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).
NSW insurers assess vehicle modifications in CTP claims by evaluating their relevance to the injury, cost, and necessity. If you’ve suffered a disabling injury and require modifications like hand controls or ramps, understanding how insurers evaluate these changes is critical. This article explains the legal framework, practical steps, and time limits for claimants in Newcastle and Hunter.
How NSW CTP Insurers Assess Vehicle Modifications
Under the Motor Accident Injuries Act 2017 (MAIA), insurers must consider whether modifications are directly related to the injury and necessary for daily living. Modifications like hand controls, ramps, or adaptive devices are eligible if they address a threshold injury or whole-person impairment. However, insurers may challenge claims if modifications are deemed excessive, not medically necessary, or unrelated to the accident.
For example, if a claimant requires a ramp after a spinal injury, the insurer will assess medical evidence confirming the injury’s impact on mobility. Modifications not directly linked to the injury, such as luxury upgrades, may be denied. The key is proving the modification’s connection to the accident and its necessity for recovery.
Practical Steps for Claimants
To support your claim, gather: medical reports confirming the injury’s severity, evidence of the modification’s cost (e.g., invoices), and documentation showing the modification’s impact on daily life. Photographs of the modification and witness statements may also be relevant. Ensure all records clearly link the modification to the injury and accident.
Time Limits and Dispute Options
CTP claims must be submitted within 52 weeks of the accident if only threshold injuries are involved. If the injury exceeds threshold criteria, there’s no strict time limit, but delays may reduce the chances of securing benefits. If an insurer denies a modification claim, you can request a review or seek mediation through SIRA. Legal advice may be necessary if the insurer’s decision appears unreasonable.
When to Seek Advice
Insurers in Newcastle and Hunter may apply inconsistent standards. If your claim is denied, consult a solicitor familiar with CTP rules to challenge the decision. Legal experts can assess whether the insurer’s evaluation of your modification meets the MAIA’s requirements.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.