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 did not wear a seatbelt, your ability to claim compensation under NSW’s Compulsory Third Party (CTP) scheme may be affected. Seatbelt use is a key factor in determining whether your injuries qualify for treatment and rehabilitation benefits. This article explains how insurers assess claims involving seatbelt non-use, the legal rules that apply, and what evidence matters most in NSW.
How Seatbelt Non-Use Impacts CTP Claims
Under the Motor Accident Injuries Act 2017 (MAIA), the NSW CTP scheme covers injuries caused by motor vehicle accidents. However, the use of seatbelts is a critical factor in assessing whether a passenger’s injuries are eligible for benefits. Seatbelts are designed to reduce the risk of serious injury, and their absence may influence how insurers evaluate the severity of your injuries.
SIRA’s guidelines state that injuries must meet specific criteria to qualify for treatment and rehabilitation benefits. For example, if a passenger did not wear a seatbelt and sustained what would otherwise be a ‘threshold injury’ (a soft tissue injury with minimal long-term impact), the injury may not meet the scheme’s requirements. This is because the absence of a seatbelt could mean the injury was more severe than it would have been, or that the injury did not occur as a result of the accident in the way it would have if the seatbelt was used.
SIRA Guidelines for Seatbelt Non-Use Cases
SIRA’s Motor Accident Claims page explains that the scheme covers treatment and rehabilitation planning for injuries that meet the ‘threshold injury’ definition under the Motor Accident Guidelines. However, seatbelt non-use may affect this assessment. For instance, if a passenger’s injuries could have been prevented or reduced by wearing a seatbelt, insurers may argue that the injury does not qualify for benefits.
In practice, insurers will consider whether the injury would have occurred without the seatbelt. If the injury is deemed to be ‘preventable’ by seatbelt use, the claim may be denied or limited. This is a key distinction under the MAIA: the scheme does not cover injuries that could have been avoided by following safety measures like seatbelt use.
Evidence and Practical Steps for Seatbelt Non-Use Claims
When seatbelt non-use is a factor, the evidence you provide will be crucial. Insurers will want to see:
- Medical records showing the nature and severity of your injuries.
- Accident reports confirming seatbelt non-use.
- Witness statements or camera footage indicating the seatbelt was not worn.
- Expert opinions from medical practitioners about whether the injury would have occurred without the seatbelt.
You should also document any treatment and rehabilitation planning, including physiotherapy sessions, medical appointments, and any advice from your treating doctor about how the injury affects your daily life. These records help insurers understand the full scope of your injuries and their impact.
Time Limits and When to Seek Advice
CTP claims in NSW have strict time limits. You must notify your insurer within 90 days of the accident, and you have 52 weeks from the date of the accident to claim benefits for injuries that meet the threshold injury definition. If your injuries do not qualify as threshold injuries, you may still have other options, such as a common law damages claim, but this requires separate legal advice.
If you are unsure whether your seatbelt non-use affects your claim, seek legal advice early. An experienced solicitor can help you understand how the MAIA applies to your specific circumstances and whether you have options for seeking compensation.
Example: How Seatbelt Non-Use Affects Treatment Planning
Consider a passenger who was not wearing a seatbelt and sustained a whiplash injury. Under the Motor Accident Guidelines, whiplash may qualify as a threshold injury. However, if the passenger’s injuries could have been prevented by wearing a seatbelt, the insurer may argue the injury does not meet the scheme’s requirements. This means the passenger may not be eligible for treatment benefits, even if they require physiotherapy.
This example shows why it is important to work with a legal professional who understands how seatbelt use affects the assessment of injuries under the MAIA.
Next Steps
CTP claims involving seatbelt non-use can be complex. The legal rules around threshold injuries, fault, and rehabilitation planning are not always straightforward. If you are unsure whether your claim is affected by seatbelt use, or if you need help with treatment planning, contact a legal professional who specializes in NSW CTP claims. Every claim depends on its own facts, and the evidence you provide will determine whether you are eligible for benefits.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.