Statutory benefits are payable for people who has sustained an injury due to a motor vehicle accident in New South Wales and is payable Under Part 3 of the Motor Accident Injuries Act 2017 (the Act).
For the first 26 weeks (and possibly longer) following a motor vehicle accident, the injured person can claim for statutory benefits provided that:
- They also do not have concurrent workers compensation benefits payable in respect of the injury;
- They are not the at-fault driver or owner of an uninsured vehicle involved in the accident;
- They have not committed a serious driving offence;
Statutory benefits may be reduced after 6 months for contributory negligence. Note that statutory benefits are payable for the first 26 weeks for injured persons until the insurer determines fault and whether their injuries are minor or non-minor for statutory benefits to continue after 26 weeks.
The Act sets out the entitlements which include:
- Payment of reasonable funeral expenses if a death of a person resulted from the motor vehicle accident;
- Reasonable and necessary treatment and care expenses relating to the injury from the accident;
- Weekly statutory benefits for the loss of earnings or earning capacity;
- Assistance in caring for any dependants.
Making a Statutory Benefits claim
A claim for statutory benefits must be made by giving notice to the relevant insurer within three months after the date of the motor accident to which the claim relates.
A claim can be made through the State Insurance Regulatory Authority (SIRA) website:
As part of our service, Alliance Compensation & Litigation Lawyers may make the claim directly with the relevant insurer on your behalf.
To be entitled to receive weekly payments for loss of income from the date of the motor accident, a claim for statutory benefits must be made within 28 days of the date of the accident.
If a claim is made outside of the three months after the date of accident, the claimant must provide a full and satisfactory explanation for the delay. This is usually provided through a signed statutory declaration.
Weekly Payments for loss of earnings or earning capacity
The insurer will pay for loss of earnings on a fortnightly basis. The payments do not include superannuation, sick leave, or annual leave.
For the first 13 weeks following the motor accident, the injured person is entitled to 95% of the difference in their pre-accident weekly earnings and post-accident earning capacity.
From weeks 14 to 78, the injured person is entitled to 85% of the difference between pre-accident and post-accident earning capacity in the case of partial incapacity or 80% of the difference in the case of total incapacity.
The injured person will need to regularly consult with their treating General Practitioner to obtain an up to date Certificate of Capacity which assesses their capacity and treatment needs.
Treatment and Care
The injured person is entitled to reasonable and necessary treatment and care expenses relating to the injury from the accident.
Examples of such treatment and care include:
- GP consultations;
- Referrals to specialists;
- Physiotherapy;
- Psychological treatment and counselling;
- Radiological investigations;
- Cortisone injections;
- Surgical procedures;
- Home and domestic assistance;
- Travel expenses;
- Personal aids such as orthotics and crutches;
- Exercise and gym programs aiding recovery;
- Rehabilitation services and vocational support.
Funeral expenses
If someone passes away due to a motor vehicle accident, the insurer will pay for the reasonable and necessary funeral expenses.
Caring for dependants
The injured person is entitled to be compensated for having to employ outside assistance to care for their dependants.
The Act restricts the definition of โdependantโ to include a person who is legally married or a de facto partner, a child, grandchild, sibling, uncle, aunt, niece, nephew, parent or grandparent, or other member of a household. The Act also includes any unborn child of the injured person at the time of the accident who is born after that time.