Understanding CTP Coverage for Children Injured in Motor Accidents
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 a child is injured in a motor accident in New South Wales, the Compulsory Third Party (CTP) insurance scheme provides support for medical treatment and rehabilitation. This includes access to necessary healthcare, therapy, and support services to help the child recover and return to normal activities. The scheme is designed to cover treatment and rehabilitation costs regardless of who was at fault, as long as the injury occurred in a motor accident involving a registered vehicle.
In Ashfield and across NSW, the Motor Accident Injuries Act 2017 governs entitlements. This means that parents or guardians of a child injured in a motor accident may be able to claim for treatment and care benefits, including physiotherapy, psychological support, speech therapy, and specialist assessments, if they are provided under a formal rehabilitation plan.
What Treatment and Rehabilitation Costs Are Covered?
Under the CTP scheme, a range of treatment and rehabilitation services may be covered for children, including:
- Medical treatment for injuries sustained in the accident
- Physiotherapy, occupational therapy, and speech therapy
- Psychological or psychiatric services, particularly if the injury affects mental health
- Specialist assessments to determine the nature and long-term impact of the injury
- Support services such as home modifications, aids, or equipment
These benefits are available through the CTP insurer, which is typically the insurer of the vehicle that caused the accident. The insurer must approve and fund treatment and rehabilitation services that are reasonable, necessary, and directly related to the accident.
How Rehabilitation Planning Works for Children
Rehabilitation planning for children is guided by the Motor Accident Injuries Regulation 2017 and the Motor Accident Guidelines issued by the State Insurance Regulatory Authority (SIRA). These documents set out that rehabilitation plans must be individualised, evidence-based, and focused on the child’s recovery and long-term wellbeing.
A rehabilitation plan for a child may include:
- A multidisciplinary approach involving medical practitioners, therapists, and sometimes educators
- Goals that reflect developmental milestones, school participation, and social engagement
- Regular review and adjustment of treatment as the child progresses or if new needs arise
The plan must be developed in consultation with the child’s parents or legal guardian, and the treating healthcare providers. It must also be submitted to the CTP insurer for approval before services can be funded.
Practical Steps and Evidence That Matter
To ensure treatment and rehabilitation are funded under the CTP scheme, parents should:
- Seek medical attention immediately after the accident and keep all records
- Notify the CTP insurer as soon as possible, ideally within 28 days of the accident
- Obtain a formal injury report from a medical practitioner outlining the nature, cause, and treatment needs of the injury
- Preserve photographs of the accident scene, vehicle damage, and any visible injuries
- Collect contact details of witnesses and keep a written account of what happened
- Maintain a diary of symptoms, treatment sessions, and any impact on the child’s daily life
The CTP insurer may request a copy of the child’s medical records, a rehabilitation plan, and evidence of treatment costs. These documents are essential for approval and ongoing funding.
Time Limits and When to Seek Advice
There are time limits that may affect entitlements. While CTP claims do not require proof of fault, a claim for treatment and care benefits must generally be made within 3 years of the accident date. For claims involving a threshold injury (such as a serious soft-tissue injury), the 52-week time limit for weekly benefits may apply, but treatment and care benefits can continue beyond that if the injury persists.
If a CTP insurer refuses to fund a treatment or rehabilitation service, or disputes the need for a service, the parent may request a review. Disputes can be escalated to SIRA, which has a formal process for resolving disagreements about treatment and care funding.
A child’s injury may have long-term implications, particularly if it affects development, education, or mental health. In such cases, parents may need to consider whether a claim for damages (beyond treatment and care benefits) may be appropriate, but this depends on whether the injury meets the threshold for damages under the Motor Accident Injuries Act 2017.
A Realistic Example: A Child with a Spinal Injury
A 10-year-old child in Ashfield was injured in a car crash in July 2024. The child sustained a soft-tissue injury to the neck and back, with ongoing pain and difficulty concentrating at school. A medical report confirmed a spinal nerve-root injury with neurological signs, but not radiculopathy as defined in the Motor Accident Guidelines.
The parents submitted a claim to the CTP insurer, including a rehabilitation plan developed by a paediatric physiotherapist and a psychologist. The plan included weekly therapy sessions, school support, and a review every 6 weeks. The insurer approved the plan and funded all services for 18 months. The child’s symptoms improved, and the plan was updated to include a transition to community-based therapy.
This example shows how a structured, evidence-based rehabilitation plan, supported by medical documentation, can lead to sustained funding for treatment and recovery.
When to Seek Independent Advice
Every claim depends on its own facts. The availability and extent of treatment and care benefits can vary depending on the nature of the injury, the child’s age, the timing of treatment, and whether the injury meets the threshold for damages. Parents in Ashfield who are unsure about their rights, the process for obtaining approval, or the long-term implications of a child’s injury should seek independent legal advice.
The CTP scheme does not cover all costs related to a child’s injury, such as loss of future earnings or non-economic damages, unless a damages claim is established. However, treatment and care benefits are designed to cover essential recovery needs.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.