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s 157

WPI 10% or more—injured person entitled to make motor accident claim

In force
Chapter 2Motor accident injuries—defined benefits
Part 2.6Defined benefits—quality of life benefits
Division 2.6.3Quality of life benefits—WPI assessment

157 WPI 10% or more—injured person entitled to make motor accident claim

(1)

This section applies if—

(a)

separate WPI reports from an independent medical examiner assess an injured person’s physical injuries and psychological injuries; and

(b)

the higher WPI assessment assesses the person’s WPI as at least 10%; and

(c)

the injured person is entitled to make a motor accident claim in relation to the motor accident.

(2)

This section also applies if—

(a)

only 1 WPI report from an independent medical examiner assesses an injured person’s WPI; and

(b)

the person’s WPI is assessed as at least 10%; and

(c)

the injured person is entitled to make a motor accident claim in relation to the motor accident.

(3)

The relevant insurer for the motor accident must give the injured person a written notice—

(a)

including a copy of each report; and

(b)

offering the person the amount of quality of life benefits payable for their WPI under division 2.6.4 (Quality of life benefits—amount payable); and

(c)

explaining the consequences of accepting the offer, including—

(i)

that the person is entitled to make a motor accident claim in relation to the motor accident; and

(ii)

that if the person accepts the offer and makes a motor accident claim, the person is not entitled to damages for loss of quality of life under chapter 5 (Motor accident injuries—common law damages); and

(d)

telling the person that the person must, by the due date—

(i)

notify the insurer, in writing, whether they accept or disagree with each report; and

(ii)

if the person disagrees with a report and wishes to have a second WPI assessment carried out—

(A)

arrange a second WPI assessment at their own expense; and

(B)

give the insurer the second WPI report.

(4)

The relevant insurer for the motor accident must give the notice to the injured person—

(a)

if there are separate WPI reports for the person’s physical and psychological injuries—within 14 days after receiving the later report; or

(b)

if there is only 1 WPI report—within 14 days after receiving the report.

(5)

If the injured person accepts the offer—

(a)

the injured person’s application for quality of life benefits is taken to have been finally dealt with; and

(b)

the relevant insurer must pay to the injured person the amount of quality of life benefits payable for their WPI under division 2.6.4.

(6)

If the injured person does not notify the insurer, and give the insurer the second WPI report, by the due date, the injured person’s—

(a)

application for quality of life benefits is taken to have been finally dealt with; and

(b)

entitlement to quality of life benefits in relation to the motor accident ends.

(7)

The relevant insurer must take all reasonable steps to notify the injured person about the due date and the consequences of failing to notify the insurer as stated in the notice under subsection (3) by the due date.

Examples—reasonable steps

1 including information in the written notice under s (3) about the due date and the consequences of failing to notify the insurer by the due date

2 sending the injured person a reminder notice before the due date

(8)

In this section:

complying notice of claim—see section 257.

due date means the later of—

(a)

5 years after the date of the motor accident; and

(b)

26 weeks after the person receives the notice; and

(c)

if the injured person gives a complying notice of claim—6 weeks after the date the claim is finally decided.

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