How Seatbelt Non-Use Affects CTP Claims in NSW
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 accident and weren't wearing a seatbelt, this could impact your claim under NSW's Compulsory Third Party (CTP) scheme. The Motor Accident Injuries Act 2017 (MAIA) governs CTP claims, and SIRA (State Insurance Regulatory Authority) assesses whether injuries meet the criteria for compensation. Seatbelt non-use may reduce or eliminate entitlements if it's deemed a contributing factor to the injury. For example, if a passenger wasn't wearing a seatbelt and suffered whiplash, SIRA might argue the injury was partly due to the passenger's failure to use the seatbelt, which could limit or deny benefits.
Common Mistakes in CTP Claims Involving Seatbelt Non-Use
- Failing to Document Seatbelt Use: If the passenger wasn’t wearing a seatbelt, you must prove this. Witnesses, dashcam footage, or statements from other passengers are critical. Without evidence, SIRA may assume the seatbelt was used, weakening your claim.
- Not Seeking Immediate Medical Attention: Delayed treatment can lead to disputes. If the passenger didn’t seek medical care promptly, SIRA might argue the injury wasn’t serious or was caused by pre-existing conditions.
- Ignoring SIRA’s Threshold Injury Rules: Under the MAIA, only injuries meeting the 'threshold injury' definition (such as soft tissue injuries with spinal nerve-root damage) qualify for benefits. If the passenger’s injuries don’t meet this, SIRA may deny claims.
- Not Notifying the Insurer Promptly: CTP claims have strict time limits. Failing to notify the at-fault driver’s insurer within 52 weeks of the accident could result in lost benefits, especially if the passenger’s injuries are limited to threshold injuries.
How SIRA Assesses Seatbelt Non-Use Claims
SIRA evaluates claims based on medical evidence, accident reports, and witness statements. If the passenger wasn’t wearing a seatbelt, SIRA may consider this a contributing factor to the injury. For example, if a passenger wasn’t buckled and suffered a neck injury, SIRA might argue the injury was partly due to the passenger’s failure to use the seatbelt. This could reduce the amount of compensation or exclude certain benefits, such as weekly income payments.
Practical Steps to Avoid Claim Rejections
- Collect Evidence: Gather medical records, accident reports, and witness statements to prove seatbelt non-use and the passenger’s injuries.
- Seek Medical Attention Immediately: Document the injury with a medical professional to establish its severity and link it to the accident.
- Notify the Insurer Within 52 Weeks: If the passenger’s injuries are limited to threshold injuries, failing to notify the insurer within 52 weeks may result in lost benefits.
- Consult a Specialist: SIRA’s guidelines are complex. A legal professional can help ensure your claim meets all requirements.
When to Seek Legal Advice
If your claim is rejected or delayed due to seatbelt non-use, it’s essential to seek legal advice. A solicitor can review SIRA’s decision, challenge the assessment of your injuries, and ensure you receive the compensation you’re entitled to under the MAIA.
Next Steps
CTP claims involving seatbelt non-use can be complex, especially on the Illawarra and South Coast. Time limits, evidence requirements, and SIRA’s interpretation of injuries all play a role in determining your entitlements. To request contact about your circumstances, complete the quick, no obligation enquiry form.