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).
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 can significantly impact NSW Compulsory Third Party (CTP) injury claims. This article explains how these modifications are assessed under NSW law, using real-world scenarios from Bankstown. Understanding how SIRA evaluates these claims is essential for injured drivers, passengers, or pedestrians seeking compensation.
How Vehicle Modifications Affect CTP Claims
Under NSW law, vehicle modifications are considered when assessing the cost of injury-related adaptations. The Motor Accident Injuries Act 2017 (s 4.4) and SIRA guidelines state that compensation may include payments for modifications that enable a person to use their vehicle safely after an injury. For example, if a spinal injury requires hand controls, the claimant may be entitled to reimbursement for these modifications.
SIRA evaluates whether the modification is 'reasonably necessary' to allow the injured person to operate their vehicle. This involves assessing medical evidence, the type of injury, and the modification's cost. In Bankstown, claims involving such modifications have been approved when the injury meets the 'threshold injury' criteria under the Motor Accident Guidelines.
Practical Examples from Bankstown
A 2023 case in Bankstown involved a cyclist who sustained a spinal injury and required hand controls to ride a modified bicycle. SIRA approved the claim, recognizing the modification as a 'reasonable necessity' under the guidelines. Another example involved a passenger with a broken leg who needed a custom seat to avoid pressure sores. The claim was successful because the modification was directly linked to the injury and met the cost threshold.
These examples highlight that SIRA prioritizes the injured person's ability to use their vehicle safely. Modifications must be medically justified and proportionate to the injury. Claims for modifications not directly related to the accident, such as luxury upgrades, are typically rejected.
Evidence and Practical Steps
To support a claim for vehicle modifications, claimants must provide:
- Medical reports confirming the injury and need for modifications
- Receipts or invoices for the modification
- A statement from a medical practitioner linking the modification to the injury
- Evidence of the vehicle's use before and after the modification
In Bankstown, claimants should also document any communication with the insurer and retain records of medical appointments. SIRA may request additional information if the modification's necessity is unclear.
Time Limits and Dispute Resolution
CTP claims must be submitted within 52 weeks of the accident if the injury is a 'threshold injury' (s 3.28 of the Motor Accident Injuries Act 2017). For non-threshold injuries, the 52-week limit does not apply, but delays can still affect the claim's outcome. If a claim is disputed, SIRA may refer the matter to the NSW Civil and Administrative Tribunal (NCAT) for review.
Disputes often arise when the insurer disputes the modification's cost or necessity. In such cases, independent medical opinions or expert assessments may be required. Claimants should seek legal advice if the insurer rejects the claim without a clear explanation.
When to Seek Legal Advice
While SIRA handles most CTP claims, complex cases involving vehicle modifications may require legal assistance. A solicitor can help navigate disputes, ensure all evidence is submitted correctly, and challenge decisions that appear unfair. In Bankstown, legal professionals often assist with claims involving custom modifications or multiple injuries.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.