A plain guide to how a compulsory third party motor accident claim proceeds in New South Wales, from the statutory benefits stage through to a damages claim.
A CTP claim in New South Wales starts with a notice to the insurer of the vehicle involved, then moves through a period of statutory benefits before a separate claim for damages can begin. The system is set out in the Motor Accident Injuries Act 2017 and regulated by the State Insurance Regulatory Authority, known as SIRA.
What compulsory third party insurance actually covers
Every registered vehicle in New South Wales carries compulsory third party insurance, commonly called the green slip, and this covers almost all of the motor accidents that occur in New South Wales. It is designed to compensate people injured in motor accidents, whether they were a driver, a passenger, a rider, a cyclist, or a pedestrian. The insurer that covers the vehicle considered most at fault, or the vehicle involved if fault is unclear, is generally the one the claim is made against.
The scheme has two stages. The first is a no fault stage of statutory benefits, covering treatment, care, and lost income, available regardless of who caused the accident. The second is a claim for damages, which is only open to people who were not wholly or mostly at fault, and who meet a threshold of injury severity.
Starting the claim
A claim begins with a notification to the insurer, made either online through SIRA or directly to the relevant insurer. The claim is given a claim number and assigned a claims officer. From notification, statutory benefits can begin to be paid for reasonable and necessary treatment and care, and for a portion of lost income, while the insurer investigates liability.
Reporting the accident to police and seeking medical attention promptly both matter, because the medical record and the police report become the foundation of the claim file. A gap in either can slow down the insurer’s assessment or create room for the insurer to dispute what happened.
Statutory benefits versus a damages claim
The table below sets out the broad difference between the two stages, which is one of the most common points of confusion for claimants.
| Statutory benefits | Damages claim | |
|---|---|---|
| Fault required | No | Yes, claimant must not be wholly or mostly at fault |
| Injury threshold | No | Yes, a minimum injury severity applies |
| What it covers | Treatment, care, some lost income | A broader assessment including pain and suffering and future loss |
| When it applies | From notification | After statutory benefits, once entitlement is established |
Because the two stages ask different legal questions, a person can be receiving statutory benefits while liability for a damages claim is still being worked out. It is common for the insurer to accept some statutory benefits while contesting fault for a damages claim, and getting early advice on how the two interact is worthwhile.
Fault and contributory negligence
Where a claimant contributed to causing the accident, for example through speed, inattention, or not wearing a seatbelt, the insurer may argue that the claimant’s own compensation should be reduced by a percentage that reflects that share of the responsibility. This is contributory negligence, and it is negotiated on the evidence, including the police report, witness accounts, and any available footage. Gathering that evidence early protects the claim later, because memories fade and footage is often overwritten within a certain time frame.
Medical assessment and the injury threshold
To bring a damages claim, an injury must be accepted as a non threshold injury, which is assessed under the guidelines published by SIRA. This usually involves obtaining a diagnosis from your treating doctors or an examination by a doctor, sometimes arranged by the claimant and sometimes by the insurer. The insurer’s own examination is a normal part of the process, not a sign that the claim is in trouble, and preparing for it properly, including bringing a full account of symptoms and their effect on daily life, helps the assessment reflect reality.
Strict timeframes apply
New South Wales sets strict timeframes for notifying an accident and for bringing a damages claim, and missing them can limit or end an entitlement to compensation. One of the time limits is 28 days from the date of accident. There are some exceptions for special circumstances, but they are not guaranteed, and relying on them is risky. Anyone who has been in a motor accident, however minor it seemed at the time, should seek advice promptly rather than waiting to see whether symptoms settle on their own. For a general sense of how time limits work across personal injury claims, see our guide on time limits for personal injury claims.
How this connects to whole person impairment
For more serious injuries, the damages claim can involve an assessment of whole person impairment, the same kind of medical assessment used in other personal injury schemes. We have written separately about how whole person impairment is worked out for readers who want more detail on that part of the process.
What to do next
If you have been injured in a motor accident in New South Wales, contact us and obtain our advice, notify the insurer promptly, keep a record of your treatment and any time off work, and avoid giving a recorded statement to an insurer without first understanding how it may be used. A short conversation early can clarify whether your circumstances support both a statutory benefits claim and a later damages claim.
Try our claim check for a quick sense of where your situation stands, or contact us to talk through your options with the firm.