Third Party Insurance Scheme
The third party insurance scheme is regulated by Motor Accident Injuries Act 2017 (the 2017 Act). Before 1 December 2017, it was Motor Accidents Compensation Act 1999 (the 1999 Act).
Under the third party insurance scheme, compensation is available where people are killed or injured as a result of a motor vehicle accident.
The scheme was developed so that compensation is available, regardless of the financial means of the owner or driver of the motor vehicle. Under the Acts the insurer is insuring the driver against liability for injury or death caused by the fault of that driver.
Benefits available under the 2017 Act are different from the 1999 Act. Anyone injured in a motor accident before 1 December 2017 will continue to claim under the 1999 Act. This means different schemes will operate at the same time until all claims under the 1999 Act are finalised.
There are three types of benefits and there are two types of damages.
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. They are:
- Payment for loss of income
- Payment for medical treatment and care
- Payment of funeral expenses.
Eligibility to claim for damages is determined by the level of injury, regardless of fault. Damages are not payable for minor injuries. There are two types of damages claims. They are:
- Damage for economic loss
- Damage for non-economic loss.
For more detail on benefits available, see the Ultimate Guide: Entitlements.
Compensation can be for economic or non-economic loss. Economic loss includes hospital, medical and rehabilitation costs and loss of earnings. Non-economic loss is for pain and suffering and loss of quality of life. The amount of compensation is limited and is dependent on many factors.
The Act was developed on the principle of being fault based. That is, for someone to be entitled to compensation there needed to be fault on the part of the driver of a motor vehicle. The Act also excluded the at fault driver from entitlement to compensation.
While the Act remains fault based, amendments to the Act changed the fault based nature of the scheme and have extended some of the benefits available under the scheme to include at fault drivers.
Information on who and what is covered is set out on this site.
There have been four principle amendments to this scheme.
1. Special Childrens Benefit
For accidents occurring after 1 October 2006, a special childrens benefit applies. Children under 16 years of age can apply for the special childrens benefit, regardless of fault and even if they caused the accident.
2. Blameless Accidents
People killed or injured in a blameless accident occurring after 1 October 2007 are entitled to compensation, despite there being no driver at fault. A blameless accident is one where the driver of a motor vehicle which causes injury is not at fault. An example of a blameless accident is one where the driver suffered a sudden illness, where there was mechanical failure or where there was an unavoidable collision with an animal. The Act excluded the driver from making a claim in a blameless accident.
3. Bulk Billing Arrangements
For accidents occurring after 1 July 2009, the costs of hospital treatment, transport by ambulance and other treatments for at fault drivers are funded by the scheme, as they are for other injured persons. The scheme funds those costs, regardless of fault.
4. Accident Notification Provisions
For accidents occurring after 1 April 2010, the entitlement to early payment of $5,000.00 for treatment and lost earnings through lodgement of an Accident Notification Form (ANF) will be extended to include at fault drivers. The compensation available through lodgment of an ANF was increased from $500.00 from October 2008.
Despite the amendments to the scheme, at fault drivers are not entitled to the same benefits as other people injured in a motor vehicle accident.
There are benefits available under the scheme which are not included in the bulk billing arrangements and which are not included in the accident notification provisions and which have not been extended to at fault drivers. For example, at fault drivers will not be entitled to claim for:
- Medical, pharmaceutical and rehabilitation expenses incurred outside a public hospital and which exceed the $5,000.00 ANF limit
- Attendant care services or respite care services
- Home modification
- Compensation for pain and suffering and loss of quality of life
- Past loss of earnings exceeding the $5,000 ANF limit
- Future loss of earnings
Amendments to the scheme, particularly the bulk billing arrangements and the accident notification provisions have significantly changed the nature and operation of the scheme.
Benefits payable to children under 16 years of age, benefits payable to people injured in a blameless accident, the cost of hospital treatment, transport by ambulance and other treatments and the entitlement to payment of $5,000.00 through an ANF are benefits payable under the scheme regardless of who was at fault in the motor vehicle accident and are available to the driver, even if the driver was at fault.
The scheme remains fault based to the extent that it excludes at fault drivers from some benefits available to other injured persons, such as those set out above.