Understanding MAC Act Legacy Claims and Treatment Cost Funding
Motor accident claims in New South Wales that arose before 1 May 2017 may be governed by the Motor Accident Claims Act 1990 (MAC Act), which remains in force for certain claims. These legacy claims are subject to different rules than those under the current Motor Accident Injuries Act 2017. For claimants in rural and remote areas of NSW, this distinction is particularly important when seeking funding for treatment costs following a motor vehicle accident.
Under the MAC Act, eligible claimants may receive funding for medical treatment, rehabilitation, and related care services. This includes treatment for injuries sustained in a motor accident, regardless of fault, provided the claim is made within the applicable time limits. The funding is not limited to a specific type of injury or treatment, and claimants may access services such as physiotherapy, specialist consultations, and allied health support through the CTP insurer or the relevant claims administrator.
Key Differences from Modern CTP Claims
Unlike claims under the current Motor Accident Injuries Act 2017, MAC Act legacy claims are not subject to the 52-week threshold injury time limit or the whole person impairment (WPI) threshold for damages. This means that treatment and care benefits may continue beyond 52 weeks if medically necessary and supported by evidence, which can be particularly significant for individuals in rural and remote areas who may face greater barriers to accessing timely care.
Under the MAC Act, claimants are entitled to treatment and care benefits for injuries that are not considered threshold injuries under the current scheme. This includes soft tissue injuries, chronic pain, and other conditions that may not meet the current statutory definition of a threshold injury but still require ongoing treatment. The absence of a WPI threshold for treatment funding under the MAC Act allows for broader access to medical services, which can be critical for people living far from specialist medical facilities.
Practical Steps and Evidence Requirements
To secure funding for treatment costs under a MAC Act legacy claim, claimants should:
- Immediately seek medical attention and keep detailed records of all treatments, including dates, providers, and diagnoses.
- Obtain written treatment plans from medical practitioners that outline the nature, duration, and necessity of the care.
- Notify the CTP insurer or claims administrator as soon as possible after the accident, even if the injury is not immediately apparent.
- Preserve all correspondence, invoices, and receipts related to treatment, travel, and out-of-pocket expenses.
- Provide witness statements, accident reports, or photographs if available, particularly in cases involving complex or disputed circumstances.
SIRA (State Insurance Regulatory Authority) advises that claims under the MAC Act are assessed on a case-by-case basis, and the onus is on the claimant to demonstrate the need for ongoing treatment. Medical evidence must clearly link the treatment to the motor accident and show that it is not merely supportive or preventative.
Time Limits and Dispute Resolution
A claim under the MAC Act must generally be made within three years of the accident date. Failure to meet this deadline may result in the claim being barred, unless an extension is granted by the Court. This time limit is strict and applies regardless of when the injury symptoms first appeared or when treatment was initiated.
If a CTP insurer refuses to fund treatment, the claimant may request a review under the insurer’s internal dispute resolution process. If unresolved, the matter may be referred to the NSW Civil and Administrative Tribunal (NCAT) for determination. In some cases, the claimant may also apply to the Court for an order to compel funding, particularly where delays or denials are affecting recovery.
Special Considerations for Rural and Remote Claimants
Residents in rural and remote areas may face unique challenges in accessing treatment and securing funding. These include:
- Longer travel times to medical providers, which may result in higher out-of-pocket costs for transport and accommodation.
- Limited availability of specialist services, requiring travel to metropolitan centres.
- Delays in receiving care due to distance and provider availability.
SIRA acknowledges that claimants in these areas may need to provide additional evidence to support travel-related expenses and treatment delays. For example, a claimant might include a log of travel dates, fuel receipts, and a medical practitioner’s statement confirming that the delay in treatment has negatively impacted recovery.
Hypothetical Example
A 42-year-old farmer in Wagga Wagga was involved in a motor vehicle accident in April 2016. He sustained a whiplash injury and developed chronic neck and back pain that required ongoing physiotherapy and specialist assessments. His claim was made under the MAC Act, as the accident occurred before the 2017 reforms. He submitted medical reports, treatment logs, and travel records showing he had to travel 120 km to see a pain management specialist every fortnight. The CTP insurer initially refused to fund the travel costs, but after a review, the claim was upheld based on medical evidence showing the travel was necessary for effective treatment.
Next Steps
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.