Benefits for injured people

Delays in payment of expenses, such as lost income, can create significant financial hardship and stress at a time when people need to recover. This can impact on a person’s ability to return to work and lead a normal life again.

The community and stakeholders told us during scheme reform in 2017, that people injured on the road should have access to support and benefits regardless of who is at fault and that these benefits should be delivered quickly.

The 2017 scheme significantly improves support for all drivers

The commencement of the 2017 scheme on 1 December 2017 introduced a six-month period of defined statutory benefits, irrespective of fault or injury severity. This provides greater support for all injured people and specifically for at-fault drivers, compared to what was available under the previous 1999 scheme.

Under the 2017 scheme, all people injured in a motor vehicle accident are entitled to 52 weeks of defined statutory benefits, which include treatment and care, return to work and vocational support, as well as weekly payments of income benefits for earners while they are off work. Additionally, injured people may receive access to treatment, such as one general practitioner consultation and two treatment consultations (for example physiotherapy), before a claim is made but after notification of an injury has been given. This is at the insurer’s discretion, having considered the injured person’s circumstances. Treatment will only be approved within the first 28 days of the accident without a claim being made. Treatment beyond the three consultations can also be approved within the 28 days.

Children

Children, 16 years and under at the time of the accident, receive treatment and care for life if necessary, irrespective of who was at-fault.

Blameless accidents

Another important aspect of the 2017 scheme is the provision of benefits for blameless accidents. This ensures that a person injured in a motor vehicle accident for which no person was at-fault is not disadvantaged when accessing benefits. Some examples of blameless accidents can include:

• A collision caused by, or with an animal on a public road
• An accident caused by debris on the road
• Poor or unsafe road conditions
• Unforeseen mechanical problems such as brake or engine failure
• An accident caused by a driver who suffered a medical episode at the wheel.

At fault drivers are receiving more benefits under the 2017 CTP Scheme

The 2017 CTP scheme has significantly increased the value of benefits paid to atfault drivers compared the 1999 scheme. Between 1 December 2017 and 30 June 2020, over $73.7 million dollars in benefits have been paid to at-fault drivers, which represented an average payment of $16,196 per claim and 17.5 per cent of overall benefits paid out to injured motorists. Between April 2010 to 30 June 2020, $17.7 million dollars in benefits were paid to 7050 at-fault drivers, with an average payment of $2,509 per at-fault ANF claim. The 1999 scheme capped payment available to at-fault drivers at $5,000.

The percentage of at-fault claims increased from 5.8 per cent of claims under the 1999 scheme, to 18.75 per cent of claims under the 2017 scheme. This reflects the increased level of support, benefits and incentives available for at-fault drivers to make a claim under the 2017 scheme.

Benefits after 52 weeks

Income benefits can continue for up to two years for people who were not at fault in the accident and whose injures are more than threshold injuries.

Medical, treatment and care benefits can continue as required, for life if necessary.

After two years

To receive income benefits after two years, a person must have made a common law claim for damages. They must also have not been at fault in the accident and their injuries cannot be threshold injuries.

The amount of extra time income benefits continue for depends on the degree of injury which can be measured by a ‘whole person impairment’ (WPI) assessment or if the insurer is satisfied that the person is over 10% whole person impaired.

Common law claim for damages

A person with more than threshold injuries can make a common law claim for damages. This type of claim for damages must be made within three years of the date of the accident. The common law claim is for past and future economic loss.

For a person with 10 per cent or less whole person impairment, weekly income benefits can continue for up to three years in total from the date of the accident) allowing time for their common law claim to be finalised.

Once the common law claim is finalised there are no further weekly income payments.

Reasonable medical and treatment benefits and commercial attendant care can be provided on an ongoing basis as needed.

For a person with 10 per cent or more whole person impairment, please read below under ‘more serious injuries’.

More serious injuries

People who are more seriously injured, with a whole person impairment of more than 10 per cent are eligible for up to five years of weekly income payments if they lodge a common law claim for damages.

A claim for damages under common law can be made up to three years after the date of the accident, and can include compensation for:

• past and future economic loss
• non-economic loss (e.g. pain and suffering).

Once the common law claim is finalised there are no further weekly income payments.

The person will continue to receive reasonable medical and treatment benefits and commercial attendant care on an ongoing basis, for life if required.

Note: A levy in the CTP scheme goes towards another scheme called Lifetime Care and Support. This is a no-fault scheme for people catastrophically injured in a road accident. This scheme is not part of this review.

Death benefits

All reasonable funeral costs for someone who dies in a motor vehicle accident will be met by the insurer.