If your child was injured in a motor accident in NSW, you may be eligible for funding to cover their medical treatment costs through the Compulsory Third Party (CTP) scheme. This article explains how SIRA funds treatment expenses, what evidence is needed, and practical steps to secure approval for children's care in Albury.
How SIRA Funds Medical Treatment Costs
Under NSW CTP rules, treatment costs are funded if they are necessary for recovery. SIRA covers medical expenses such as hospital visits, specialist consultations, and rehabilitation if they are directly related to the injury caused by the accident. For children, this includes therapies like physiotherapy or speech pathology.
The Motor Accident Injuries Act 2017 (s 4.4) specifies that weekly benefits and treatment costs are generally limited after 52 weeks if only threshold injuries are involved. However, if the child's injury meets the 'whole person impairment' threshold (e.g., significant long-term disability), treatment funding may continue beyond this period.
Evidence Required for Treatment Claims
To support a treatment cost claim, families must provide:
- Medical records confirming the child's injury and treatment
- Itemized invoices from healthcare providers
- Doctor's notes linking the treatment to the accident
- Proof of the child's age and relationship to the claimant
For example, if a child requires surgery for a broken arm, the surgeon's report must explicitly connect the injury to the motor accident. SIRA may also request a medical expert's opinion to assess the necessity of treatment.
Practical Steps for Families
- Seek immediate medical attention - Ensure the child receives treatment from a registered medical practitioner. Delaying care may affect funding eligibility.
- Document the accident - Keep records of the incident, including witness statements, photographs of injuries, and police reports if applicable.
- Notify the at-fault driver's insurer - SIRA requires claims to be submitted to the insurer within 52 weeks of the accident. Delays may reduce the chances of approving treatment costs.
- Request a treatment cost assessment - SIRA will evaluate whether the proposed treatment is medically necessary. Families should submit all supporting evidence promptly.
Time Limits and Dispute Resolution
Families must submit a CTP claim to SIRA within 52 weeks of the accident. If treatment costs are denied, they can request a review by contacting SIRA's Albury office. In some cases, a dispute may be escalated to the NSW Civil and Administrative Tribunal (NCAT) for further review.
When to Seek Legal Advice
While SIRA handles most claims, complex cases involving multiple injuries, long-term care needs, or disputes over treatment funding may require legal assistance. A solicitor can help ensure all evidence is properly submitted and that the child's best interests are prioritized.
Example Scenario
Consider a 7-year-old child injured in a car accident in Albury. The child requires surgery for a fractured leg and ongoing physiotherapy. The family submits medical records showing the injury is directly linked to the accident. SIRA approves the treatment costs, covering both the surgery and therapy, as the injuries meet the threshold for funded care.
Next Steps
CTP funding for children depends on the accident date, injury severity, and evidence submitted. To request a free, no-obligation assessment of your circumstances, complete the quick, no obligation enquiry form. Every claim is unique, and understanding your options is essential to securing the support your child needs.