COMPENSATION EXPERTS

Motor vehicle claims



CAN I CLAIM?


If you are injured in a motor vehicle accident and you were not at fault you may claim compensation.
There are rules around what is covered by CTP insurance so check with us to see if you have a claim.
Time limits also apply.  For example, a claim against an unknown vehicle must be served and made compliant within 9 months of the accident.  All claims have a 3 year time limit to start Court action.

WHAT IS THE PROCESS?


There is a mandatory pre-Court process which includes:

o    give a report of the accident to police;

o    obtain a medical certificate using the claim form;

o    give notice of your claim to the CTP insurer of the vehicle at fault;

o    obtain treatment which can be funded by the CTP insurer

o    exchange information with the CTP insurer;

o    attend medical examinations; and

o    attend settlement conference.

HOW MUCH CAN I CLAIM?


Your compensation claim will usually allow damages for pain & suffering, treatment costs, lost income and voluntary care, subject to qualifying rules.
Legal costs can also be claimed, again if your claim meets regulatory limits set by law.
The value of each of these items of damage will depend on numerous factors, such as:
o    Severity of your injuries;
o    Extent of any permanent impairment;
o    Wages or earnings history and ability to return to work;
o    Care received exceeding a qualifying amount.


Your claim can be assessed once your injuries are stable and treatment completed.
All relevant information is gathered by this time, such as cost of treatment and expert opinion about your injuries.
It is strongly recommended that you do not try to settle your own claim, and especially not without first obtaining legal advice.

DO I NEED A LAWYER?


Yes.  Of course we’d say that!  Why you need a lawyer is proven by the data for claims.  People who run their own claims and settle it themselves recover significantly lower amounts than if a lawyer was engaged.
It pays to get legal advice, even just to give you peace of mind.
It is too late once you sign a discharge or release which will include a clause saying you cannot later change your mind.
It is especially important not to settle your claim too early. Medical experts commonly advise injured people that you will not know if you will fully recover until at least 9 months has passed since your accident.



Workers Compensation claims


TYPE OF CLAIMS

1.    Statutory claims


Queensland has a compulsory statutory claim system covering all workers.
If you meet legal definitions for “worker” and “injury”, and your injury is caused “by, through or in connection with your work”, then you can apply for a statutory claim.


The benefits a statutory claim pays include:
•    Treatment – including medication, doctor visits, private specialist treatment, private hospital treatment, counselling, equipment and aides and allied health treatment ( eg physio).
•    Wages – you receive a proportion of your pre-injury wages (around 80%) while you cannot resume full or part-time work.
•    Re-training or host employment – your workcover insurer will first try to get you back to your job, but if this cannot be done, they will look to place you with a host employer, or add to your employability with training or certificate course qualifications.
•    A lump sum payment for any permanent injuries – usually made after your claim has closed, and only sometimes if you ask for it.
If you receive a lump sum offer, which is set out in a Notice of Assessment, there can be strict consequences that may prevent you from later re-opening your claim or seeking additional compensation.
Do not accept a lump sum offer without first obtaining legal advice.

2.    Common law claims


If you have had a statutory claim accepted, or are entitled to have made one, you should get advice on your common law claim rights.
This is vital before you accept any lump sum offer.
A common law claim should be considered where you feel your employer is at fault for your injury, and you will have ongoing trouble with your injury and ability to work.


A common law claim process involves:
•    Serving a notice of claim on your employer at time of injury, and the workcover insurer;
•    Exchanging relevant information about your claim;
•    Being medically assessed by medical experts; and
•    Attending a settlement conference.


Your claim will cover pain and suffering, treatment costs and lost income (or impact on your ability to work).
A common law claim can involve complex legal argument on fault and the value of the claim.
It is important to obtain expert advice and support to successfully make this claim.


Public Liability claims 


Public liability claims cover injuries not suffered in car or work accidents, and typically include:
•    Slips, trips and falls in public places, commercial and residential properties;
•    Product failures causing injuries;
•    Assaults by security providers or police;
•    Other criminal assaults by third persons;
•    Animal attacks – eg dog bites;
•    School bullying and harassment;
•    Labour hire workers injured at a host employer’s workplace;
•    Medical negligence;
•    Boating accidents;
•    Recreational pursuits (eg injuries while horse riding, water sports etc).

The pre-Court process requires a notice of your claim to be given to all responsible parties, information to be exchanged and attending a settlement conference.


Public liability claims are usually strongly defended and sometimes the responsible party is uninsured.  It is important to get expert legal advice before embarking on a claim.


 

Life insurance – TPD – Income protection claims 

TPD Insurance


TPD stands for Total Permanent Disablement.
It is insurance held privately either with your superannuation fund or outside super.


Inside super – these policies will usually cover you if you are unable to work in any occupation for which you have experience, training or skills.  You need to have been out of work for at least 3 months, and up to 6 months, depending on the policy, to lodge a claim.  There are time limits for lodging a claim (eg 2 years of ceasing work, but check your policy!).  Claims paid under a super based TPD policy are subject to tax via a complicated formula.


Outside super – insurance privately obtained outside super can provide for coverage for disablement from “own occupation”.  This is a lower threshold to meet than the “any occupation” policy.  A payout is not usually taxable at time of payment.


With all claims, expert medical opinion is usually needed to substantiate you meet the policy definition.
Claims can take from 6 months (for very serious and obvious disablements) to 18 months.


Income protection insurance

This insurance covers up to 75% of your pre-tax income.  A waiting period from 2 weeks to 2 years applies before any benefit is paid.  Benefits can be paid for up to 2 years or to retirement age usually specified at 65.
Insurers require regular medical certificates (initially monthly, then later bi-monthly) and can dispute your inability to work by seeking expert medical opinion.

Life / trauma cover

Other types of medical / personal insurance are life and trauma insurance.


Life insurance pays your nominated beneficiary an agreed sum on your death. There are restrictions which relate to self harm.  The benefit does not usually form part of your estate.  The trustees of the policy will follow a binding nomination if provided.  If no binding nomination is provided, the trustee will determine your next of kin (most likely person you wanted to benefit – eg spouse, children).  The safest option is to make a binding nomination that does not expire.


Trauma insurance, or critical event insurance, provides for payment of set sums for specified injuries or ailments.  EG loss of limb, eyesight, cancer or heart attack.  These insurances can provide a safety net where income insurance does not cover say all of a house mortgage.  The policy will set out the criteria to enable a claim, and usually statements from 2 treating medical officers will be needed.

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2190 Gold Coast Hwy
Miami, Qld 4220
Australia

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