Motor vehicle accident claims in NSW: the MAIA scheme.

If you were injured in a NSW motor vehicle accident on or after 1 December 2017, your claim is governed by the Motor Accident Injuries Act 2017 (MAIA). The scheme is administered by the State Insurance Regulatory Authority (SIRA) with disputes determined by the Personal Injury Commission (PIC).

Two pathways — statutory and common-law

NSW CTP claims now run through two parallel pathways:

1. Statutory benefits (no-fault). Available to everyone injured in a motor accident, regardless of fault. Weekly payments, medical and treatment expenses, and (where threshold met) lump-sum compensation for permanent impairment.
2. Common-law damages (fault-based). Available where the other driver was “mostly at fault” AND the injured person has more than minor injury. Damages cover past and future economic loss, non-economic loss, and care.

The two pathways operate concurrently for the first 26 weeks, then become alternatives if the injured person has a non-minor injury.

What counts as “minor” vs “non-minor”

A core mechanic of MAIA is the “minor injury” definition (s1.6). A minor injury is:

• A soft-tissue injury (sprain or strain) with no permanent impairment, or
• A minor psychological or psychiatric injury (adjustment disorder, mild anxiety, mild depression without diagnosable impairment).

Anything else — fractures, surgery requirements, serious psychiatric injury, brain injury, spinal injury — is non-minor and unlocks the longer-term statutory benefits plus the common-law damages pathway.

The minor/non-minor categorisation is made by the insurer in the first instance and is disputable through the PIC. This is one of the most common disputes in NSW CTP matters.

Time limits

• Notify within 28 days to receive statutory benefits backdated to the date of accident. Notification beyond 28 days remains available but benefits run from the notification date forward only.
• Personal injury claim form must generally be submitted within 3 months of accident (extendable on good reason).
• Common-law damages claim must be filed within 3 years of the accident (extendable in limited circumstances).

The statutory benefits explained

Weekly payments

For up to 26 weeks regardless of fault. Continues beyond 26 weeks only if the injured person was not mostly at fault and has more than minor injury. Rate calculated under the Act — up to 95% of pre-injury weekly earnings for first 13 weeks; 80% for weeks 14–78; 80% with reduction for partial capacity beyond.

Medical and treatment expenses

Reasonable and necessary treatment expenses are paid by the insurer. Includes hospital, GP, specialist, physiotherapy, psychology, and pharmaceutical costs. Pre-approval often required for treatment plans beyond 6 weeks.

Domestic services

Where injury prevents the injured person performing usual home tasks, gratuitous care provided by family members can be claimed. Strict criteria apply — minimum 6 hours per week for at least 6 months.

Lump-sum impairment compensation

Where permanent impairment is assessed at 11% or more whole-person impairment (or 10%+ for psychological), a lump sum is payable. Calculated under SIRA’s schedule, ranging from $5,000 to $570,000+ depending on severity.

Common-law damages — when available

You can claim common-law damages where:

1. You have more than minor injury, AND
2. You were not mostly at fault (less than 61% contributory negligence), AND
3. You commence proceedings within the time limit.

Common-law damages cover:

• Past economic loss (lost income to date)
• Future economic loss (future earning capacity)
• Non-economic loss (pain, suffering, loss of amenities) — subject to a threshold of 10% whole-person impairment
• Past and future medical expenses
• Past and future care needs (commercial or gratuitous)

When to engage a lawyer

Statutory-only claims for minor injuries can sometimes proceed without legal representation — SIRA-funded approved advisors are available. You should engage a lawyer if:

• Your minor/non-minor classification is disputed
• The insurer has cut off your weekly payments
• You have a non-minor injury (potential common-law claim)
• You disagree with an impairment assessment
• You receive a settlement offer and need an independent view
• You are facing a contested liability or contributory negligence finding

Most NSW personal injury firms offer free first consultations and operate on no-win-no-fee for common-law work. See our no-win-no-fee guide.