How NSW CTP Insurers Assess Vehicle Modifications in Claims
In New South Wales, vehicle modifications such as hand controls, ramps, or adaptive aids are considered when assessing claims under the Compulsory Third Party (CTP) scheme. The Personal Injury Commission (PIC), which administers CTP claims, evaluates whether these modifications are directly related to the injury and whether they meet the legal criteria for compensation. For example, if a driver requires hand controls after a disabling injury, the PIC will assess whether this modification is a reasonable and necessary outcome of the accident.
Practical Steps and Evidence for Vehicle Modifications
To support a claim involving vehicle modifications, injured persons must provide:
- Medical evidence linking the modification to the injury (e.g., a doctor’s report confirming the modification is medically necessary)
- Documentation of the modification (e.g., receipts, invoices, or a vehicle inspection report)
- Expert opinion from a medical practitioner or occupational therapist explaining the modification’s role in daily living
Insurers may dispute the necessity or cost of modifications. For instance, if a claimant requests a ramp for a wheelchair but the PIC questions its relevance, medical evidence must clearly show the modification is essential for mobility post-injury.
Time Limits, Disputes and When to Seek Advice
Under the Motor Accident Injuries Act 2017, weekly benefits for threshold injuries (e.g., soft tissue injuries) are generally limited to 52 weeks. If a claimant’s injuries exceed this threshold, benefits may continue beyond 52 weeks. However, disputes over vehicle modifications often require review by the PIC or the NSW Civil and Administrative Tribunal (NCAT).
If an insurer rejects a modification claim, the claimant may:
- Request a review by the PIC within 28 days of the decision
- Lodge a formal dispute with NCAT within 28 days of the PIC’s review
- Seek legal advice to challenge the decision, especially if the modification is critical for daily living
Disputes over vehicle modifications are resolved based on medical evidence and SIRA guidelines. For example, if a claimant’s hand controls are deemed unnecessary by the PIC, a medical report showing the modification’s necessity must be submitted.
Hypothetical Example: Dispute Over Hand Controls
Consider a driver who sustained a spinal injury in an Armidale road accident. After treatment, the claimant requires hand controls to operate the vehicle. The PIC disputes the modification’s necessity, arguing it’s not directly related to the injury. To resolve this, the claimant must provide:
- A medical report confirming the injury caused permanent mobility issues
- Evidence that hand controls are a standard modification for similar injuries
- A statement from an occupational therapist explaining how the modification enables independent living
This example illustrates how the PIC evaluates modifications based on medical and functional evidence.
Next Steps for Claimants
If your CTP claim involves vehicle modifications, ensure all documentation clearly links the modification to your injury. Disputes are common, but medical evidence and adherence to SIRA guidelines can strengthen your case. For personalized advice, complete the quick, no obligation enquiry form to request contact about your circumstances.