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 a passenger in a motor vehicle accident in Ashfield and weren't wearing a seatbelt, you may have questions about your CTP compensation claim. Under NSW law, seatbelt non-use can affect the assessment of your claim, but it doesn't automatically disqualify you from receiving benefits. This article explains how SIRA evaluates such claims, what evidence is required, and common concerns injured passengers have.
How SIRA Assesses CTP Claims with Seatbelt Non-Use
SIRA (State Insurance Regulatory Authority) evaluates CTP claims based on the Motor Accident Injuries Act 2017 and guidelines. If a passenger wasn't wearing a seatbelt, SIRA will consider whether the injury would have been prevented or reduced if the seatbelt was used. This is known as the 'contributory fault' principle. For example, if a passenger suffered a soft-tissue injury that could have been avoided with a seatbelt, SIRA may reduce the compensation amount. However, if the injury was severe enough to meet the 'threshold injury' definition under the Motor Accident Guidelines, the claim may still qualify for benefits.
Evidence Required for Seatbelt Non-Use Claims
To support your claim, you'll need to provide evidence that the seatbelt wasn't used. This includes:
- Police reports or accident statements noting seatbelt non-use
- Witness statements from other passengers or drivers
- Photographs of the vehicle showing seatbelt condition
- Medical records confirming the injury's nature and severity
SIRA will also assess whether the injury meets the 'threshold injury' criteria, which includes spinal nerve-root injuries or radiculopathy. If the injury is below this threshold, benefits may be limited after 52 weeks.
Can a CTP Insurer Dispute a Seatbelt Non-Use Claim?
Yes, but the insurer must prove that the seatbelt non-use contributed to the injury. For instance, if a passenger suffered a broken leg due to not wearing a seatbelt, the insurer may argue the injury was preventable. However, if the passenger's injury was caused by a collision that would have resulted in a more severe injury regardless of the seatbelt, the claim may still proceed. SIRA will review medical evidence and accident reports to determine the claim's validity.
Legal Implications of Seatbelt Non-Use
Under NSW law, drivers and passengers are legally required to wear seatbelts. Failing to do so can affect your claim, but it doesn't mean you're entirely excluded from compensation. SIRA will consider the injury's nature, the accident's circumstances, and whether the seatbelt non-use was a significant factor. If the injury is a 'threshold injury' (as defined by the Motor Accident Guidelines), you may still qualify for treatment and care benefits.
Practical Steps for Injured Passengers in Ashfield
- Seek immediate medical attention and document all treatment records.
- Preserve evidence of the accident, including photos, witness details, and police reports.
- Notify your insurer or SIRA within the required time limits (usually 52 weeks from the accident date for benefits).
- Avoid discussing your injury or fault with anyone, as this could impact your claim.
When to Seek Legal Advice
If you're unsure whether your claim is affected by seatbelt non-use, or if the insurer is disputing your claim, it's important to consult a legal professional. A solicitor can help you understand how SIRA evaluates your specific circumstances and ensure you meet all requirements for benefits.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.