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).
Vehicle modifications such as hand controls or mobility aids are critical for injured claimants in rural and remote NSW to regain independence. Under the NSW Compulsory Third Party (CTP) scheme, these modifications are assessed as part of the claim for daily activity recovery, but specific rules apply. This article explains how vehicle modifications impact CTP claims, the SIRA guidelines governing modified vehicles, and practical steps for rural claimants navigating recovery timelines.
How Vehicle Modifications Affect CTP Claims
The NSW CTP scheme covers injuries resulting from motor vehicle accidents, including modifications required to enable daily activities. Under the Motor Accident Injuries Act 2017, claimants must demonstrate that modifications are necessary due to a threshold injury, a defined level of harm under the Motor Accident Guidelines. For example, a spinal nerve-root injury producing neurological signs may qualify for hand controls or other aids.
SIRA (State Insurance Regulatory Authority) assesses whether modifications are 'reasonably necessary' and proportionate to the injury. Rural claimants must provide evidence such as medical reports detailing mobility limitations and how modifications address them. This includes documenting how modifications enable tasks like cooking, shopping, or managing household chores.
SIRA Guidelines for Modified Vehicles
SIRA’s approach to modified vehicles focuses on functionality and necessity. Key considerations include:
- Whether the modification directly addresses a threshold injury
- The cost of the modification relative to the injury’s severity
- The claimant’s ability to perform daily activities without the modification
For rural areas, SIRA may consider additional factors such as limited access to specialist equipment or longer travel distances. Claimants should retain records of all modifications, including invoices, medical advice, and any correspondence with insurers.
Practical Steps for Rural Claimants
Rural claimants face unique challenges, including longer travel times to medical services and limited access to specialists. To support a CTP claim for daily activity recovery:
- Obtain medical evidence confirming the need for modifications
- Document how modifications improve independence (e.g., through a diary or photographs)
- Notify your insurer promptly about modifications
- Seek advice on meeting the 52-week statutory benefit limit for threshold injuries
Time limits are critical. Under the Motor Accident Injuries Act 2017, weekly benefits and treatment payments generally stop after 52 weeks if only threshold injuries are involved. Rural claimants must ensure their claim timeline aligns with these rules.
When to Seek Legal Advice
Disputes may arise if insurers question the necessity of modifications or the injury’s severity. For example, an insurer might argue that a hand control is not 'reasonably necessary' for a low-severity injury. In such cases, claimants should consult a solicitor experienced in rural CTP claims to:
- Challenge adverse assessments
- Ensure modifications are properly documented
- Navigate jurisdiction-specific challenges like remote access to services
Example Scenario
Consider a rural claimant who sustained a soft-tissue injury requiring hand controls to manage household tasks. SIRA would assess whether the injury meets the threshold injury definition under the Motor Accident Guidelines. If the claimant can demonstrate that the modification enables independent living, the CTP scheme must cover the cost.
Next Steps
CTP entitlements depend on the accident date, injury type, and claim history. Rural claimants must act promptly to preserve their rights. For tailored advice on vehicle modifications and daily activity recovery, complete the quick, no obligation enquiry form.