, and traffic camera footage are crucial.
- Medical evidence: Doctors must confirm injuries align with the accident’s nature. SIRA requires medical reports to show a 'threshold injury' (e.g., soft tissue damage, whiplash) or higher.
- Liability assessment: SIRA evaluates whether the accident occurred in a motor vehicle context, even if the PIC was a pedestrian or cyclist.
Practical Steps and Evidence for Disputes
To challenge an insurer’s decision, the PIC must:
- Document the accident scene: Photos of the roundabout, vehicle positions, and road signs.
- Secure medical records: Include treatment timelines, diagnosis, and how injuries relate to the collision.
- Gather witness details: Statements from drivers, pedestrians, or cyclists who saw the incident.
- Review insurer correspondence: Keep records of all communications with the CTP insurer.
A hypothetical example: A cyclist injured at a roundabout may dispute an insurer’s refusal to cover soft tissue injuries. The PIC must show the injury aligns with SIRA’s threshold injury criteria and that the accident occurred in a motor vehicle context.
Time Limits and Dispute Resolution
CTP claims must be submitted within 52 weeks of the accident, though extensions may apply. If the insurer disputes liability or compensation, the PIC can:
- Request an internal review with the insurer.
- Appeal to the Personal Injury Commission (PIC) via the NSW Civil and Administrative Tribunal (NCAT).
- Seek legal advice if the insurer refuses to reconsider.
Disputes often hinge on whether the injury meets SIRA’s threshold and whether the accident qualifies as a motor vehicle incident. The PIC must prove the injury’s connection to the collision and that the insurer’s decision contradicts the guidelines.
Next Steps for the PIC
If your CTP claim is disputed, time and evidence are critical. The PIC must act quickly to challenge decisions that conflict with SIRA’s rules. Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.