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A Guide to Car Accident Injury Claims in NSW

24 July 2024

If you’ve sustained an injury in a motor vehicle accident in New South Wales, you might be eligible for compensation. Depending on your circumstance, your compensation can take many forms, including a lump-sum payment, ongoing medical expense coverages, or income support payments.

This guide will provide a general overview of the eligibility criteria, legal process, and types of compensation available for NSW motor vehicle accident claims. To get personalised advice on what you may be entitled to, book a free consultation with one of our personal injury lawyers.

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Motor vehicle injury claims eligibility
The legal process

Reasons for seeking legal help

Motor vehicle injury claims eligibility

Motor vehicle accidents aren’t limited to collisions between cars and trucks.

They can involve pedestrians, motorcyclists, bicyclists, buses and trains. This means those affected, and therefore those eligible to make a compensation claim, can be drivers, passengers, pedestrians, bus riders and anyone else on or near the road.

What injuries following a motor vehicle accident can I be compensated for?

If you’ve been injured in a road accident, you could be eligible for compensation.

However, the compensation you receive is impacted by:

your role (if any) in causing the injury.
the extent and nature of your injuries and others.

In assessing what injuries are compensable (and to what degree they’re compensable), insurers generally categorise injuries into the following two categories: threshold injuries and non-threshold injuries.

Threshold injuries

Threshold injuries, previously termed ‘minor injuries,’ typically include soft tissue injuries and psychological or psychiatric injuries that do not meet the criteria for a recognised psychiatric illness such as depression or PTSD.

These injuries encompass damage to muscles, tendons, ligaments and other connective tissues but exclude nerve injuries and ruptures.

Individuals with threshold injuries are generally expected to recover within a short period, and benefits are limited to an initial period of up to 52 weeks following the accident.

The exception to this 52-week benefits period is if the injured person was partially (or entirely) responsible for their injuries or if their accident took place before 1 April 2023, in which case the benefits period may be reduced to six months.

Non-threshold injuries

Non-threshold injuries are more severe and include conditions such as fractures, nerve damage, ruptured tendons, ligaments or cartilage, head injuries and internal organ damage.

Psychological injuries that qualify as non-threshold include diagnosed conditions such as depression, PTSD or specific phobias. These injuries entitle the affected individual to extended benefits beyond the initial period, including potential lump sum claims for past and future income loss, as well as non-economic losses like pain and suffering.

Lump sum compensation eligibility hinges on whether the injured person has a whole person — permanent — impairment exceeding 10%. This means that the individual’s overall functional capacity has been reduced by more than 10% due to the injuries sustained in the accident, impacting their ability to perform daily activities and work tasks.

Common permanent injuries that arise from motor accidents include:

Fractures
Spinal cord injuries
Traumatic brain injuries
Nerve damage
Joint injuries requiring surgical interventions, such as discectomies or fusions
Loss of limbs
Significant vision or hearing loss
Severe psychological conditions, like PTSD.

These injuries often result in long-term or lifelong impairment, significantly affecting the individual’s quality of life and ability to work, thus qualifying them for higher compensation under non-threshold injury claims.

Injury and impairment ratings

Examples of permanent impairment-injury ratings are as follows.

Example of Injury	Impairment Rating (Approximate)
Discectomy surgery on the lumbar spine.	10-16%
Wrist fusion surgery.	18%
Lumbar spine fusion.	21%
Joint replacement in the knee, shoulder, or hip.	21%
Loss of vision in one eye.	32%

Do you want to learn more about filing a compensation claim?

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Motor vehicle injury compensation types and payout

In the 12 months leading up to April 2024, NSW saw 12,945 reported motor accident injury claims, with a total payout of $1.44 billion in benefits and lump sums.

This amounts to an average of $111,240 paid for each new claim.

The nature of the individual’s threshold and/or non-threshold injuries influences the economic and non-economic damages they may be entitled to.

Economic damages refer to quantifiable financial losses such as medical expenses, lost income, future loss of income and travel expenses related to treatment.
Non-economic damages compensate for the non-monetary impacts, including pain and suffering, loss of enjoyment of life and permanent disability.

Consider the following implications for economic and non-economic compensation in motor vehicle accident claims.

Income support

For the first 52 weeks following a motor vehicle accident, income support payments are available — regardless of fault.
These payments compensate for lost income due to injury, with a maximum of 95% of pre-accident earnings for the first 13 weeks and 85% thereafter.
These payments help cover bills and other expenses, enabling the injured person to focus on recovery. However, after one year, payments end if the injured person is found at fault or if the injuries are classified as ‘threshold.’
To continue receiving payments beyond two years, there must be an ongoing loss of earning capacity, and a claim for damages must be lodged.

Medical expense coverage

Notably, initial treatment can be accessed without lodging a claim — simply notify the insurer, and they may approve a GP visit and two physiotherapy sessions.
For more extensive treatment, submitting a personal injury claim is necessary.
The insurer may cover all reasonable and necessary expenses related to the accident, including medical, dental, pharmaceutical, rehabilitation and travel expenses.
Ambulance and many public hospital costs are covered by the Fund levy, but some doctors’ bills are not. If a CTP claim is made, the insurer typically covers these bills. Otherwise, private health insurance or out-of-pocket payment is required.

Common law payment

Common law payments provide lump sum compensation for individuals who were not wholly at fault and have more serious injuries from a motor vehicle accident.
To be eligible, the accident must have been caused by the fault or negligence of another driver, and the injured person must have major injuries.
Claims for common law damages must be made within three years of the accident date. Compensation can include damages for economic loss and non-economic loss, provided the degree of permanent impairment exceeds 10%.
It’s important to note that medical and treatment costs are not covered under common law claims but are instead claimed through statutory (personal injury) benefits.

Gathering evidence for motor vehicle injury claims

We recommend you consult with your medical treatment providers to undergo all relevant investigations to determine if your injuries entitle you to a lump sum claim beyond the Initial Period. These treatment referrals should be sent to the CTP insurer for approval and payment.

If you have:

Physical injuries: Obtain a referral for a CT scan or MRI of the injured areas.
Pain, numbness, tingling: Obtain a referral to a specialist neurologist for nerve conduction tests if symptoms radiate from your neck to your arms or other body parts.
Scarring: Send the insurer a photo of your scarring.
Difficulty sleeping: Obtain a referral for a sleep study.
Stomach issues: Obtain a referral to a gastrointestinal specialist if experiencing constipation or diarrhoea from medication.
Psychological injuries: Obtain a referral to see a psychologist/psychiatrist and ask for a medical certificate for a diagnosis. Conditions like depression, PTSD, or specific phobia for car travel need to be assessed as non-threshold injuries.

Can I file a motor vehicle accident claim if I was at fault?

The amount of compensation you receive may be impacted by your contribution to the accident’s cause (fault). However, even if you share some fault, you may still be eligible for compensation in NSW.

‘Contributory negligence’ refers to the degree to which the injured person’s actions contributed to the accident or their injuries.

Examples of partial contributory negligence include:

Driving at an unsafe speed
Travelling with an impaired driver
Not wearing a seat belt or — where necessary — a helmet
Driving while under the influence.

In such cases, the compensation you receive may be reduced based on your level of responsibility for the accident. However, you may still be eligible for certain benefits, such as the initial $5,000 for treatment costs and lost income within the first 52 weeks after the accident, provided by the Green Slip insurance.

Green Slip insurance refers to (Compulsory Third Party) CTP insurance. In New South Wales, all vehicles must have CTP insurance, which covers the cost of compensation claims for injuries caused to other people in a motor vehicle accident. This insurance ensures that drivers, passengers, pedestrians, and other road users are financially protected if they are injured in an accident.

There are certain exceptions to contributory negligence:

Children under 16: In NSW, all children under 16 who are injured in a motor accident are covered by a Green Slip, regardless of who was at fault. This ensures they receive necessary medical treatment and support without reductions due to contributory negligence.
Severe injuries: Individuals who sustain severe injuries, such as spinal cord or brain injuries, are provided with treatment, care, and support regardless of fault through care, funded by a levy on Green Slips. Those not at fault can also claim economic and non-economic loss.
Blameless accidents: If the accident is considered blameless—such as those caused by vehicle failure or a driver suffering a medical emergency (e.g., a stroke)—those injured, except for the driver of the vehicle that caused the accident, may still be covered under their Green Slip without reductions for contributory negligence.

Book an appointment with our expert team of injury compensation solicitors.

Call 1800 004 878

Motor vehicle injury claims: The legal process

Following is an overview of what you can expect the motor vehicle accident claim process to look like.

Within 28 days of the accident: The claimant needs to report the accident to the police within this timeframe.
Within 3 months of the accident: Lodge a Personal Injury Claim Form (PICF) within three months of the accident date to ensure your claim is processed.
Within 9 months of receiving the PICF: The insurer will assess liability and make a determination within nine months of receiving your Personal Injury Claim Form.
Within 12 Months of receiving the insurer’s instructions: Obtain and submit the following documents:
- Tax returns.
- Treating doctors’ reports.
- Clinical notes.
- Payslips.
- Letters from employers.
Within 12 months from the date of the accident: Arrange for medico-legal examinations to evaluate the extent of your injuries.
Within 14 Months of receiving the insurer’s instructions: Draft statements of evidence from yourself and your careers to support your claim.
Within 15 months of receiving the insurer’s instructions: Lodge an application for Common Law Damages within this period.
Around 15 months from the accident: If there is a dispute with the insurer, your legal team will apply to the Personal Injury Commission (PIC) to assess if your impairment exceeds 10%.
Within 17-20 months of the accident: Arrange an Informal Settlement Conference once the PIC dispute is resolved or if there is no dispute regarding impairment.
Within 19-22 months of the accident: Submit a PIC application for general assessment within this timeframe.
28-day time limit: Following the PIC assessment hearing, if the award is unsatisfactory, you must lodge an appeal to the District or Supreme Court within 28 days.

Note, there’s a time limit for filing a car accident claim in NSW.

The statute of limitations is three years from the date of the accident. This means you must file your claim in court on or before the last day of this period. If you don’t file your claim by this deadline, you may lose the right to compensation.

While there may be exceptions in rare cases, it’s important to act promptly. The sooner you file your claim, the stronger your case will likely be. The evidence is fresher, witnesses are easier to locate, and it demonstrates your intent to pursue compensation.

Applying for personal benefits vs applying for common law damages

In NSW, if you expect your accident-related expenses to exceed $5,000, your recovery will take longer than six months, and you weren’t at fault for the crash, you should complete a personal injury claim form with the insurer within six months of the accident.

To be eligible for personal benefits claims in NSW, you must meet the following criteria:

Another driver or vehicle owner was partially or fully at fault for your injuries, or
The accident was ‘blameless’ (e.g., due to vehicle failure or sudden driver illness such as a stroke), or
You were under 16 and a resident of NSW at the time, regardless of who was at fault.

If you’re applying for personal benefits, you can apply online or through post.

Here’s how the process works:

Complete the form: Fill out the application for personal injury benefits form on SIRA’s website. Include as many details about the accident as possible, such as the police event number, specifics of your injuries, and the medical treatment you have received so far.
Attach supporting documents: Provide any documents or information that will help the insurer assess your claim. This should include your certificate of fitness, receipts for medical expenses, and proof of earnings, such as pay slips (photos are acceptable).
Submit to the insurer: Send the completed form and attached documents to the insurer via email or post. Using registered post is recommended as it allows you to track the delivery date of your claim form.

If you’re applying for a lump sum payment for the long-term impacts of your auto accident, here’s what the common law claim process involves:

Complete the form: Visit SIRA’s website to fill out the ‘application for damages under common law’ form and submit it to the insurer. If you haven’t already, you must also complete an ‘Application for personal injury benefits’ claim form. Consider seeking assistance from a lawyer for your common law application.
Attach supporting documents: Provide all necessary information in the forms to enable the insurer to assess your claim. This may include proof of the accident (e.g., photos, police/ambulance reports), proof of medical expenses (e.g., receipts), a Certificate of Fitness, and proof of earnings (e.g., payslips, income statements). The insurer will specify the further required documents.
Submit to the insurer: Ensure to sign the declaration and authority to verify that your statement is true and honest before sending it to the insurer.

Reasons for seeking legal help

SIRA enables you to file a motor vehicle accident compensation claim without consulting with a personal injury lawyer.

However, there are instances where the help of a qualified motor vehicle accident lawyer becomes helpful:

If you’re filing a common law claim: Navigating the complexities of common law claims can be challenging, and a lawyer can ensure you meet all eligibility criteria and deadlines. They can also help maximise your compensation by effectively negotiating on your behalf.
If you’re disputing the insurer’s decision: Insurers may deny or undervalue claims, and a lawyer can provide expertise in negotiating or appealing these decisions. They can represent your interests and increase your chances of a favourable outcome.
If a reassessment of your compensation is required due to the worsening of your condition: Over time, your injuries may worsen, affecting your ability to work and quality of life. A car accident lawyer can assist in gathering additional medical evidence and re-evaluating your claim to secure the appropriate level of compensation for your changed circumstances.

GMP Law: Expert car accident injury lawyers

We’re Australia’s leading personal injury firm. We have extensive experience helping those who’ve sustained injuries in motor vehicle accidents receive the compensation they’re entitled to.

We offer our clients our no-win, no-fee policy. This means that you can gain access to our expert legal services without the typical financial burden of such representation and legal advice. Through this policy, we take on all of your case’s upfront costs: court fees, expert witness testimony expenses, and others. We also only get paid if we win your case; in the rare instance that your case isn’t successful, this would come as no financial burden to you.

Click here to book a free, no-obligation consultation with one of our personal injury lawyers.

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