How NSW CTP Insurers Assess Liability for Funeral Expenses
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).
If you've suffered a motor accident resulting in a death, funeral expenses may be recoverable under New South Wales' Compulsory Third Party (CTP) scheme. Insurers assess liability for these costs based on specific legal rules under the Motor Accident Injuries Act 2017 (MAIA) and SIRA guidelines. This article explains how funeral expenses are evaluated, what evidence matters, and when to seek legal advice.
Key Legal Rules for Funeral Expenses
Under the MAIA, funeral costs are considered part of the 'consequences' of a motor accident. Insurers must assess whether the expenses are directly related to the deceased’s death and necessary for the funeral. SIRA’s What you can claim page confirms that funeral expenses are recoverable if they are:
- Reasonable and necessary,
- Directly related to the deceased’s death, and
- Incurred within 52 weeks of the accident (unless the claim is for ongoing care or other benefits).
Insurers may dispute claims if expenses are deemed excessive, not directly related to the accident, or incurred beyond the 52-week limit. For example, if a family chooses a more expensive funeral than the minimum required, the insurer may argue the excess cost is not recoverable.
Practical Steps and Evidence to Gather
To support a funeral expense claim, you’ll need to provide:
- Medical or coroner’s report confirming the deceased’s death was caused by the motor accident,
- Itemised funeral bills showing the cost of services (e.g., coffin, transportation, burial),
- Proof of payment (e.g., receipts, bank statements),
- Evidence that the expenses were incurred within the 52-week timeframe (unless the claim involves ongoing care or other benefits).
If the deceased was a passenger or pedestrian, the insurer may also assess whether the funeral costs were necessary and not influenced by other factors, such as pre-existing health conditions.
Time Limits and Dispute Options
CTP claims must be made within 52 weeks of the accident (or 52 weeks from the date of death, if the deceased was a passenger). If the claim is not submitted on time, the insurer may refuse to pay. For disputes over funeral expenses, you can:
- Request a review from the insurer,
- Apply to the NSW Civil and Administrative Tribunal (NCAT) for a decision, or
- Seek legal advice if the insurer’s refusal is unreasonable.
When to Seek Legal Advice
If the insurer refuses to cover funeral expenses or disputes the amount, it’s important to consult a solicitor. A lawyer can help you:
- Challenge the insurer’s assessment of necessity or reasonableness,
- Submit a formal dispute request to the insurer,
- Explore options for a review by NCAT or the NSW Supreme Court.
Summary of Key Points
Funeral expenses under NSW CTP claims are assessed based on the deceased’s death being caused by the motor accident, the reasonableness of the costs, and the timing of the expenses. Gathering detailed evidence and understanding the 52-week deadline are critical. If your claim is denied, seeking legal advice can help you challenge the insurer’s decision.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.