Being ‘doored’ on Burgundy Street in Heidelberg left Tom Adams unconscious on the road. Fortunately for Tom he was with a group of mates who called the ambulance and police.
If the unthinkable happens; what should you do?
1. Call the Police and Ambulance
By calling the police to attend the scene of the car accident you will be issued with a police report that contains the police report number. This is a permanent record of the incident and forms part of your TAC (Transport Accident Commission) claim (Victoria only) as well as your insurance claim.
So if you or another rider is injured, always call the ambulance, but if the police are not called, you will need go to the police station and lodge a report of the accident.
Make sure you record the rego plate number of the offending vehicle or get the details of the driver if your accident involved a train, tram or bus.
2. At the hospital
The TAC has participating hospitals that allow you to lodge the TAC form electronically (via an iPad) at the hospital. This can be from a Liaison Officer appointed by the TAC or using their TAC Portal. If this is not available request a print-out of the TAC form.
From Tom's personal experience, ensure that you're being seen by the correct departments. In Tom's case he needed to see neurology and get an ECG scan and as it turns out, the day after being discharged, he suffered a seizure.
Tom goes on to say "In a way you need to be your own advocate to ensure that you receive the care from the right department", i.e. if you do not know the extent of your injuries and what the appropriate treatment is.
3. Before being discharged fill out the TAC form
Before leaving the hospital make sure that you have the TAC form filled out by the medical practitioner/surgeon/doctor that performed the treatment/surgery/process.
This information includes the name of the doctor and the condition or injury sustained.
If you have not been approached by the hospital's Liaison Office then you should request the TAC form. In some instances you may be supplied a card with instructions to call the TAC to begin the claim process.
4. Contact the TAC
After being discharged, if you have already lodged the TAC form at the hospital, call the TAC to follow up your claim and supply any additional information they may require.
Alternatively, if no form has been lodged, the TAC will conduct an interview over the phone which is a 25-30 minute process asking you a bunch of questions including:
- Was the cyclist transported by ambulance to hospital?
- What are your injuries?
- Information about the incident
- The police report number (the claim process is subject to you supplying a police report number)
Once all of the questions have been answered the claim process begins.
This also serves to have your injuries documented in the case that a related injury may occur 6 - 12 months or years after the accident.
Note: You have 12 months from the date of the accident to lodge your TAC claim.
5. The claims department will contact you.
The TAC will create a case and assign a case number. A case number may be assigned prior to the claims department calling you, depending on the level of information previously supplied. To establish whether there was a motor vehicle accident, the cyclist must have been involved with a moving vehicle (car, bus, train, tram, truck or any vehicle). This may be as simple as the motorist opening their door.
Even if you did not make contact, for example if a car was heading straight at you and you were forced off the road and crashed, then this is still a transport accident.
If you are claiming lost wages the TAC will then send you a booklet, together with an extensive form that requires very detailed information including your wage/salary, last year’s tax return and other information which forms part of the assessment of what they provide for loss of earnings.
There will also be an authority to release information that grants permission to the TAC to liaise with medical practitioners and other parties involved with your treatment.
Note: The TAC does not pay the first five days of lost wages.
Getting reimbursed for out of pocket expenses
You can claim reimbursements based on their schedule of fees (this varies) for out of pocket expenses such as physiotherapy and chiropractic services. Usually the provider will bill the TAC directly.
Travel expenses to/from hospital and additional travel costs to/from work can be claimed. If you cannot drive nor have access to public transport there are taxi vouchers available.
Loss of earnings payment can be claimed based on roughly 80% of your earnings capped at $1260 per week gross (before tax) but again this may depend on your circumstances for up to 18 months. You will need to provide 12 months of pay slips or a pay summary from your employer.
If the injury continues after 18 months a 'loss of earning capacity payments' is available until the three year anniversary of your accident and again this is subject to meeting the TAC's assessment criteria based upon advice from your treaters.
Note: The TAC can provide detailed information regarding eligibility and amounts.
Getting accident Compensation
A. Lump Sum Payments for impairment - quantitative loss
Depending on the severity of the impairment and someone else was at fault (note fault is not applicable for Impairments) you may be entitled to a lump sum payment based on the degree of physical and/or psychological impairment.
An impairment is compensable at 11% or greater 'of whole person' with a set formulae used to determine the value for each percentage over 11%, i.e. a loss of an eye is 24% impairment, calculated using measurements such as the range of motion of a joint.
However to establish an impairment the injury needs to be stable for a minimum of 3 months (the optimal period varies depending on the nature of the injury). The determination regarding the impairment is made in accordance with Transport Accident Act 1986 (TAA 1986) reference: s.46A, s.47 and s.48. The impairment scale from the TAC
The process involves submitting supportive information as well as numerous examinations. Your case will be managed by a TAC Lump Sum Co-ordinator.
More at http://www.tac.vic.gov.au/clients/lump-sum-compensation/impairment-benefits
B. Common Law Damages - quality of life & financial loss
Depending on the severity of the injury, you may seek a common law action where there is a negligent party.
Part of this process involves quantifying the financial loss and impact upon your quality of life. While it’s easy to put a number to the damage to your bike, measuring the emotional, psychological, mental, physical stress and impact on your life can be difficult.
For example ‘I can no longer ride a bike, or play social basketball.
Appointing a lawyer
If you choose to engage a lawyer, the process begins with the lawyer contacting the TAC to have your level of impairment assessed and/or apply for a 'Serious Injuries certificate’, if your score is:
a. 30% or more, which is an automatic qualification to pursue common law damages if you have a negligent party to sue.
b. Under 30%, the other way of qualifying to pursue common law damages is to receive a serious injury certificate from the TAC.
This second method is designed to recognise that whilst someone may not have an impairment that is 30% or more, their injuries may still be considered ‘serious’ when the impact upon their life is evaluated.
If you are not satisfied with the determination of your level of impairment, that decision can be challenged via a dispute.
However, if the TAC refuses to grant the 'Serious Injuries certificate' that decision can be challenged at court. Contact the TAC or your lawyer for more information.
Note if you have an accepted TAC claim and you wish to pursue common law damages, there is a limit of 6 years from the date of your accident.
Bike Cover - damage to your bike
Specifically, this covers you for the damage to your bike in the event of an accident or crash. Depending on the insurer this may vary, but typically, it involves documenting the damage with photos and getting quotes for repair or replacement from your local bike shop (similar or same model) or a shop that stocks the same model (like for like) which forms part of the normal insurance claim process.
An assessment is then made against your claim regarding the amount the insurers will pay out or ‘offer’. This, depending on your insurer or third party insurer, (if claiming against the driver’s insurance company) can be a long and protracted process, as experienced by Tom.
There are numerous companies providing extended home and contents insurance to cover your bike or a dedicated policy that is added to your home insurance:
There is always the option of contacting your local insurance broker who can make an individual assessment on the best insurance to meet your individual needs and requirements. Insurance coverage can save a lot of mucking around, stress and anxiety in having to personally seek a legal redress against the driver for damages to your bike.
Note any damage to your bike is not covered by the TAC
Personal Injury/Health Insurance
It’s best to consult your health insurance company to gain professional assistance in regards to which policy will cover you, and most importantly, cover any gaps from the TAC (if in Victoria).
General Health Insurance
This type of insurance cover will vary from one health insurance provider to another.
Cycling Australia and Bicycle Network Australia have insurance cover included in their membership but you will need to read the fine print of their individual policies to determine the level of insurance coverage.
Third Party Personal Injury & Property Insurance
It can be an expensive exercise if you hit a $250k sports car, so whether it’s your fault or not, having that peace of mind that, in the unfortunate event you have a collision with a car, you just claim through your own insurance company. In this scenario your insurance company will speak to the driver’s insurance company and manage the finer details and communications.
Income Protection Insurance
The TAC will cover you to an income ceiling for a proportion of your income (as outlined above) so depending on the possible level and period of incapacitation, it may be worth looking into personal income protection insurance which is offered in conjunction with many life insurance policies.
Again, it's better to seek professional assistance when obtaining advice to ensure that you are adequately covered.
Tom second from the left- photo courtesy Richard Kemp @rich_kemp
Tom on the far left- photo courtesy Lewis Greenhalgh @melbacycle
Ride with other people
Make sure that you ride with other people, and most importantly, that those in your group know who to call in the event of an accident.
Stay calm and get details
Just in case the driver does do a hit and run, try to recompose yourself (Ed - I have experienced this and it's very hard) or those within the group and take note of the number plate and the description of the car for the police to investigate.
Tom's update after 3 months
Thankfully, Tom is okay now after 3 months of not being able to drive due to the risk of possible seizures. He went back to work last week and is on the bike for the first time this week. His mates joked that if you are going to crash, make sure it’s near a hospital which luckily for Tom he was 400ms from the Austin Hospital.
This article seeks to provide a very broad overview of a highly complex area outlined above and currently available to a Victorian resident. It in no way forms or purports to form an exhaustive list of providers or in any way should be relied upon to form an opinion based on a particular action nor which remedies are available in the event of a car accident.
Note this information is provided by the TAC (Transport Accident Commission), www.tac.vic.gov.au and calls to their customer support line 1300 369 819. Each state and territory's equivalent transport accident body will vary based on what solutions are available. All the information was up to date at the time of publishing.
Furthermore, the processes outlined will vary depending on the individual’s circumstances, their level of injuries and their level of support required.
When pursuing any insurance policy it’s always recommended to read the full terms and conditions (the fine print) and seek professional advice in determining the best policy to suit your own individual needs.
If you are seeking compensation for an incident with a car driver or any other third parties, we highly recommend seeking your own independent legal advice.