- Do I have a claim?
Motor Vehicle Accident
If you sustain injuries in a motor vehicle accident and you can prove that
the accident was caused by the driver of the other motor vehicle (even if the identity
of that vehicle is unknown, for example hit and run) you are entitled to receive
compensation or 'damages'. In order for your Compulsory Third Party claim to be
successful, it is essential for negligence to be established on the part of the
other driver.
Work Injuries and Workers Compensation
Workers compensation in the ACT is available if you suffer personal injury arising
out of, or in the course of, your employment. A successful workers compensation
claim will enable you to recover your statutory entitlements – that is, your reasonable
and necessary treatment expenses and rehabilitation costs, as well as incapacity
payments (i.e. lost wages), and if your injuries are permanent a lump sum amount
to compensate you for that permanent impairment.
If your work injury was caused by negligence on the part of your employer or on
the part of another party, you may also be able to bring a common law negligence
claim. A common law negligence claim will enable you to recover compensation over
and above your statutory workers compensation entitlements. For example, you will
be able to recover compensation for your pain and suffering and loss of enjoyment
of life as well as compensation for any time spent by family members providing care
and assistance to you as a result of your injuries.
Comcare Claims
The Comcare scheme provides workers compensation benefits to Australian
Government employees, and to the employees of a limited number of other national
businesses, such as Australia Post. Benefits available to injured workers under
the Comcare scheme include medical expenses and rehabilitation costs; travel costs
in attending treatment; household and attendant care services; aids, appliances
and modifications; incapacity payments (i.e. lost wages); and a potential lump sum
if your injuries result in permanent impairment which exceeds the threshold. We
can advise you regarding your entitlements.
Public Liability Claims
Public liability compensation is awarded when you have suffered injuries
in an accident that occurred in a public place because of someone else’s negligence.
For example, a slip and fall in a shopping centre. You may be entitled to receive
compensation (i.e. damages) if you can prove that the accident was caused by the
negligence of a person or corporation, even if you were partly responsible for the
accident.
Medical Negligence
A medical negligence claim may arise where treatment provided by a doctor, hospital
or other health professional falls below an acceptable standard and the treatment
(or failure to treat as the case may be) causes an injury or some harm that would
not otherwise have occurred (such as the loss of an opportunity to achieve a better
outcome). For example, there may be a failure or a delay in diagnosing a condition;
a failure to make appropriate referrals; a failure or delay in providing test results;
or a failure to undertake a surgical procedure with reasonable care and skill. We
can advise you regarding any potential claim and advise you regarding the compensation
you can expect to receive if you have a successful claim.
- Do time limits apply?
Motor Vehicle Accident
Yes. For motor vehicle accidents that occur in the ACT, you must notify the Compulsory
Third Party (CTP) insurer of the at-fault vehicle that you are making a claim within
9 months of the accident, unless the insurer is the Nominal Defendant, in which
case, notice of the claim must be given within 3 months. Under the legislation,
if you provide a complying notice of claim to the insurer within 28 days of the
accident, you will qualify for payment of your medical treatment expenses up to
a maximum of $5,000 even if the insurer has not yet admitted liability. In addition,
a strict 3 year limitation period applies, which means that you must either finalise
your claim or file court proceedings within 3 years. Different provisions may apply
for injuries to children under the age of 18 years. We recommend you contact us
as soon as possible after your accident so we can fully advise you of your entitlements
and take steps to protect your interests.
Workers’ Compensation and Comcare Claims
Yes. The ACT Workers Compensation Act 1951 requires an injured worker to
tell their employer that they have a workplace injury as soon as possible after
being injured. If you are entitled to make a common law negligence claim in addition
to your statutory workers compensation claim, a 3 year limitation period applies
(i.e. you must either finalise your claim or file court proceedings within 3 years).
Under the Comcare scheme, an injured worker must give written notice of their workplace
injury to their employer as soon as practicable after they become aware of their
injury. We recommend you contact us as soon as possible after your accident so we
can fully advise you of your entitlements and take steps to protect your interests.
Public Liability Claims
For public liability claims in the ACT, notice of your claim must be given to the
respondent within either 9 months from the day of the accident or within 4 months
of instructing a solicitor, whichever is the earliest. A strict 3 year limitation
period applies (i.e. you must either finalise your claim or file court proceedings
within 3 years). Different provisions may apply for injuries to children under the
age of 18 years. We recommend you contact us as soon as possible after your accident
so we can fully advise you of your entitlements and take steps to protect your interests.
Medical Negligence
For medical negligence claims in the ACT, notice of your claim must be given to
the respondent within either 9 months from the day of the accident or within 4 months
of instructing a solicitor, whichever is the earliest. A strict 3 year limitation
period applies (i.e. you must either finalise your claim or file court proceedings
within 3 years). Different provisions may apply for injuries to children under the
age of 18 years. We recommend you contact us as soon as possible after your accident
so we can fully advise you of your entitlements and take steps to protect your interests.
- What do I need to prove?
Motor Vehicle Accident, Public Liability, and Sporting Accidents Claims
The onus is on you (with our help) to prove all aspects of your claim, on the balance
of probabilities. The insurance companies do not have to prove anything except the
extent to which you may have been the cause of the accident. We will apply for a
police report and talk to any relevant witnesses to ensure we can establish that
the other driver or other party was responsible for the accident leading to your
injuries.
Workers’ Compensation and Comcare Claims
We need to prove, on the balance of probabilities, that you were injured
in the course of your employment or that your employment or your working conditions
were a substantial contributing factor to your injury or disease or aggravation
of a pre-existing injury or disease.
Medical Negligence
Again, you are responsible for proving all aspects of your medical negligence
claim, which often depends on expert medical evidence. Essentially we need to prove,
on the balance of probabilities that your injuries were caused by the negligence
of your treating doctor or hospital. The standard of care in cases of medical negligence
has been affected by tort reform legislation and case law in Australia.
- How is the compensation paid, ie, periodically or in a
lump sum and will I have to pay tax?
Motor Vehicle Accident, Public Liability, Sporting Accidents, and Medical Negligence
Claims
Generally, compensation will be paid as a once only lump sum. Although in some motor
vehicle accident cases, the insurer may agree to make interim payments for treatment
expenses and rehabilitation costs.
Workers Compensation and Comcare Claims
A combination of periodic payments and, possibly, a lump sum payment. Tax is payable
on weekly compensation payments but not on lump sum payments.
- How long will my claim take?
Motor Vehicle Accident, Public Liability, Sporting Accident, and Medical Negligence
Claims
The length of time that your personal injury claim will take depends on the severity
of the injuries you have sustained and the type of personal injury claim that you
have.
Generally claims conclude within 2 years of the date of the accident, however, your
claim will not be finalised until your injuries have stabilised and a long-term
prognosis can be made. Of course, if this occurs reasonably quickly, your claim
can be finalised sooner.
Workers’ Compensation and Comcare Claims
The length of time that will be involved in obtaining your workers’ compensation
or Comcare depends on many factors. If your claim is not disputed, you will be paid
the weekly benefits quickly. If your claim is disputed, the length of time that
it takes for you to obtain your compensation depends on whether the dispute is able
to be resolved through settlement negotiations or conciliation or whether the dispute
needs to be resolved through the Court or Tribunal. We can provide you with advice
based on the specifics of your case.
- Will I have to go to court?
Motor Vehicle Accident, Public Liability, Sporting Accident, and Medical Negligence
Claims
Over 95% of personal injury compensation cases settle without going to Court. In
fact, most claims settle without Court proceedings even being commenced. Settlement
conferences and mediation are the most common procedures used to reach settlement.
If liability is not disputed, it is more likely your claim will be settled without
a Court hearing.
Workers’ Compensation and Comcare Claims
If your claim is disputed and not able to be settled through settlement
negotiations, it can be dealt with in the Magistrates Court (for ACT workers compensation
claims) or in the Administrative Appeals Tribunal (for Comcare claims).
- Who pays the legal costs?
Motor Vehicle Accident, Public Liability, Sporting Accident and Medical Negligence
Claims
If your claim is successful, the insurance company will pay most of the
legal costs. You will pay the difference between what the insurance company has
to pay and the actual costs. As a rule of thumb, the difference is about one third.
If you choose to pay all the disbursements (e.g. fees for medical reports) these
will be reimbursed at the end of the case. In the unlikely event that your case
is lost, we will not charge any fees but we will seek reimbursement of any disbursements
that we have paid. However, if you lose your case the insurance company may seek
to recover its costs from you. See ‘No Win, No Fee’ (hyperlink).
Workers’ Compensation Claims
If you have an ACT workers compensation statutory claim, you are protected from
paying any legal fees, with the exception of cases of fraud. We will be paid for
our work by the insurance company if your case succeeds. If you lose your case,
and it is determined that the whole of the claim was a fraud or sham, the insurance
company is entitled to seek an order that you pay its costs for the claim.
If you have a common law negligence claim in relation to your work injury and your
common law claim is successful, the insurance company will pay most of the legal
costs. You will pay the difference between what the insurance company has to pay
and the actual costs, which is generally about one third (as a rule of thumb). In
the unlikely event that your case is lost, we will not charge any fees but will
seek reimbursement of any disbursements incurred by us. However, the insurance company
may seek to recover its costs from you.
Comcare Claims
For claims under the Comcare scheme, legal costs are payable by you. If your dispute
is lodged with the Administrative Appeals Tribunal and you win your case, you can
expect to recover most of your legal costs from Comcare.
- What will the insurer pay whilst the case is being prepared?
Motor Vehicle Accident
If you lodge a complying notice of claim within 28 days of your accident, the insurance
company will pay up to $5,000 of your reasonable treatment expenses.
If the insurer has admitted liability, the insurer may pay your ongoing reasonable
medical expenses. If you have been seriously injured, the insurance company may
consider paying for services such as paid nursing care or domestic assistance (such
as house cleaning or gardening), and in appropriate cases, may pay for home and/or
transport modifications.
Workers’ Compensation and Comcare Claims
If the insurer has accepted your claim, the insurer may pay your ongoing
reasonable medical costs and rehabilitation expenses and make incapacity payments.
If you have been seriously injured, the insurance company may consider paying for
services such as paid nursing care or domestic assistance (such as house cleaning
or gardening), and in appropriate cases, may pay for home and/or transport modifications.
If liability has been denied, it is more than likely that nothing will be paid by
the insurance company.
Public Liability, Sporting Accident and Medical Negligence Claims
The insurance company is unlikely to pay your ongoing medical expenses
or rehabilitation costs; however, if your claim is ultimately successful, you will
be able to recover your full reasonable treatment expenses and rehabilitation costs.
- Can I go back to work?
Motor Vehicle Accident
If you can return to work, you should, provided your doctor certifies that
you are fit to do so.
If you were working at the time of the accident, or if you had the potential to
earn income and your injuries have stopped you from working or from realising your
potential, you are entitled to claim the loss of income or income earning potential
from the date of the accident and for as long as your injuries continue to affect
your ability to work.
Workers’ Compensation and Comcare Claims
If you can return to work, you should, provided your doctor certifies that
you are fit to do so. Your employer and workers’ compensation insurer should assist
you in returning to suitable work.
Public Liability, Sporting Accidents and Medical Negligence Claims
If you can return to work, you should, provided your doctor certifies that
you are fit to do so.
If you were working at the time of the accident, or if you had the potential to
earn income and your injuries have stopped you from working or from realising your
potential, you are entitled to claim the loss of income or income earning potential
from the date of the accident and for as long as your injuries continue to affect
your ability to work.
- What if I am held to be partially to blame for the accident?
Motor Vehicle Accident, Public Liability and Sporting Accident Claims
If you were partly responsible for the accident, the amount of compensation
you receive will be reduced by the level of your responsibility, for example, 50%
your fault means a 50% reduction in compensation.
Workers’ Compensation and Comcare Claims
Workers compensation is a no-fault system, which means that you can claim
workers compensation benefits regardless of whether you or someone else was at fault
or even if it was just an accident (but you can't claim if you deliberately self-inflict
your injury, if you were under the influence of alcohol or illicit drugs, or if
your injury is caused by your serious and wilful misconduct.
- Will I have to see any doctors?
Motor Vehicle Accident, Public Liability and Sporting Accident Claims
You should consult your own doctor as soon as possible after your injuries
for advice and treatment in relation to your injuries. The insurer may make appointments
for you to be medically assessed by its own medico-legal doctors, especially in
the case of serious or persisting injuries.
Workers’ Compensation, Comcare and Medical Negligence Claims
You should consult your own doctor as soon as possible after your injuries
for advice and treatment in relation to your injuries. The insurer may make appointments
for you to be medically assessed by its own medico-legal doctors, especially in
the case of serious or persisting injuries.
- Is the insurance company likely to follow me or spy on
me?
Motor Vehicle Accident, Workers’ Compensation, Comcare, Public Liability, Sporting
Accident and Medical Negligence Claims
It is possible that the insurance company will arrange surveillance, however, there
is nothing to fear if you act honestly and tell the truth at all times.
- How often will I need to see you?
Motor Vehicle Accident, Workers’ Compensation, Comcare, Public Liability, Sporting
Accident and Medical Negligence Claims
We will need to communicate with you regularly to keep you informed about the progress
of your claim, to obtain updates on your medical condition, etc. We will contact
you when we need to see you.