So, you have been in a motor vehicle accident. You have been rendered unable to work because of your injuries. You have required medical treatment because of your injuries. You were not at fault. 26 weeks later, your insurance statutory benefits cease. Why?
Motor Accidents Injuries Act NSW (2017)
If you have been injured in an accident post 1 December 2017, your claim is ruled by the provisions of the Motor Accident Injuries Act NSW (2017) (MAIA).
Under the Act, the CTP Insurer for the driver at fault is obliged to pay your benefits for 26 weeks.
After 26 weeks, the Insurer can stop benefits if you were more than 61% at fault, or if your injuries are 'minor'.
Section 1.6 of MAIA confirms there are two types of minor injury:
- Soft tissue injury; or
- Minor psychological or psychiatric injury.
The Act sets out that a soft tissue injury is "an injury to tissue that connects, supports or surrounds other structures or organs of the body (such as muscles, tendons, ligaments, menisci, cartilage, fascia, fibrous tissues, fat, blood vessels and synovial membranes), but not an injury to nerves or complete or partial rupture of tendons, ligaments, menisci or cartilage".
The Act states an injury to a nerve root will only be non-minor if it results in radiculopathy.
In respect to a minor psychological injury, the Act provides that an acute stress disorder or adjustment disorder are considered minor.
If you have sustained multiple injuries as a result of the accident, and only one of those injuries is 'non-minor', this is enough to ensure you are looked after and paid your entitlements.
If you have received a Minor Injury Notice from the CTP Insurer, please urgently contact Kells as strict timeframes are imposed to review that determination.
Minor injury but still need treatment?
After your benefits cease, you may still require further ongoing medical treatment.
Section 3.28 (3) provides that medical treatment expenses can be paid after 26 weeks if there is evidence that the treatment is necessary to improve the recovery of our client.
Kells believes it is important for injured persons to understand the complexities of the Motor Accidents Injuries Act 2017 (NSW) and to ensure statutory benefits are paid. Please do not hesitate to contact our compensation team if you have been injured as a result of a motor vehicle accident, regardless of whether your injury is minor, non-minor or a liability decision has been made. First appointment/consultation is free and we provide a "no win, no fee" service. Home and hospital appointments are also available for your convenience.
The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.