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 accident and weren't wearing a seatbelt, your ability to claim compensation under NSW's Compulsory Third Party (CTP) scheme may be affected. Seatbelt non-use is a key factor in determining claim validity, and mistakes in this area can reduce or eliminate entitlements. This article explains how seatbelt use impacts CTP claims, common errors to avoid, and how to navigate the process effectively in Greater Sydney.
How Seatbelt Non-Use Affects CTP Claims
Under NSW law, seatbelt use is a critical factor in assessing the validity of a CTP claim. The Motor Accident Injuries Act 2017 (MAIA) and SIRA guidelines state that failure to wear a seatbelt may reduce or eliminate compensation if the injury could have been prevented by proper use. For example, if a passenger suffered a soft-tissue injury (a 'threshold injury') but was not wearing a seatbelt, the claim may be limited or denied. This is because the injury must be 'caused by the accident' and not 'preventable by reasonable precautions' like seatbelt use.
SIRA's guidelines clarify that seatbelt non-use can affect the assessment of 'threshold injuries', injuries that meet the minimum severity criteria under the MAIA. If the injury is deemed preventable by seatbelt use, the claim may not qualify for the full range of benefits, including weekly payments or treatment costs.
Common Mistakes in CTP Claims Involving Seatbelt Non-Use
- Failing to Document Seatbelt Use: If the passenger was not wearing a seatbelt, you must provide evidence to support this. Lack of evidence may lead to the claim being dismissed. Witnesses, vehicle cameras, or medical records can help prove seatbelt non-use.
- Ignoring the 52-Week Limit for Threshold Injuries: If your injury is a threshold injury and the accident caused only such injuries, benefits like weekly payments are generally limited to 52 weeks. This applies even if the injury is ongoing. For example, if a passenger suffered a whiplash injury (a threshold injury) but was not wearing a seatbelt, the claim may be limited to 52 weeks of benefits.
- Not Seeking Medical Attention Immediately: Delayed medical treatment can weaken a claim. SIRA requires evidence that the injury was caused by the accident and not pre-existing conditions. If you waited days to seek treatment, the insurer may argue the injury was not caused by the accident.
- Assuming Fault Doesn't Matter: While CTP claims are typically no-fault, seatbelt non-use can affect the claim's validity. If the passenger's injury was preventable by seatbelt use, the claim may be denied regardless of the driver's fault.
How SIRA Guidelines Help Avoid Errors
SIRA's guidelines provide clear criteria for assessing seatbelt-related claims. For instance, they state that injuries caused by the accident must be 'caused by the accident' and not 'preventable by reasonable precautions.' This means that if a passenger's injury could have been avoided by wearing a seatbelt, the claim may not qualify for benefits. SIRA also emphasizes that evidence of seatbelt non-use is essential to support the claim.
A practical example: A passenger in a car crash suffered a soft-tissue injury but was not wearing a seatbelt. The insurer argues the injury was preventable. Under SIRA guidelines, the claim may be limited to the 52-week benefit period for threshold injuries, as the injury is deemed preventable by seatbelt use.
Time Limits and When to Seek Advice
CTP claims must be made within 52 weeks of the accident, unless the injury is not immediately apparent. If the injury is a threshold injury, the 52-week limit applies to benefits. For non-threshold injuries, the time limit is longer, but the claim must still be made promptly. Delays can lead to the claim being rejected, especially if the injury is not immediately apparent.
If you're unsure about how seatbelt non-use affects your claim, seek legal advice early. A solicitor can help you understand your options, ensure all evidence is collected, and challenge any unfair decisions by the insurer.
Next Steps
CTP claims involving seatbelt non-use require careful attention to evidence, legal criteria, and time limits. Mistakes in this area can lead to reduced or denied benefits. To ensure your claim is handled properly, gather all relevant evidence, understand the 52-week limit for threshold injuries, and seek legal advice if you're unsure about your options.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.