If you’ve been injured in a public place or at work, you might be able to claim for compensation. But with so much confusing insurance terminology and legal jargon out there, knowing where to start can be overwhelming.
To make the process as simple and stress-free as possible, this article provides a guide to the ins and outs of personal injury claims in NSW — who qualifies for compensation, what you can claim for and more.
What is a personal injury claim?
A personal injury is a broad term used to describe a physical or psychological injury or illness you have suffered that has occurred because of someone else’s negligence. For lots of people, it’s often the case that you need to take time off work, pay for hospital treatment or receive rehabilitation. Rather than suffer and be out of pocket because of someone else’s wrongdoing, a personal injury claim can compensate you for those losses.
How much can I get from a personal injury claim?
This depends on several factors unique to your situation — something a consultation with a qualified claims professional can help with. To get a clearer idea of how much your claim is worth, you can use our online claims calculator. Some of the specific factors that may impact how much your claim is worth include:
- The seriousness of the injury
- The impact the injury has had on your ability to work
- The circumstances in which the accident took place
- Your employment and income before the incident
Remember, your personal injury claim payout amount will depend on the extent of your injuries. While personal injury claim payouts can vary from thousands to millions of dollars, if your injury is only minor and you don’t need to take much time off work, it’s unlikely that you’ll receive millions. This is generally only for more serious injuries where you’re unable to permanently return to work and require expensive medical care.
It’s also crucial that you make sure you claim for all your injuries. In order to get the maximum amount that you deserve, it’s important that you go with a good personal injury lawyer who will take all relevant physical and psychological injuries into account.
Who qualifies for a personal injury claim?
If you’re not sure whether you qualify for a personal injury claim, ask yourself if you have been:
- Injured in an incident that was not your fault;
- Forced to take time off work to get better or receive medical care as a result of the incident.
If the above applies to you, then you probably qualify for a personal injury claim.
What types of personal injury claims qualify for compensation?
There are numerous types of personal injury claims in NSW that qualify for compensation, but they usually come under one of four categories. These are:
- Motor Vehicle Claims. This applies to those who’ve been injured in a motor vehicle incident that was someone else’s fault, whether they’re a driver, passenger, pedestrian or cyclist. You will generally receive compensation through CTP (Compulsory Third Party) insurance, which all NSW vehicles are required to have.
- Public Liability Claims. This is a pretty wide-ranging area of personal injury law that can compensate you if you’re injured in a public place. This includes slips and falls, psychological injuries, food poisoning and any other injury in a public place that’s been caused by someone else’s negligence.
- Workers’ Compensation Claims. This applies to people who’ve become injured or ill while at work or a result of their work. You’re able to file claims for immediate and long term injuries.
- Medical Negligence Claims. This covers negligence claims related to medical care and can include surgical errors, misdiagnosis, delayed diagnosis, prescribing the wrong medicines, medical results and more.
What can I claim for?
It depends on everything you’ve been through — something a lawyer will be able to help determine for you — but in many cases, you can claim for:
- Any lost wages
- Future lost wages (for example, if you have to change your job role or work less)
- Medical expenses (including rehabilitation and any travel arrangements you’ve had to make to receive care)
- General damages (this is a legal term used to refer to compensation for the negative impact the injury has had on you, physically and emotionally)
How do personal injury claims work?
Personal injury claims require you to prove that your injuries were caused by someone else’s negligence — the only exception being workers’ compensation claims. Since that can be difficult to do yourself, you often need a personal injury lawyer. They can help you put in the best possible claim.
In most cases, your claim will be paid by an insurer. This is because the person/parties you are claiming against will generally be covered for legal liability. For example, if you are injured in a car accident by another driver, their CTP insurance will protect them financially by paying you. The same is true of workers’ compensation — which is a legal requirement for employers in Australia — and public liability insurance for businesses. A personal injury lawyer is the most effective way of avoiding disputes with the insurer and getting the compensation you deserve.
What does the claims process look like?
Your personal injury lawyer will generally take the following steps:
- They’ll work out whether you have a valid claim
- Identify the insurer
- Gather evidence to support your claim. This can include medical reports, invoices or wage slips, written statements, photos, video evidence & other relevant documents.
- Submit your claim to the insurer. At this point, the insurer will accept and offer to settle, or in some cases, they might reject your claim. If neither parties can come to a settlement agreement, you can dispute the claim and take them to court
How long do I have to submit a personal injury claim?
The time limit to submit a personal injury claim is usually around three years. However, the date from which the three year period starts is not always the date you were injured; it is the date you discovered you had the injury. In legal terms, this is known as the discoverable date or date of discoverability. While for some it might be obvious when the injury occurred — like a car accident — it can often be less clear when it comes to medical negligence that you may only discover further down the line.
With that being said, it’s generally easier to submit a public injury claim as near the time it occurred as possible. The recommended time limits for personal injury claims in NSW are as follows:
- Motor Vehicle Claims. It’s advisable to submit your claim to the CTP insurer as soon as possible and no later than six months from the date of the incident.
- Public Liability Claims. In NSW, the time limitation for a personal injury claim is generally three years from the date on which you discovered you were injured.
- Workers’ Compensation. Claims can be submitted within six months of the injury or accident. This can sometimes be extended, for instance, if your injuries surface later or have had long term implications, though you may need to get approval from the State Insurance Regulatory Authority (SIRA) for this. You can find out more about making a workers’ compensation claim here.
- Medical Negligence Claims. Claims for medical negligence generally need to be brought within three years of the date of injury for adults. Exceptions can be made for children and people with disabilities.
How long does it take to settle personal injury claims in NSW?
While each claim is different, personal injury claims generally take between 12 and 18 months to be resolved. The process can vary though depending on:
- The severity of your injuries
- If the insurer denies liability
- Disputes over settlement
- If the dispute goes to court (litigation)
How are personal injury claim payouts worked out?
It’s often hard to tell how your personal injury payout is calculated. In most cases, settlements include:
- The money you lost by having to take time off work
- The money you will lose from future lost wages
- The medical expenses you paid as a result of the injury
- The travel expenses you incurred to receive that medical care
- The cost of care you needed because of your injuries, including if your partner needed to take time off to care for you
- General damages (or pain and suffering) to cover non-economic loss suffered as a result of pain, disability, loss of enjoyment of life and more
How is non-economic loss calculated?
In NSW, you are eligible for compensation for non-economic loss if your injuries are permanent and you have experienced a loss in excess of 10% of your capacities. This sounds a little tricky to determine yourself but it’s something that a personal claims lawyer can assist you with. The maximum you can generally receive for pain and suffering is approximately $521,000.
Are personal injury claim payouts taxable?
No. Whether you receive your personal injury settlement in the form of one lump sum or monthly payment, you don’t need to pay tax on it. So if a $200,000 settlement is made in your favour, that’s how much you should receive.
Will my personal injury claim affect my Centrelink payments?
Yes, any compensation payment you receive can affect the amount you get from Centrelink. For example, if you get income payments from Centrelink and then receive a lump sum for a personal injury claim, you’re essentially being compensated twice for your losses — so Centrelink will need to adjust your payments accordingly.
To avoid any confusion, let Centrelink know if you get compensation and they’ll most likely ask you to fill out a form detailing your personal injury claim settlement.
How to win a personal injury claim
Here’s how to win a personal injury claim:
- Retain as much evidence as possible. This includes written statements, details of everyone involved including eyewitnesses, photographs and video evidence.
- Have detailed medical records. Keep all your receipts related to the medical treatment you receive, from medical reports to travel expenses. It helps show that you’ve required medical treatment for the injury and ensures that you get properly reimbursed.
- Don’t forget about future damages. Many personal injury cases result in huge expenses for future damages, from ongoing medical treatment and rehabilitation to time taken off work. Make sure you take into consideration your recovery before you agree to a settlement amount.
- Stay off social media. A successful personal injury claim is all about building a clear picture that outlines what has happened to you. In some cases, a seemingly innocent social media post can conflict with that narrative, giving the insurer reason to discredit or dispute your claim. To be on the safe side, stay off social media.
- Get a personal injury lawyer. While you can submit your claim without a lawyer, their experience and expertise increase your chance of a successful claim. They’ll also take the time to know your case inside out and get you the compensation that you deserve. To avoid paying a fee if you lose, go with a lawyer that works on a no win no fee basis.
What do I do if my personal injury claim is denied?
If your personal injury claim is rejected, you still have options. Here’s what you can do:
- Ask for an internal review. Before taking the dispute to an external body (the Australian Financial Complaints Authority, AFCA) you need to try and resolve the complaint through the insurer’s Internal Dispute Resolution (IDR) department. This generally means that your dispute will be taken to a more senior level. You can do this by writing to them, or have your lawyer do it, explaining to them why you think they’ve made the incorrect decision.
- Complain to an external body. If the dispute still can’t be resolved, you can take your claim dispute to the AFCA or other relevant government body. They’ll be able to look at your claim and decide whether or not to overturn the insurer’s decision.
Go to court. If you are still not happy with the decision, you still have the option of taking the dispute to court. You generally need to do this within six years from when the claim was first made.