How long does a TAC claim take?

How long does a TAC claim take graphic

An initial TAC claim can be accepted in as little as 21 days post accident.

Sometimes it can take longer if the TAC require further information. 

Once a TAC claim has been accepted, you will be entitled to claim reasonable medical and like expenses, and if your ability to work has been impacted because of the accident, you’ll also be able to claim income benefits.

A TAC claim however also has other parts.

This page will look at each of the separate parts in order to answer the question how long does a TAC claim take.

How long does an initial TAC claim take to be accepted or rejected?

The first step in pursuing a TAC claim is to initiate the claim.

This can be done over the phone by calling the TAC directly.

It can also be done online by using the TAC’s online claim lodgement page.

If you’ve been hospitalised after the accident, then sometimes the hospital will lodge a claim on your behalf (and in many cases, people may not be told that a claim has been lodged on their behalf).

Once the claim has been lodged, the TAC have 21 days to accept or reject liability or alternatively request further information either from you or another party that may assist them in determining the claim.

During this 21 days they may also request that you attend a medical examination.

If they have requested further information, the TAC will accept or reject the claim within 14 days after receiving the information for the results of the medical examination, as the case may be.

You can read more about the TAC claim process here.

If the claim has been accepted:

If your claim has been accepted, then you should receive confirmation of this in writing. 

You’ll then be entitled to claim medical expenses and potentially income replacement benefits.

If the claim has been rejected:

Likewise, if your claim has been rejected by the TAC you should receive confirmation of this in writing.

If the TAC does not accept your initial claim, and if you still wish to pursue the claim, then there are a few options open to you:

Asking the TAC to perform an internal review

Internal review means having the decision to reject your claim reviewed by TAC’s review team.

Basically, they consider review the decision that was made and make their own decision.

They can request further information if they think it’s required.

They are required to complete an informal review within 60 days.

It can however take longer if further information is required or if a decision is particularly complex.

Initiate the dispute resolution process

This is likely the option you will pursue if you have legal representation.

Basically, your lawyer will lodge an application form which will initiate the dispute resolution process.

The matter will then be set down for a telephone conference that will occur between the your lawyer and the TAC (or their representatives).

It will usually occur within a few weeks to a couple of months after the application has been lodged.

VCAT review of the decision

If the matter does not resolve either by internal review or by a dispute resolution application, then the third option is to have VCAT review the decision.

Once VCAT proceedings have been initiated, then a conference may be organised to try and resolve the matter without the need for a hearing.

This can happen within a few weeks or months after the application has been lodged.

If the matter does not resolve at the conference then VCAT will set a hearing date which can occur some months after the initial application was lodged.

Once your claim has been accepted:

Once your claim has been accepted, whether it was accepted at first instance or after a internal review, via the dispute resolution process or VCAT, you are entitled to the payment of any medical expenses incurred and any income benefits if you have not been able to work to the capacity that you were working prior to the injury. You are entitled to be backpaid.

Claim for impairment benefits

This is a lump sum claim that anyone that is injured in a motor vehicle accident in Victoria is entitled to pursue.

You do not need to show that someone was at fault in order to pursue this claim.

In terms of the process, you will need to be assessed by specially trained doctors (not your treating doctors) who put percentage figures on your injuries.

These percentage figures will then match up to compensation amounts.

In terms of the expected timeframes for this claim, before you can lodge the claim your injuries need to be stablised.

Stabilised means that your injuries are not getting any better and not getting any worse. That is, that your injuries have plateaued. 

The TAC’s general position is that injuries are stable after a minimum of 12 months post accident.

Sometimes it can take longer than this however depending upon the nature of the injury (or injuries) and what treatment is required.

Once the claim has been lodged

For example, if you need surgery, then you you will generally need to wait until you’ve had the surgery and your injury has stabilised after the surgery before the claim can be lodged.

Depending on the nature of the surgery, this could add another couple of months, or a year or more to the claim processing time.

Once your claim has been lodged, an impairment claim can resolve anywhere from a few weeks after lodgement of the application to 6 months, sometimes more.

If there is a dispute in terms of what you’ve been assessed at, then this can lengthen the impairment claim process.

If you need to have further medical assessments, or undergo medical scans then this can also add to the processing time.

So, generally speaking, an impairment benefit can resolve anywhere from about 14 months to 18 months post accident, sometimes longer.

Common law claim for damages

Some people that are injured in a transport accident can pursue a common law claim for damages.

This is the second lump sum claim under the TAC scheme.

This claim can compensate people for pain and suffering and loss of earnings.

Two things are required to be proven in order to succeed in a common law TAC claim.

The first is that someone else was responsible for the accident due to their negligence.

The second is that as a consequence of the accident, you suffered a serious injury.

There are two ways that you can show that you have a serious injury.

The first way is the quickest way.

If, in relation to your impairment claim referred to above, you’ve been assessed as having a 30% or greater whole person impairment rating, then you will automatically be deemed as having a serious injury for the purposes of a common law claim.

The second way that you can show that you have a serious injury is by what’s called the narrative test which basically involves telling your before and after story.

How were you before the accident and how are you now after the accident.

That is, what impact has the accident had on your life.

In terms of how long a common law TAC claim will take, this really depends upon how contested the matter is.

In relation to both aspects of a common law claim, that is, negligence and serious injury, the TAC can contest both of those aspects, one of them or none of them.

So the more that your claim is contested, generally speaking the longer it will take.

Like an impairment claim, in order to pursue a common law claim for damages you need your injury to have stabilised.

The first step in pursuing a common law claim is lodging what’s called a serious injury application. Once the TAC receive this application, they will usually make a decision within 3 to 6 months.

Sometimes quicker, sometimes longer depending upon the circumstances of your matter.

If they think that you’ve got a serious injury, they’ll provide you with a serious injury certificate and then your matter will proceed to a settlement conference which generally will occur a month or two after the TAC provided you with the serious injury certificate.

Many matters resolve at this conference.

If however your matter does not resolve at this conference, then the next step is for court proceedings to be issued.

It can then take six months or more for your matter to end up in court.

Going back a step, lets say that you lodge the serious injury application and the TAC conclude that in their opinion you do not have a serious injury.

The next step then is if you want to proceed with the matter, to issue proceedings in the County Court and have your matter heard before a Judge to determine whether you have a serious injury or not.

This can add 6 to 8 months, approximately, to the processing time.

If you succeed and obtain a serious injury certificate, then you’ll go to the settlement conference referred to above to try and negotiate the matter.

Keep in mind though that even if your matter does get set down for court at some stage, at any time prior to the court hearing the matter can resolve by way of negotiations between the parties.

Conclusion

Once you lodge a TAC claim after an accident, it can be accepted within 21 days after the accident.

If the TAC require further information then it may take longer than this.

Once your claim is accepted then you are entitled to the payment of medical and like expenses and if your ability to work as in being impacted, the payment of income benefits.

If your claim has been rejected, then depending upon what avenue or avenues you pursue to appeal the rejection, it may add a month or two, all the way up to 12 months.

The initial claim entitles you only need to claim medical expenses and weekly payments. There are two further entitlements under a TAC scheme that you may also be able to access, both of which are lump sum claims.

The first is a claim for impairment benefits and in order to pursue this claim your injuries need to be stable, which generally means a minimum of 12 months post accident.

Once the impairment claim has been lodged it can resolve anywhere from a few weeks after lodgement to up to 6 months, sometimes more.

The second claim is a common-law claim for damages and again your injuries need to be stable before you can pursue this claim.

It is difficult to provide an exact answer in relation to how long a common law claim will take because there are many variables.

Generally speaking however, the more the TAC contests or opposes the claim the longer that it will take.

Once you have lodged your serious injury application, then it is possible for the matter to resolve within the next six months or thereabouts if the TAC conclude that you have a serious injury.

If however the TAC contests the common law claim on either the basis of serious injury or negligence, then it may take much longer than this.