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 NSW and weren't wearing a seatbelt, your claim for compensation under the Compulsory Third Party (CTP) scheme may be affected. This article explains how NSW insurers assess claims involving seatbelt non-use, how this impacts treatment and rehabilitation planning, and what evidence matters. It also outlines time limits and when to seek legal advice.
How NSW CTP Rules Apply to Seatbelt Non-Use
Under the Motor Accident Injuries Act 2017, the CTP scheme covers injuries caused by motor vehicle accidents, regardless of fault. However, seatbelt use is a key factor in determining the severity of injuries. If a passenger wasn't wearing a seatbelt, insurers may argue the injury was worsened by this, potentially affecting compensation.
The Motor Accident Guidelines state that seatbelt non-use can influence the assessment of injuries. For example, if a passenger wasn't wearing a seatbelt and suffered a soft-tissue injury (like whiplash), the insurer may question whether the injury would have occurred without the seatbelt. This is known as the 'threshold injury' concept. Under the Act, only injuries meeting specific medical criteria are eligible for compensation. Seatbelt non-use may affect whether an injury qualifies as a 'threshold injury' under the guidelines.
Practical Steps and Evidence for CTP Claims
To support your claim, you'll need to provide evidence of:
- Medical records showing the injury's severity and treatment plan
- Accident reports from the police or insurance company
- Witness statements or photographs of the accident scene
- Proof of seatbelt non-use (e.g., vehicle inspection reports)
- Documentation of treatment and rehabilitation (e.g., physiotherapy records, medical opinions)
Your treatment and rehabilitation planning must align with the injury's severity. For example, if seatbelt non-use contributed to a more serious injury, your medical team must document how the injury impacts your daily life and recovery. This helps insurers assess whether your claim meets the 'threshold injury' criteria.
Time Limits and When to Seek Advice
You have 52 weeks from the accident date to claim benefits for injuries that meet the threshold injury definition. After this period, weekly payments and treatment benefits are generally limited. However, if your injury results in long-term impairment (e.g., chronic pain or mobility issues), you may still be eligible for compensation. It's crucial to act promptly and consult a legal professional if your claim is disputed.
A Hypothetical Example
Imagine a passenger in Ballina who wasn't wearing a seatbelt during a collision. They suffered whiplash and required physiotherapy. The insurer argues the injury was not severe enough for compensation. Your medical team must prove the injury meets the threshold injury definition under the Motor Accident Guidelines. If the seatbelt non-use worsened the injury, this must be documented in your treatment plan.
Next Steps
CTP claims involving seatbelt non-use depend on the accident date, injury type, and evidence provided. If you're unsure how your claim will be assessed, seek legal advice. Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.