What Attendant Care Services Are Covered Under NSW CTP Claims?
If you have been injured in a motor accident in NSW and now require assistance with daily personal care tasks such as bathing, dressing, toileting, or mobility, you may be entitled to claim attendant care services through your Compulsory Third Party (CTP) insurance. These services are provided by a qualified carer and are intended to support you while you recover from injuries that affect your ability to care for yourself independently. The CTP insurer must pay for these services if they are reasonable and necessary, and if they are directly related to injuries from the motor accident. This includes care provided in your home, at a medical facility, or during travel for treatment.
How Do I Prove I Need Attendant Care Services for My CTP Claim?
To claim attendant care services, you must provide evidence that you have a genuine and ongoing need for assistance with personal care tasks due to your injuries. The primary evidence is a medical certificate from your treating medical practitioner. This certificate must state that your injuries prevent you from performing essential personal care tasks without help, and that the need for care is expected to last for a reasonable period. The certificate should also include details about the type of care required, how often it is needed, and the estimated duration.
Supporting evidence may include a care plan developed by a registered nurse or allied health professional, a diary of daily care needs, and a record of how your injuries have limited your ability to manage basic self-care. If you have received care from a family member or friend, you may need to provide a written statement explaining the nature and frequency of that care, as well as a record of any time spent assisting you. The insurer may request a review by an independent medical practitioner to assess the need for care.
What Happens If My Insurer Disputes My Attendant Care Claim?
If your CTP insurer disputes your claim for attendant care services, they must provide a written reason for the dispute. Common grounds for dispute include a belief that the care is not necessary, not directly related to the accident, or not reasonable in cost. You have the right to respond in writing and submit additional evidence, such as updated medical reports, care logs, or a second medical opinion.
If the dispute remains unresolved, you may request a review by the State Insurance Regulatory Authority (SIRA). SIRA provides independent assessment and can make binding decisions on disputed claims. You may also seek assistance from a legal or claims support service to help you prepare your case. It is important to keep all correspondence with the insurer, including emails, letters, and call records, as they may be needed to support your position.
Are There Time Limits for Claiming Attendant Care Services Under NSW CTP Laws?
There is no fixed deadline for making a claim for attendant care services under NSW CTP laws, but it is important to notify your insurer as soon as possible after the accident. Delays in reporting may affect the insurer’s ability to verify your claim or obtain evidence, such as witness statements or accident scene details.
The claim for attendant care services must be made within the time limits that apply to your overall CTP claim. For most claims, the time limit is three years from the date of the motor accident. However, if you are claiming for damages (such as for pain and suffering or future care needs), the time limit is three years from the date you first became aware of the injury, which may be later than the accident date.
If you have already received a weekly income payment or treatment and care benefit, the insurer may have a right to recover payments if you later receive a damages award. This is because CTP benefits are intended to cover immediate and short-term needs, while damages are for long-term or permanent impacts. You should not delay making a claim for attendant care services, as ongoing care needs may change over time and evidence may become less reliable.
Practical Steps and Evidence That Usually Matter
- Obtain a medical certificate from your treating doctor confirming your need for attendant care.
- Keep a daily record of care received, including who provided it, the time, and the tasks performed.
- Preserve all correspondence with your insurer, including emails, letters, and call logs.
- Request a copy of any assessment report from the insurer’s independent medical practitioner.
- Seek a second medical opinion if the insurer refuses your claim and you believe the care is necessary.
A Realistic Example: How This Might Work in Ballina
A 42-year-old resident of Ballina was injured in a car crash on 15 May 2025. She sustained a spinal injury that left her unable to stand or transfer from bed without assistance. Her doctor confirmed she needed daily help with bathing, dressing, and using the toilet. She submitted a claim for attendant care services, supported by a medical certificate and a care log from her sister, who provided care for 12 hours per week over a 10-week period. The insurer initially declined, citing a lack of objective evidence. After the claimant submitted a second medical report and a formal request for review, SIRA upheld the claim and ordered the insurer to pay for 12 weeks of care at a rate approved under the Motor Accident Injuries Act 2017.
Next Steps
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.