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Hurt in a Motor Accident – A Step by Step Guide to Lodging a Claim.
Being involved in a motor vehicle accident is a very stressful and frightening time. No doubt, if you have been injured in an accident you will be concerned about paying for the costs of medical treatment and the loss of wages you may sustain from being unable to return to work due to your injuries.
In order to ensure your claim in dealt with promptly, making a claim under the motor accidents scheme, should be done within 28 days of the accident and the accident must be reported to the Police.
There are two types of claims that can be made if you have an injury due to a motor vehicle accident:
1. A claim for Statutory Benefits which includes payment of medical expenses, care and income payments for time of work and:
2. A Common Law Claim for Damages – this is a claim for pain and suffering, past and future loss of income and loss of superannuation.
We provide the following step by step outline to making a claim for compensation because of a motor vehicle accident, in circumstances where you have sustained personal injury and require treatment and wage reimbursement.
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STATUTORY BENFITS CLAIM.
Step 1: You need to make a claim for statutory benefits under the NSW Motor Accident CTP Scheme within 28 days of your initial accident. To make a claim for compensation for injuries sustained in a motor vehicle accident, you need to complete an Application for Person Injury Benefits form. This form can be found on the SIRA website https://www.sira.nsw.gov.au/claiming-compensation/motor-accidents-injury-claims
This is a no fault scheme and anyone injured in an accident can obtain benefits for up to 52 weeks (for accidents post 1 April 2023) or 26 weeks (for accidents occurring between 1 December 2017 and 31 March 2023)
PRIOR TO LODGMENT.
Step 2: Prior to lodgement of the form, you need the following information to support your claim:
– A NSW Police Event Number – this is a number that you obtain from the NSW Police Service upon making a report of the motor vehicle accident to which you are involved. The Police will give you an event number or a number starting with a “E” with a series of numbers after which will correlate with the report to NSW Police.
– A medical certificate from your General Practitioner/Specialist outlining your injuries and your fitness for work.
– Evidence of your income prior to the accident – if you are claiming loss of income associated with your injuries you need to provide records to show your earnings and loss of such earning due to the accident.
– Accounts/receipts for reimbursement of medical treatment you have incurred.
IDENTIFY THE NAME OF THE CTP INSURER.
Step 3: You need to identify the name of the CTP insurer for the vehicle you believe to be most at fault. If you did not obtain these details as part of the accident process, then you can contact the State Insurance Regulatory Authority (SIRA) who maintains a registry of all CTP insured vehicles in NSW.
To obtain the relevant CTP insurer details for the vehicle most at fault, we recommend that you contact CTP Assist on 1300 656 919 or email ctpassist@sira.nsw.gov.au.
CTP Assist or CTP Connect will take some initial details from you and provide you with the right insurer for the vehicle most at fault. They will also forward your details to the relevant CTP Insurer who will then contact you and assist you further with the claims process.
NOTABLE TIME PERIODS.
To receive back payment of wages flowing directly to the accident, the CTP Insurer needs to receive a claim for compensation within 28 days of the date of accident.
If the claim is made on the Insurer after 28 days, then you will need to explain your delay in lodging the claim to be considered eligible to receive weekly payments of statutory benefits from the day of the date of accident.
For claims made outside the first 28 days, weekly payments of statutory benefits will only begin from when the day the claim is made and will not be backdated.
You can still submit a claim up to three (3) months after the accident, but it is best to submit a claim as soon as possible and within 28 days if you want payments to start directly from the day of the accident.
WAGE COMPENSATION.
In respect of compensation, you are entitled to receive income support payments under the statutory scheme where you have lost income because of your injury.
If you are off work, these payments will help you pay the bills so you can focus on getting better.
For the first 12 months (for injuries post 1 April 2023 or six months for accidents occurring between 1 December 2017 and 31 March 2023) of statutory payments, you will receive the following percentage of your pre accident earnings:
– For the first 13 weeks the maximum is 95%.
– After 14 weeks the maximum is 85% (depending on whether you have total or partial loss of earning capacity).
After 52 weeks income and medical payments end if:
– You were “wholly or predominantly” at fault or;
– Your injuries are assessed as a minor injury and do not meet the “threshold injury” as defined by the legislation.
If you do satisfy theses requirements, then income payments continue for up to after 2 years if you have an ongoing loss of earning capacity.
Medical expenses and care are payable for life.
If you then make Common Law claim for damages (see below) income support payment can be extended up to a maximum of 5 years.
MEDICAL EXPENSES.
You should be aware that you do not need to lodge a formal claim to receive early treatment. Once you have notified the relevant insurer, they can approve a GP visit and 2 treatment sessions such as physiotherapy without further documents. You can use the online accident notification system through CTP Connect or CTP Assist to lodge an early notification to the relevant CTP insurer.
If you will require more than 1 GP visit and 2 treatment sessions, it is important to submit an Application for Person Injury benefits.
The Insurer may pay for all reasonable and necessary expenses for injury resulting from the accident. This includes:
1. Medical, dental and pharmaceutical expenses;
2. Rehabilitation and treatment expenses (such as physiotherapy);
3. The cost of travelling to and from appointments; and
4. In some cases, support services (such as personal care and domestic assistance).
WHO CAN APPLY.
Anyone who is injured in a motor vehicle accident in NSW can apply. This includes:
– Drivers and passengers.
– Riders and pillion passengers.
– Pedestrians; and
– Cyclists.
The injury sustained must either be physical or psychological.
Step 4: Lodge your claim documents with the relevant CTP Insurer of the vehicle that caused the accident (if only a one vehicle accident make a claim against that vehicle). Upon lodgement of your claim, the insurer should contact you within three (3) days after you have lodged the claim. They will confirm that they have received your application and will outline the next steps in the process. They should provide you with a claim number, a case manager, and their contact details. If you need immediate medical treatment, ask the Insurer what you should do next and how you go about obtaining immediate medical care.
Step 5: Upon lodgement the Insurer will investigate your claim and shortly after let you know if they are accepting your claim. Once acceptance is received, they should start making payment towards your loss of income, medical expenses, and care.
Note – If the motor accident is also work related, you will need to make a workers compensation claim against your employers’ workers compensation insurer rather than a statutory motor accident claim.
COMMON LAW DAMAGES CLAIM.
If the car accident was not your fault and your injuries are serious (and meet the threshold injury definition of “non minor”), you may be eligible to make a common law claim for damages and receive lump sum compensation associated with your accident.
Common law damages for lump sum compensation are limited to people who:
– Have more than minor injury; and
– Where not wholly at fault for causing their injury or their accident; and
WHEN SHOULD I APPLY FOR COMMON LAW DAMAGES?
A claim for common law damages must be made within 3 years from the date of the motor vehicle accident. If you are making a claim for common law damages more than 3 years after the motor vehicle accident, you will need to provide a full and satisfactory explanation for the delay in making the claim.
Ac common law claim for damages is usually made at about 1 year following and accident.
The benefits of making a lump sum claim for common law damages is that you can claim damages for economic loss and damages for non-economic loss (if the degree of permanent impairment of the injured person is greater than 10%).
Non-economic loss is an amount of money to compensation for pain and suffering and loss of enjoyment of life. You need to be assessed as having more than 10% whole person impairment to be entitled to any compensation for pain and suffering. You will need a lawyer’s assistance to make a common law claim and have the WPI assessed.
The lump sum amount payable for pain and suffering is usually in the range of $200,000 to $400,000.00.
You also claim for economic loss, that is loss of past and future income due to the injuries sustained as well of loss of superannuation. This can be a significant amount if the injuries prevent you from undertaking your usual employment.
The amount payable varies in each claim and you will need the consult an Accredited Specialist in Personal Injury law to ensure you have the right lawyer who has the experience to get the best result for your case.
If you have been injured a motor vehicle accident and need the assistance of an expert in person injury law, contact Garling and Co lawyers. Our lawyers are accredited specialists in personal injury law and available to assist you with your claim. Contact us today by telephone at (02) 8329 9500, visit our website www.garlingandco.com.au or complete a free case assessment by clicking here.
