Home Modifications and Treatment Costs Covered Under NSW CTP Claims
If you have suffered a serious injury in a motor accident in New South Wales, you may be entitled to funding for home modifications and treatment costs through the Compulsory Third Party (CTP) insurance scheme. This funding is available under the Motor Accident Injuries Act 2017 and is administered by the State Insurance Regulatory Authority (SIRA). The scheme supports people with serious injuries by covering reasonable and necessary expenses related to long-term care, rehabilitation and accessibility improvements, including home modifications in Greater Sydney and elsewhere in NSW.
Eligibility for funding depends on the nature of the injury, the need for ongoing treatment, and whether the injury meets the legal definition of a serious injury under the Act. This includes injuries that result in a permanent impairment, require long-term treatment, or significantly affect daily living. Home modifications such as ramps, stair lifts, bathroom adaptations, and door widening are considered reasonable and necessary if they are directly linked to the injury and improve safety, independence or quality of life.
How Claimants Apply for Home Modification Funding
To access funding for home modifications, you must first have a claim under the CTP scheme and have been assessed as having a serious injury. You will need to provide a formal application to your CTP insurer, supported by medical evidence and a report from a qualified professional such as an occupational therapist or rehabilitation specialist. This report must detail the nature of the modification, its purpose, and why it is necessary due to the injury.
The application should include a cost estimate from a licensed builder or contractor, and in some cases, a quote from a specialist accessibility designer. The insurer will assess whether the proposed modification is reasonable and necessary in relation to the injury and the claimant’s functional needs. Approval is not automatic and may involve a review by the insurer or a SIRA-appointed assessor.
Required Documentation and Evidence
The following documents are typically required to support a claim for home modification funding:
- A medical report from your treating practitioner or specialist confirming the nature and permanence of the injury.
- A functional assessment report from an allied health professional (e.g. occupational therapist) outlining how the injury limits daily activities and why the modification is needed.
- A detailed quote from a licensed builder or accessibility specialist, including itemised costs and timelines.
- Evidence of ownership or tenancy of the property, such as a lease agreement or title search.
- Photographs of the current home conditions, particularly areas affected by mobility or safety issues.
All documentation must be clear, dated, and signed. Incomplete or vague submissions may delay approval or result in a partial or denied claim.
Limits on CTP Funding for Home Modifications
There is no fixed cap on home modification funding under the CTP scheme, but payments are limited to reasonable and necessary costs. The insurer may require evidence that the proposed modification is the most cost-effective option, and may only approve a proportion of the quoted cost if alternatives are available.
Funding is not available for improvements that are purely cosmetic, for upgrades beyond what is needed for safety and accessibility, or for modifications that would have been made regardless of the injury. For example, a home renovation to increase property value would not be covered, but a bathroom modification to allow safe use of a wheelchair would be.
The insurer may also require that modifications be completed by a registered contractor and that work be inspected upon completion. In some cases, the insurer may pay the contractor directly, or reimburse you after you provide proof of payment and completion.
Time Limits and Procedural Requirements
There is no fixed deadline for applying for home modification funding, but it is best to apply as soon as the need is identified and confirmed by a professional. Delaying may affect the availability of funds, particularly if the insurer has already made a final determination on treatment and care benefits.
If you have already received treatment and care benefits under the CTP scheme, you may still apply for home modifications, but you must ensure that the application is made within the timeframe for submitting a claim for damages or additional benefits. The Motor Accident Injuries Act 2017 sets a 3-year limitation period for initiating a claim for damages, which includes claims for future care and modifications.
If your application is denied or you believe the insurer’s assessment is incorrect, you may request a review under the CTP scheme. You can also seek an external review through SIRA or, if necessary, apply to the NSW Civil and Administrative Tribunal (NCAT) for a decision.
Practical Example: Home Modification for a Wheelchair User
A 42-year-old man in Sydney was injured in a motor accident in April 2025. He sustained a spinal cord injury that resulted in paraplegia and permanent loss of lower limb function. His treating neurologist confirmed the injury was serious and would require long-term care. An occupational therapist assessed his home and recommended a ramp, a bathroom conversion with a walk-in shower, and wider doorways to accommodate a wheelchair.
The claimant submitted a formal application to his CTP insurer, including a medical report, the occupational therapist’s assessment, and three quotes from licensed contractors. The insurer approved the modifications, subject to a 10% cost reduction to reflect market rates. The claimant received funding to cover 90% of the approved cost, and the work was completed within six months.
When to Seek Independent Advice
While the CTP scheme provides a framework for funding home modifications and treatment costs, the process can be complex, particularly when the injury is serious and long-term. Disputes may arise over the reasonableness of costs, the necessity of a modification, or the interpretation of medical evidence.
If you are unsure about your rights, the documentation needed, or how to respond to a decision from your insurer, it is advisable to seek independent legal or case management advice. This is especially important if you have a history of previous claims, are seeking funding for multiple modifications, or believe your insurer has not properly assessed your needs.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.