If you have been injured in a motor vehicle accident which occurred after 1 December 2017, you may be entitled to make a claim for statutory benefits under the Motor Accident Injuries Act.
The statutory benefits payable are as follows:
- Funeral expenses
- Weekly payments for loss income
- Treatment expenses and care
If you were at fault in the accident, the above benefits are available for the first 26 weeks after the accident only. No further benefits may be claimed.
If, however, you were not at fault in the accident, you are entitled to claim the above benefits for the first 26 weeks. Beyond the first 26 weeks, you are entitled to ongoing payments of statutory benefits only if your injury is assessed as non-minor and you were not wholly or mostly at fault in the accident.
Minor injury is defined as a soft tissue injury being “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 a complete or partial rupture of tendons, ligaments, menisci or cartilage”. For a psychological injury, a minor injury is defined as an injury which is not a recognised psychiatric illness.
The insurer is required to make a determination of fault and whether an injury is minor within three (3) months of lodgement of your claim. The decision will be based upon the available evidence including any radiological investigations and treating doctor reports for minor injury determination.
If the insurer has determined that you were mostly or wholly at fault or sustained a minor injury in the accident, you are entitled to lodge an internal review with the insurer. Should the insurer confirm the decision, you are entitled to apply to the Dispute Resolution Service (DRS) for determination of the disputes.
If you are unable to alter a determination of wholly or mostly at fault or minor injury made by an insurer, then your entitlement to statutory benefits cease. Further, you are not entitled to make a damages claim which is only permitted if fault can be proved by the owner or driver of a motor vehicle and the injury is non minor. Provided they can prove fault, the injured person may claim the following damages:
- Damages from non-economic loss if injury is assesses at greater than 10% WPI
- Damages for economic loss