How MAI Act Transitional Claims Fund Treatment Costs in Rural NSW
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 were injured in a motor accident before 1 October 2017 and now need treatment, the Motor Accident Injuries Act 2017 (MAI Act) determines how your costs are funded. Rural and remote NSW residents face unique challenges accessing healthcare, which may affect how treatment expenses are covered under transitional claims. This article explains how the MAI Act applies to your case, what evidence matters, and how location impacts funding decisions.
Key NSW CTP Rules for Transitional Claims
Transitional claims under the MAI Act apply to accidents occurring before 1 October 2017. These claims are governed by the Motor Accident Injuries Act 2017 and the Motor Accident Guidelines. For treatment costs, the SIRA guidelines specify that eligible expenses include medical bills, physiotherapy, and specialist consultations. However, rural residents may need to demonstrate additional factors, such as:
- Travel costs for appointments (e.g., fuel, tolls, accommodation)
- Limited access to local healthcare providers
- Extended wait times for specialist care
SIRA’s What you can claim page confirms that treatment costs are funded if they are 'reasonably necessary' for recovery, with location-based access issues considered as part of the 'reasonableness' test.
Practical Steps and Evidence for Funding Treatment Costs
To secure funding for treatment in rural NSW, you must provide:
- Medical records showing the injury’s connection to the accident
- Evidence of treatment necessity (e.g., doctor’s notes, treatment plans)
- Proof of location-related barriers (e.g., travel logs, distance from nearest specialist)
- Documentation of out-of-pocket expenses (e.g., receipts, invoices)
For example, if a rural resident needed a specialist surgery in Sydney but couldn’t access it locally, the claimant must show that the distance was a genuine barrier under the MAI Act’s 'reasonableness' standard.
Time Limits and Dispute Resolution
Transitional claims must be submitted within 52 weeks of the accident under the MAI Act. If treatment costs are disputed, SIRA will review the claim based on medical evidence and location-specific factors. Rural claimants should seek advice if:
- The insurer refuses to cover travel-related expenses
- There are delays in accessing specialist care
- The claimant is unsure if their location-based challenges meet the 'reasonableness' test
When to Seek Legal Advice
The MAI Act’s transitional rules are complex, especially for rural residents facing access barriers. A legal professional can help assess whether your treatment costs meet the funding criteria and ensure all location-related factors are properly documented. Time limits apply, so prompt action is essential.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.