What Are Attendant Care Services in NSW CTP Claims?
If you have sustained a serious injury in a motor accident in New South Wales, you may be entitled to claim for attendant care services. These are paid services that provide personal care and supervision because you are unable to perform daily tasks such as bathing, dressing, preparing meals or managing medications due to your injury. The Motor Accident Injuries Act 2017 and the Motor Accident Injuries Regulation 2017 set out the legal framework for these claims. Insurers assess eligibility based on medical evidence and the impact of your injury on your daily functioning.
How Insurers Assess Eligibility for Attendant Care
Insurers assess your claim for attendant care services by reviewing medical evidence, including reports from your treating medical practitioner and any independent medical assessors. The assessment focuses on whether your injury has caused a permanent or long-term loss of function that prevents you from carrying out essential daily activities independently. The decision must be made in accordance with the Motor Accident Guidelines, which set out the criteria for determining the need for attendant care.
Insurers consider factors such as the nature and severity of your injury, the duration of your functional impairment, and whether the care is required on a regular and ongoing basis. They may also review your personal care needs, mobility limitations, and cognitive or physical impairments that affect your ability to manage at home. The insurer must provide a written explanation if they deny or limit your claim for attendant care.
What Evidence Supports an Attendant Care Claim?
To support your claim, you must provide evidence that demonstrates your need for paid care. This includes:
- A detailed medical report from your treating practitioner outlining your functional limitations and the need for assistance with daily tasks.
- A care plan developed by a qualified health professional, such as an occupational therapist, that specifies the type, frequency, and duration of care required.
- Records of any prior care arrangements, including informal support from family or friends, to show the extent of your dependency.
- Documentation of your daily routine and how your injury affects your ability to perform basic self-care tasks.
Photographs of your home environment, if they show barriers to independent living, may also be useful. Insurers may request a home visit or assessment to verify your needs.
Time Limits and Dispute Options
There are time limits for making a claim for attendant care services. You must notify your insurer of your claim within 3 months of the accident, or within 3 months of becoming aware of the injury, whichever is later. Failure to meet this deadline may result in your claim being refused, unless you can demonstrate a valid reason for the delay.
If your insurer denies your claim or limits the amount of care they will fund, you have the right to dispute the decision. You can request a review of the decision from the insurer, or apply to the State Insurance Regulatory Authority (SIRA) for a formal review. SIRA provides guidance on how to make a dispute and what information to include. You may also seek assistance from an independent legal or claims support service.
When to Seek Independent Advice
The assessment of attendant care claims can be complex, particularly where injuries involve neurological or cognitive impairments. If your claim is denied or you believe the insurer’s decision does not reflect your actual needs, it is advisable to seek independent legal advice. A solicitor experienced in motor accident claims can help you interpret the Motor Accident Guidelines, challenge a decision, and ensure your rights under the Motor Accident Injuries Act 2017 are upheld.
A Realistic Example
A 42-year-old woman was involved in a motor vehicle accident in Sydney in June 2025. She sustained a spinal cord injury that left her with partial paralysis and limited mobility. She requires assistance with transferring from bed to wheelchair, bathing, and preparing meals. Her treating neurologist confirmed she cannot perform these tasks independently and recommended 20 hours of attendant care per week. The insurer initially approved only 10 hours, citing insufficient evidence of long-term dependency. After the claimant submitted a detailed care plan and a second medical report, the insurer revised their decision. This example illustrates how medical evidence and a structured care plan can influence insurer decisions.
Next Steps
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.