In New South Wales, the Compulsory Third Party (CTP) scheme covers care and family support costs for injured road users. This article explains what types of support are covered, how to claim them, and what evidence is needed. If you or a loved one has been injured in a motor accident, understanding these rules can help you access financial support for essential care needs.
What Types of Care and Family Support Costs Are Covered?
Under the NSW CTP scheme, you may claim compensation for care and family support costs if your injury meets the 'threshold injury' criteria. This includes:
- Paid care costs (e.g., hiring a nurse or home help)
- Unpaid family support (e.g., a spouse or child taking time off work to care for you)
- Specialist equipment or modifications to your home
- Travel expenses for medical appointments
SIRA's guidelines state that support must be 'reasonably necessary' due to your injury. For example, if you need regular physiotherapy sessions, the cost of hiring a carer to accompany you may be covered. However, routine household tasks like cleaning or cooking are generally not included unless they are essential for your recovery.
How to Claim Care and Family Support Costs
To claim support costs through the CTP scheme, you must:
- Notify your insurer within 52 weeks of the accident. This is a strict deadline set by the Motor Accident Injuries Act 2017. Delays may reduce your entitlements.
- Provide evidence of your care needs. This includes:
- Medical reports confirming your injury meets the threshold
- Invoices or receipts for paid care services
- Proof of income loss for family members taking time off work
- A care plan from a medical practitioner
- Submit a claim form through the insurer or the Nominal Defendant if the accident involved a government vehicle.
What Evidence Matters Most?
Courts and insurers rely on specific evidence to assess care and family support claims. Key documents include:
- Medical records showing the nature and severity of your injury
- Accident reports from police or witnesses
- Care provider invoices with dates and descriptions of services
- Employment records for family members claiming lost income
- Statements from medical professionals confirming the necessity of support
For example, if a family member needs to take time off work to care for you, you must provide payslips or employer statements showing the income loss. This helps demonstrate the 'reasonably necessary' nature of the support.
Time Limits and Dispute Options
You have 52 weeks from the accident date to notify your insurer of care needs. After this period, claims for 'only injuries' (threshold injuries) are generally limited under the Motor Accident Injuries Act 2017 s 4.4. This means weekly benefits and treatment costs may stop after 52 weeks, even if care needs persist.
If your claim is disputed, you can:
- Request a review from the insurer
- Apply to the NSW Civil and Administrative Tribunal (NCAT) for a decision
- Seek independent medical opinions to support your case
When to Seek Legal Advice
While many claims can be resolved through the insurer, complex cases may require legal assistance. A solicitor can help if:
- Your injury involves long-term care needs
- The insurer disputes the necessity of support
- You need to challenge a decision to stop benefits
- You want to pursue a common law damages claim alongside CTP benefits
Example: A Family's Care Needs
Consider a scenario where a cyclist is injured in a car accident and requires 24/7 care. The family must hire a carer, and the primary income earner takes unpaid leave. Under the CTP scheme, the family may claim:
- The cost of hiring a carer
- Lost income from the primary earner
- Travel expenses for medical appointments
However, if the injury is classified as a 'threshold injury' (e.g., soft tissue damage without long-term impairment), the 52-week limit may apply to benefits. This means the family could face reduced support after this period, even if care needs continue.
Next Steps
Understanding the rules around care and family support is essential for injured people in NSW. While the CTP scheme covers many costs, the process requires careful documentation and timely action. Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.