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).
In New South Wales, funeral expenses resulting from a motor accident are covered under the Compulsory Third Party (CTP) scheme. Insurers assess liability for these costs based on specific legal criteria, including the date of the accident, the claimant’s circumstances, and the nature of the funeral expenses. This article explains how insurers evaluate claims for funeral costs in regional NSW, the evidence required, and how the SIRA guidelines apply.
What Funeral Expenses Are Covered Under NSW CTP Claims?
Under the Motor Accident Injuries Act 2017, funeral expenses are included in the definition of 'loss or damage' for CTP claims. This covers costs such as funeral home services, transportation of the deceased, burial or cremation fees, and clothing or other direct costs related to the funeral. Insurers typically require documentation such as a funeral invoice, a death certificate, and a statement from the funeral director confirming the expenses. The claimant must also provide evidence that the funeral costs were incurred as a direct result of the motor accident.
How Do Insurers Assess Liability for Funeral Costs in Regional NSW?
Insurers evaluate funeral expense claims by considering:
- The date of the accident: CTP coverage rules may vary depending on when the accident occurred. For example, claims arising from accidents before 1 January 2020 are governed by the old scheme, while newer claims fall under the current Motor Accident Injuries Act 2017.
- The claimant’s circumstances: Insurers assess whether the funeral expenses were necessary and reasonable. For instance, they may scrutinise claims where the deceased’s family incurred additional costs beyond standard funeral services.
- SIRA guidelines: The State Insurance Regulatory Authority (SIRA) provides detailed guidance on what constitutes a valid claim. Insurers must apply these guidelines consistently, even in regional areas.
Documentation Required to Support a Funeral Expense Claim
To support a funeral expense claim, claimants must submit:
- A copy of the death certificate
- Funeral invoices or receipts
- A statement from the funeral director confirming the expenses
- Proof of the accident (e.g., police report, witness statements)
- Evidence that the funeral costs were incurred as a direct result of the motor accident
Insurers may also request additional information, such as medical records or accident reports, to establish the connection between the accident and the funeral expenses.
Time Limits and Dispute Options
CTP claims must be made within a reasonable time frame, typically within 52 weeks of the accident. However, funeral expense claims may have different time limits depending on the circumstances. If an insurer disputes a claim, the claimant can request a review by the insurer’s internal dispute resolution process or seek mediation through SIRA.
When to Seek Legal Advice
If an insurer rejects a funeral expense claim or disputes the amount, it may be necessary to seek legal advice. A solicitor can help assess whether the claim meets the legal criteria and whether the insurer’s decision is justified under the CTP scheme.
Next Steps
CTP entitlements and liability assessments depend on the specific facts of each case. To request contact about your circumstances, complete the quick, no obligation enquiry form.