As of 1st July 2013, the compulsory third party scheme underwent a major overhaul.
The new Act now provides a scheme for the lifetime treatment, care and support of all persons catastrophically injured in motor vehicle accidents, whether at fault or not.
The amendments to the relevant Act, Civil Liability Act, hold significant changes in relation to an entitlement to make a claim for compensation and introduces new thresholds for assessments for everyone injured in South Australia.
The amendments effectively reduce the overall benefits to many victims injured after 1 July 2013 who are not at fault, although the Government now extends compensation to some accident victims who were not covered under the previous legislation, including drivers at fault.
The major features that are different to the old CTP scheme
There is a new methodology for the assessment of damages for non economic loss (pain and suffering). This new methodology introduces an injuries scale value (ISV) and an injured person’s total pain and suffering must be assigned to a numerical value which is a scale from 0-100. The value cannot be assessed until the claimant’s medical condition is stabilised. A person can only receive compensation for pain and suffering if they are assessed as 11 points or greater on the ISV scale.
An individual is only entitled for economic loss if they meet a threshold of 8 points or greater out of 100 on the scale. In addition, there is an automatic 20% discount for damages for economic loss relating to both past and future economic loss or impairment of earning capacity.
There is now a double threshold to be met in relation to the entitlement for damages in respect of gratuitous services. Gratuitous services are the services that your immediate family provide to you as a result of your accident injuries. The first of this threshold is that the damages in respect of gratuitous services are not to be awarded unless the person is assessed at 11 points or higher out of 100. This is the same as the threshold that applies to pain and suffering.
The second threshold for gratuitous services is that it is not to be awarded unless the services are provided or is to be provided for at least six hours per week and for a period of six consecutive months.
Many victims, who would have been compensated in the past, will not pass the new thresholds outlined above.
All claimants, either short term or long term who are participants in the scheme depending on the nature of the injuries, have no pay out for future care, treatment or therapy. This is paid on an ongoing basis if the claimant is a long term participant. Generally they will be a long term participant if their injuries are catastrophic.
Medical panels have been introduced similar to those under the Workcover scheme. It will still be necessary to obtain medical evidence in support of a claim, and to issue proceedings for compensation within three years of the injury, except in relation to infant claims.