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).
Wildlife strikes on NSW roads are covered under the Compulsory Third Party (CTP) scheme, and claimants in regional areas have specific dispute resolution options. If you've been injured in a wildlife-related accident, understanding how to challenge a claim decision or dispute compensation is critical. This article explains the legal steps, evidence requirements, and time limits for resolving disputes under NSW CTP laws, with a focus on regional claimants.
How Wildlife Strikes Are Handled Under NSW CTP Laws
Under the Motor Accident Injuries Act 2017, wildlife strikes are treated as motor vehicle accidents if the incident involves a vehicle. The claimant must prove the accident occurred while the vehicle was in use, and the injury was caused by the collision. SIRA (State Insurance Regulatory Authority) administers the CTP scheme, and its guidelines clarify that injuries from wildlife strikes are eligible for benefits if they meet the 'threshold injury' criteria outlined in the Motor Accident Guidelines.
Key to resolving disputes is understanding the distinction between statutory benefits and common law damages. Statutory benefits (like weekly payments and treatment costs) are governed by the CTP scheme, while claims for additional compensation (e.g., for pain and suffering) fall under common law and require separate legal action. For regional claimants, SIRA's role is central, as it oversees claims processing and dispute resolution.
Practical Steps for Regional Claimants
If you're involved in a wildlife strike accident, take these steps to strengthen your claim:
- Document the incident: Record details of the strike, including the type of animal, location, time, and any witness statements.
- Seek medical attention: Obtain medical records to establish the nature and severity of your injury. SIRA requires evidence that the injury meets the threshold injury definition, which includes spinal nerve-root injuries or radiculopathy with specified clinical signs.
- Notify SIRA: Submit a claim through SIRA's online portal or contact their regional office. Ensure you provide all required documentation, including accident reports and medical evidence.
- Review SIRA's assessment: If your claim is denied or the compensation offered is disputed, request a written explanation. SIRA provides a 21-day internal review period for most claims, which is a key dispute resolution step.
Time Limits and Dispute Options
CTP claims must be submitted within 52 weeks of the accident if the injury is classified as a 'threshold injury.' If the injury is more severe, the time limit extends to 10 years. For regional claimants, delays in reporting or submitting evidence can jeopardize eligibility for statutory benefits.
If you disagree with SIRA's decision, you can:
- Request an internal review within 21 days of receiving the claim assessment.
- Appeal to the Personal Injury Commission (PIC) for a formal review. The PIC can reassess medical opinions or dispute the classification of injuries.
- Seek independent medical evidence to challenge SIRA's assessment. A medical report from a qualified practitioner may be required to demonstrate that the injury meets the threshold criteria.
Example: Disputing a Threshold Injury Assessment
Consider a claimant who was struck by a deer while cycling. SIRA initially classifies the injury as a 'threshold injury' but denies additional compensation. The claimant disputes this by providing medical records showing prolonged recovery and neurological symptoms. SIRA's guidelines require specific clinical signs for radiculopathy, so the claimant must prove the injury meets these criteria. This example highlights how evidence and SIRA's interpretation of guidelines shape dispute outcomes.
When to Seek Legal Advice
Disputes over wildlife strike claims can be complex, especially in regional areas where access to legal resources may be limited. If you face challenges with SIRA's assessment, consider consulting a solicitor specialising in CTP claims. Legal professionals can help navigate the PIC's review process, challenge medical opinions, or explore common law damages if applicable.
Next Steps for Regional Claimants
Wildlife strikes in NSW are governed by the CTP scheme, and resolving disputes requires a clear understanding of SIRA's processes. Regional claimants must act promptly, gather comprehensive evidence, and utilise the internal review and PIC pathways when necessary. Every claim depends on its own facts, and the right steps can make a significant difference in securing fair compensation.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.