How NSW CTP Claims Cover Care and Family Support Costs
A threshold injury under the Motor Accident Injuries Act 2017 (NSW) includes a soft tissue injury and a psychological or psychiatric injury that is not a recognised psychiatric illness (adjustment disorder and acute stress disorder are the usual examples; s 1.6 and Motor Accident Guidelines Part 5).
If you've suffered a serious motor vehicle accident in Newcastle or the Hunter region and require care or family support, the NSW Compulsory Third Party (CTP) scheme may cover these costs. This article explains what care and family support costs are covered, how SIRA assesses eligibility, and what evidence you'll need to claim.
What Types of Care and Family Support Costs Are Covered?
Under the Motor Accident Injuries Act 2017, CTP claims cover 'care and family support costs' if they are reasonably necessary due to your injury. This includes:
- Assistance with daily living tasks (e.g., dressing, eating, mobility)
- Home modifications or equipment (e.g., ramps, lifts)
- Support for dependents (e.g., children, elderly relatives) if your injury prevents you from providing care
- Paid or unpaid care assistance, including respite care
These costs must be directly related to your injury and not a pre-existing condition. For example, if your injury requires a carer to assist with mobility, that's covered. However, routine household tasks like cooking or cleaning are generally not included unless they're medically necessary.
How SIRA Determines Eligibility in Newcastle and Hunter
SIRA (State Insurance Regulatory Authority) assesses claims based on the Motor Accident Guidelines. To qualify for care and family support funding:
- You must have a 'threshold injury' or higher under the guidelines
- The care or support must be reasonably necessary due to your injury
- You must provide evidence of the care's necessity, such as:
- A medical professional's statement linking the care to your injury
- Invoices or receipts for paid care services
- Evidence of your injury's impact on your ability to care for dependents
In the Newcastle and Hunter regions, claims are processed through the NSW CTP scheme, and local SIRA offices may have specific procedures. Always confirm with your insurer or SIRA if you're unsure about regional variations.
Documentation Needed for Care and Family Support Claims
To claim care and family support costs, you'll need to provide:
- Medical records confirming your injury and its impact
- A detailed care plan from a healthcare professional
- Evidence of the care's necessity (e.g., a doctor's note stating you require assistance with daily tasks)
- Invoices or receipts for paid care services
- Proof of your dependents' needs (e.g., school records, care requirements for a child)
Keep all documentation organized. SIRA may request additional evidence if your claim is disputed.
How This Differs From Other CTP Claims
Care and family support costs are distinct from other CTP claim categories:
- Medical treatment costs (e.g., hospital bills, specialist visits) are covered separately
- Travel expenses are limited to reasonable transportation to medical appointments
- Weekly income payments are for lost earnings, not care costs
Care and family support is a specific category under the CTP scheme. It's not automatically included with other benefits, so you must explicitly claim it.
Time Limits and Dispute Options
You have 52 weeks from the accident date to claim care and family support costs under the CTP scheme. After this period, you may still seek compensation through the NSW Civil and Administrative Tribunal (NCAT) if your injury meets the 'whole person impairment' threshold. Always check with SIRA about time limits for your specific case.
If your claim is disputed, you can:
- Request a review from SIRA
- Lodge an application with NCAT
- Seek independent legal advice to assess your options
When to Seek Legal Advice
CTP claims involving care and family support can be complex. A solicitor can help you:
- Navigate SIRA's assessment process
- Challenge denied claims
- Ensure you receive all eligible benefits
If your injury has long-term care needs or involves dependents, legal advice is particularly valuable to ensure you're not missing out on support.
Next Steps
CTP claims for care and family support depend on the accident date, injury severity, and evidence provided. While the scheme covers many costs, each case is unique. To request contact about your circumstances, complete the quick, no obligation enquiry form.