How dependants access CTP funding for treatment costs after a fatal motor accident
Where a person's only injuries resulting from the accident are threshold injuries, weekly benefits and treatment and care generally cease after 52 weeks (ss 3.11 and 3.28).
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 motor accident results in a fatality, dependants may be eligible for financial support to cover treatment costs under the NSW Compulsory Third Party (CTP) scheme. This guide explains how dependants in the Illawarra and South Coast regions can access funding for medical and therapeutic expenses, including the process for claiming and regional considerations.
What treatment costs are covered under NSW CTP?
Dependants of deceased claimants can claim funding for treatment costs related to injuries sustained before the accident. Eligible costs include:
- Medical treatments (e.g., physiotherapy, specialist consultations)
- Rehabilitation services
- Medications prescribed for pre-existing conditions
- Transportation to and from medical appointments
SIRA assesses whether the treatment is directly related to the injury caused by the accident. Costs must be reasonable and necessary for recovery, as outlined in the Motor Accident Injuries Act 2017.
How SIRA evaluates treatment funding claims
SIRA reviews claims by:
- Confirming the treatment was provided within 52 weeks of the accident (unless the injury was a threshold injury)
- Verifying the treatment is for an injury caused by the accident
- Ensuring the cost aligns with standard medical practices
Dependants must provide medical records, invoices, and a statement from a medical practitioner linking the treatment to the accident. SIRA may request additional documentation to support the claim.
Regional considerations for Illawarra and South Coast claimants
While the CTP scheme applies uniformly across NSW, dependants in the Illawarra and South Coast regions should:
- Contact the local SIRA office for region-specific guidance
- Note that treatment providers in these areas must be registered with SIRA
- Allow additional time for processing due to potential delays in regional offices
SIRA’s Illawarra office (now closed) and South Coast office (currently operational) handle claims for these areas. Dependants should confirm the current contact details through the SIRA website.
Applying for CTP funding for treatment costs
To apply, dependants must:
- Submit a claim form through SIRA’s online portal
- Provide medical evidence showing the injury was caused by the accident
- Include itemised bills for treatment costs
- Complete the application within 52 weeks of the accident (unless the injury was a threshold injury)
Claims must be submitted to the SIRA office responsible for the accident location. Dependants should also notify the at-fault driver’s insurer to initiate the process.
Time limits and dispute resolution
Dependants have 52 weeks from the accident date to claim treatment costs unless the injury meets the threshold injury criteria. If a claim is denied, dependants can:
- Request a review from SIRA within 28 days
- Seek mediation through the NSW Civil and Administrative Tribunal (NCAT)
Disputes over treatment costs often hinge on whether the injury was caused by the accident. Medical experts may need to provide evidence to resolve such conflicts.
When to seek legal advice
Dependants should consult a solicitor if:
- The claim is denied and a review is needed
- There are disputes over the value of treatment costs
- The deceased had multiple injuries requiring long-term care
A lawyer can help ensure all evidence is submitted correctly and deadlines are met.
Next steps for dependants
Dependants in the Illawarra and South Coast regions should act quickly to secure funding for treatment costs. Contacting SIRA directly and gathering all medical evidence are critical steps. For assistance with claims or disputes, complete the quick, no obligation enquiry form to request contact about your circumstances.