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 were a passenger in a motor vehicle accident and weren't wearing a seatbelt, your claim for treatment costs under NSW's Compulsory Third Party (CTP) scheme may be affected. Seatbelt non-use is considered contributory negligence, which can reduce the amount of funding available for medical treatment. However, the CTP scheme still covers essential care, and regional NSW has specific considerations for accessing services. Understanding how SIRA assesses these claims is critical to securing support.
How Seatbelt Non-Use Impacts CTP Claims
Under the Motor Accident Injuries Act 2017, passengers who fail to wear seatbelts may be deemed partially at fault. SIRA’s guidelines state that contributory negligence reduces the funding available for treatment costs, but the CTP scheme still covers necessary medical care. For example, if a passenger’s injury requires physiotherapy or specialist consultations, the insurer must fund these costs unless the claimant’s failure to wear a seatbelt is found to have significantly contributed to the injury.
In regional NSW, access to medical services can delay treatment, which may affect the timing of claims. SIRA requires evidence that treatment was both necessary and timely, such as medical records showing the injury’s progression and the reason for delays. If treatment was delayed due to geographic barriers, this may be considered in assessing the claim.
Practical Steps to Support Your Claim
To fund treatment costs, you must provide:
- Medical records confirming the injury’s link to the accident
- Evidence of seatbelt non-use (e.g., vehicle camera footage, witness statements)
- Proof of treatment costs, including invoices and receipts
- Documentation of any delays in accessing care, such as travel time to regional clinics
SIRA also requires a ‘reasonable opportunity’ to seek treatment. If your injury required specialist care unavailable in your area, this may be factored into the assessment. However, failure to pursue treatment within a reasonable time could reduce the amount of funding available.
Time Limits and Dispute Resolution
CTP claims must be submitted within 52 weeks of the accident, unless an extension is granted. If your injury is classified as a ‘threshold injury’ (e.g., soft tissue damage), benefits are limited after 52 weeks. However, if your injury meets the whole person impairment threshold, you may still be eligible for long-term support.
Disputes over contributory negligence or treatment funding can be resolved through SIRA’s review process. If your claim is rejected, you may request a review by submitting additional evidence or a written explanation of why your failure to wear a seatbelt did not significantly contribute to the injury.
When to Seek Legal Advice
If your claim is denied or you’re unsure how seatbelt non-use affects your funding, contact a legal professional. They can help you:
- Challenge the assessment of contributory negligence
- Navigate regional healthcare access issues
- Ensure your claim meets SIRA’s time and evidence requirements
CTP claims involving seatbelt non-use require careful evaluation of both the injury and the circumstances of the accident. Regional NSW’s unique challenges mean your claim may need tailored support to secure funding for treatment.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.