Claims – Entitlements

Benefits available for people injured in a motor vehicle accident in NSW

If you are injured in a motor vehicle accident in NSW you are entitled to benefits and you may be entitled to damages.

There are three types of benefits and there are two types of damages.

Benefits

Benefits are payable to all injured parties, regardless of fault. The period for which benefits are payable is determined by fault and the level of injury.

Three types of benefits are payable:

1. Payment for loss of income
2. Payment for medical treatment and care
3. Payment of funeral expenses.

1. Payment for loss of income

Payment for loss of income and earning capacity is available to all injured parties, regardless of fault.

The period for which payments are available varies, based on fault and the level of injury, as shown in the table below.

Payments are calculated based on pre-accident earnings and post-accident earning capacity.

Payments vary and are capped in three tranches.

		Maximum Benefit Period – Payment for Loss of Income
At Fault	All Injuries	12 months
Not at Fault	Threshold Injuries	12 months
	More than Threshold Injuries	2 years
	More than Threshold Injuries and a Claim for Damages	3 years
	More than 10% Permanent Impairment	2 years
	More than 10% Permanent Impairment and a Claim for Damages	5 years
Claims Period	Within 3 months, unless delay is justified and either within 3 years or more than 10% permanent impairment

2. Treatment and care

Injured parties are entitled to the reasonable cost of treatment and care, regardless of fault.

The period for which treatment and care is available depends on fault and the level of injury, as shown in the table below.

Treatment and care includes medical, pharmaceutical, dental, rehabilitation, ambulance, respite, attendant care, aids, appliances, prosthetics, educational and vocational training, home and transport modification, workplace and educational facility modification.

		Maximum Benefit Period – Treatment and Care
At Fault	All Injuries	12 months
Not at Fault	Threshold Injuries	12 months
	More than Threshold Injuries	Ongoing
	More than 10% Permanent Impairment	Ongoing
Claims Period	Within 3 months, unless delay is justified and either within 3 years or more than 10% permanent impairment

 3. Funeral expenses

Benefits are payable for reasonable funeral expenses.

Damages

Eligibility to claim for damages is determined by the level of injury, regardless of fault. Damages are not payable for threshold injuries.

There are two types of damages claims. They are:

1. Damage for economic loss (loss of past income and future earning capacity)
2. Damage for non-economic loss (pain and suffering).

The tables below are for each type of damages claim.

1. Economic loss

Injured parties with more than threshold injuries can claim damages for economic loss, regardless of fault.

This includes past loss of earnings and future reduced earning capacity.

	Eligibility to Claim for Economic Loss
Threshold Injuries	No
More than Threshold Injuries	Yes
More than 10% Permanent Impairment	Yes
Claims Period	Within 3 years of the accident.

2. Non-economic loss

Injured parties with more than 10% permanent impairment can claim damages for non-economic loss, regardless of fault.

This includes pain and suffering, loss of amenity and expectation of life and disfigurement.

	Eligibility to Claim for Non-Economic Loss
Threshold Injuries	No
More than Threshold Injuries	No
More than 10% Permanent Impairment	Yes
Maximum Claim	$521,000
Claims Period	Within 3 years of the accident.

At Fault means the person was wholly at fault or the contributory negligence of the person was greater than 61%.
Threshold Injury means a soft tissue injury or a psychological or psychiatric injury that is not a recognised psychiatric illness.

Note, if you were injured in a motor vehicle accident before 1 April 2023, then different benefits apply under the previous Motor Accident Guidelines.

Information in these tables is intended as a guide and for general information purposes only. It does not take into account your specific needs, objectives or circumstances, and is not advice. When making decisions about claiming, your insurance or any other matters, you must seek legal advice specific to your situation and you should not rely on these tables. While we use reasonable attempts to ensure the accuracy and completeness of the tables, we make no representation or warranting regarding the tables, to the extent permitted by law.