29 frequently asked questions in motor vehicle accident claims

1. What do I do if I am injured in a car accident in NSW?

To make a claim for compensation you must have sustained an injury in a motor vehicle accident in NSW. You also need to be able to demonstrate that the driver or owner of a vehicle, other than your vehicle, was partially or completely responsible for the accident.

Any kind of road user can make a claim under the Act, including; the driver, the passenger, pedestrian, cyclist or motor cyclist.

Examples where you may be partially at fault include; not wearing a seat-belt, driving whilst drunk, or travelling in a vehicle where you know the driver to be drunk or not wearing a helmet when cycling or riding a motorcycle.

There are also two special circumstances where you can make a claim under the scheme regardless of who caused the accident.

a) If the injured person is under 16 years of age and is a resident of NSW at the time of the accident you can make a claim for special benefits for hospital, common medical and rehabilitation and attendant care for any of the injuries sustained.

b) If you were injured as a result of a ‘blameless accident’ you may also be able to make a claim. A blameless accident is an accident caused by unexplained mechanical vehicle failure, driver suffering a sudden illness such as a heart attack or an unavoidable collision with an animal on the road.

There is complex law surrounding who can make a claim for a ‘blameless accident’ and you should always contact a lawyer to discuss if you have a right to make a claim.

2. What is an accident notification form?

Anyone injured in a motor vehicle accident in NSW regardless of who was at fault can receive benefits up to a maximum of $5000 by submitting an Accident Notification Form.

The Accident Notification Form provides for early payment of reasonable and necessary medical expenses up to a maximum of $5000.

The treatment expenses and loss earning expenses is payable regardless of who was at fault in the accident.

3. What compensation benefits are paid by the insurer upfront?

The only benefits that are paid upfront by the insurer are in relation to medical expenses.

Occasionally if you are seriously injured an insurer will also pay for attendant care services. Attendant care services are services that provide assistance to people with everyday tasks and activities of daily living and can include personal assistance, nursing assistance, home maintenance and domestic services.

In the majority of claims however the insurer will only pay for the cost of medical treatment up front.

Your remaining entitlements to compensation are not payable until the conclusion of the claim.

4. What if I have a dispute with the insurer about payment of medical expenses?

If the insurer refuses to pay for medical treatment which you consider are reasonable and necessary you need to make an application to the Medical Assessment Service (MAS) run by the Motor Accidents Authority of NSW.

MAS will allocate the treatment dispute to a medical assessor to resolve the disagreement.

You are likely to be examined by a medical assessor who will review your medical records, examine you and determine whether the treatment you say is reasonable and necessary is required.

A decision by the medical assessor is binding on you and the Insurer.

You should always have the assistance of a lawyer when challenging an insurers decision to not pay for treatment as this decision may have a significant impact on the whole of the claim and affect how much compensation you will ultimately receive.

5. How are claims resolved with the insurer?

If the insurance company denies there driver was at fault then your claim is resolved by going to court and having a judge hear and determine your claim.

If the insurer admits their driver was at fault then there are two ways to resolve the claim.

• Agree to a settlement with the insurance company; or
• If you are unable to reach a settlement agreement with the insurance company your claim will be determined through a dispute resolution process known as CARS run by the Motor Accident Authority of NSW.

Review our Motor Vehicle Compensation Claim Guide today.