Do TAC claims go to court?
TAC claims do, from time to time, go to Court depending upon what the issues involved are.
We unpack all the scenarios in this article.
Statutory benefit claims
Statutory benefits are your basic entitlements through the TAC – like medical and like expenses, weekly payments and an impairment benefit.
Most of these benefits are payable as a right if you have an accepted TAC claim – you don’t need to go to Court to get these benefits in the first place.
There can be occasions where your benefits are reduced or stopped, or in some circumstances your TAC claim for statutory benefits might be rejected.
How to resolve a dispute about statutory benefits
The way to resolve a dispute about statutory benefits will vary slightly depending upon whether you have a lawyer involved or not, and if you do, whether that lawyer uses that TAC dispute resolution protocols.
Most law firms that are involved in regular TAC work do use the dispute resolution protocols.
If there is a dispute regarding your statutory entitlements, the first step is to go through the protocol process.
This involves meeting with the TAC and their lawyers without there being any Court proceedings on foot.
The parties discuss the issues and see whether they can reach an agreement to resolve the dispute.
If the dispute can’t be resolved, then it may need to go through to the Victorian Civil and Administrative Tribunal (VCAT).
This is very similar to a Court, but perhaps a bit less formal.
If your dispute goes to VCAT, it could still be resolved by negotiation at any time before the VCAT member makes a decision.
Common law damages claims
Common law damages are where you are suing an at fault party for the injuries caused to you.
There is a similar process involved in bringing a claim for common law damages as there is for disputing a TAC decision about your statutory benefits.
Firstly, your lawyer will make an application to the TAC for a serious injury certificate.
Having a serious injury certificate is a requirement under Victorian law for bringing a claim for damages.
If the application is not accepted, then you will need to go to Court to prove that you have a serious injury.
If you either have your serious injury application accepted by the TAC, or go to Court and have it accepted by the Court, you will then have another conference with the TAC to try and resolve the value of the claim for damages.
If the value of the claim can be agreed between you and your lawyers, and that TAC, then your claim for damages will be settled.
If an agreement cannot be reached on the value of the claim, then your lawyers will need to commence Court proceedings on your behalf.
Those proceedings may involve arguments regarding who is at fault and whether you contributed to the accident or to your injuries in any way.
In some circumstances, that TAC will admit fault on behalf of the insured party and if they do, liability will not form part of the claim in Court.
The other issue to be determined by the Judge or jury in the Court case will be the value of the damages payable to you.
Both claims for statutory benefits and serious injury/common law damages can go to Court after going through the TAC protocol dispute resolution process.
The protocols do allow many matters to be resolved without having to go to Court.
This isn’t always the case, particularly when it comes to the amount of common law damages payable by the TAC, and those claims can end up in Court.