How CTP Funds Treatment Costs for Amputation Injuries in NSW
If you've lost a limb in a motor accident in New South Wales, the Compulsory Third Party (CTP) insurance scheme may cover your treatment costs. This includes medical care, prosthetics, rehabilitation, and related expenses. The Motor Accident Injuries Act 2017 (MAIA) and SIRA guidelines set the rules for funding these costs. This article explains how the CTP scheme covers treatment for amputation injuries and what you need to know.
What Treatment Costs Are Covered
Under the CTP scheme, you may claim funding for:
- Medical treatment for your injury and complications
- Rehabilitation services like physiotherapy and occupational therapy
- Prosthetic limbs and their maintenance
- Psychological support and travel costs for treatment
These benefits apply regardless of who was at fault in the accident. The scheme ensures injured people can access necessary care without delay.
How SIRA Manages Funding Requests
SIRA oversees the CTP scheme in NSW. While it doesn't directly fund treatment, it ensures insurers comply with the MAIA. If your insurer refuses to cover a treatment, you can request a review through SIRA. The Motor Accident Guidelines help determine what treatments are reasonable and necessary.
Steps to Secure Funding
To ensure your treatment costs are covered, take these steps:
- Seek immediate medical attention and document all treatment
- Notify your CTP insurer within 3 months of the accident
- Get a written medical report outlining your treatment needs
- Keep records of all invoices, appointments, and correspondence
- Request a review if your insurer denies a treatment
Time Limits for Claims
You must notify your insurer of the accident within 3 months and apply for benefits within 6 months. Delays may affect your ability to claim for past treatment costs. The CTP scheme doesn't cover treatment not reported in a timely manner unless there's a valid reason for the delay.
When to Seek Advice
Amputation injuries often require complex medical and financial decisions. Get independent advice if:
- Your insurer refuses to fund a treatment
- You're unsure if a treatment is covered
- You need help with long-term care planning
SIRA provides guidance on its website, but it doesn't represent individuals in disputes. A legal or medical professional can help you understand your rights and options.
Example: Funding a Prosthetic Limb
A 34-year-old cyclist lost a lower limb in a car park collision on 15 August 2026. After emergency treatment, they needed a custom prosthetic. The insurer initially refused to fund the device. The cyclist obtained a second medical opinion, submitted a detailed treatment plan, and applied for a review. SIRA confirmed the prosthetic was a reasonable and necessary treatment under the MAIA, and the insurer was required to fund it.
Next Steps
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.