Death benefits for dependants, how NSW CTP covers treatment costs
If a motor accident results in death, dependants may be eligible for financial support to cover medical treatment costs under New South Wales' Compulsory Third Party (CTP) scheme. The NSW CTP scheme provides death benefits to dependants of deceased claimants, including funding for ongoing medical treatment. This article explains how dependants access these benefits, what treatment costs are covered, and the steps to claim.
What death benefits are available to dependants under NSW CTP?
Under the Motor Accident Injuries Act 2017, dependants of deceased claimants may receive:
- Death benefits to cover living expenses and funeral costs
- Funding for medical treatment to address injuries sustained before death
- Weekly income payments if the deceased was a primary earner
The CTP scheme also covers treatment costs for dependants who require ongoing care, including specialist medical services, therapy, and equipment. These benefits are available regardless of fault in the accident, as the CTP scheme is no-fault.
How does the CTP scheme fund medical treatment costs for dependants?
The CTP scheme funds treatment costs through the SIRA (State Insurance Regulatory Authority), which manages claims under the Motor Accident Injuries Act 2017. To qualify for treatment funding, dependants must:
- Prove the deceased claimant was injured in a motor accident
- Demonstrate the dependant required medical treatment as a result of the injury
- Show the treatment was necessary to manage the injury's impact
SIRA assesses whether the treatment costs are reasonable and directly related to the injury. For example, if a deceased claimant suffered a spinal injury requiring ongoing physiotherapy, the dependant may claim the cost of that treatment.
What documentation is required to claim treatment costs for dependants?
To claim treatment costs, dependants must provide:
- A death certificate confirming the deceased claimant's death
- Medical records showing the deceased's injury and the dependant's treatment needs
- Accident details including the date, location, and circumstances of the accident
- Proof of treatment costs such as invoices, receipts, or medical reports
SIRA may also request witness statements or medical opinions to assess the dependant's ongoing needs. It's important to submit all documentation promptly to avoid delays.
How does SIRA assess eligibility for dependant treatment funding?
SIRA evaluates claims based on the Motor Accident Guidelines, which outline what treatment costs are covered. Key factors include:
- Whether the treatment was necessary to manage the injury's impact
- Whether the treatment was provided within a reasonable timeframe
- Whether the treatment cost was reasonable and appropriate
For example, if a dependant requires ongoing psychiatric care following a traumatic brain injury, SIRA will assess whether the treatment is directly related to the injury and whether the cost is reasonable. Claims must be submitted within 52 weeks of the deceased claimant's death, unless an extension is granted.
Practical steps and time limits
Dependants should:
- Notify the CTP insurer within 52 weeks of the deceased claimant's death
- Submit a claim form through SIRA's online portal or by post
- Provide all required documentation promptly
- Respond to SIRA requests for additional information
If a claim is denied, dependants may request a review by SIRA or seek independent legal advice. Time limits are strict, so acting quickly is essential.
When to seek legal advice
While SIRA manages most claims, dependants may need to consult a solicitor if:
- The claim is denied and the decision is not appealed
- There are disputes over the scope of treatment costs
- The deceased claimant's family has complex financial needs
A solicitor can help navigate SIRA's processes and ensure all legal requirements are met.
Conclusion
Dependants of deceased claimants in NSW may access funding for medical treatment costs through the CTP scheme. Understanding the eligibility criteria, required documentation, and time limits is crucial to securing these benefits. Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.