How Treatment Costs Are Funded in CTP Claims for Passengers Not Wearing Seatbelts
If you were a passenger in a motor vehicle accident in rural or remote New South Wales and were not wearing a seatbelt, you may still be entitled to have your treatment costs funded through the Compulsory Third Party (CTP) insurance scheme. This funding is not automatically denied because of seatbelt non-use. Under the Motor Accident Injuries Act 2017 and the Motor Accident Injuries Regulation 2017, the CTP insurer must provide treatment and care benefits for injuries sustained in a motor accident, regardless of whether the injured person was wearing a seatbelt at the time. This applies equally in rural and remote areas of NSW, where access to medical services may be limited.
The CTP insurer is responsible for funding reasonable and necessary treatment, including medical consultations, rehabilitation, allied health services, and diagnostic tests. This includes care provided by a medical practitioner, physiotherapist, psychologist, or other allied health professional, whether located in a regional town or a remote community. The insurer must cover treatment that is directly related to injuries arising from the accident, as confirmed by a medical practitioner.
Legal Framework for CTP Claims Involving Seatbelt Non-Use
Seatbelt non-use does not automatically disqualify a passenger from receiving CTP benefits. The Motor Accident Injuries Act 2017 does not provide that failure to wear a seatbelt bars entitlement to treatment and care benefits. The law focuses on whether the injury was caused by the accident, not on the passenger’s behaviour prior to impact.
However, if the CTP insurer disputes the claim, they may argue that the injury was exacerbated by not wearing a seatbelt. In such cases, the insurer may seek to reduce the amount payable for treatment and care benefits, or for damages, on the basis of contributory fault. This means that if a medical expert concludes that not wearing a seatbelt contributed to the severity of the injury, the insurer may apply a reduction in compensation under the principle of contributory fault. This reduction is not automatic and must be supported by medical evidence.
Practical Steps and Evidence That Matter
To secure funding for treatment costs, it is essential to act promptly and preserve evidence. The first step is to seek medical attention as soon as possible after the accident, even if injuries are not immediately apparent. Delayed symptoms are common in soft tissue injuries, and early treatment helps establish a clear link between the accident and the need for care.
Key evidence that supports a claim includes:
- A written record from a medical practitioner confirming the diagnosis and treatment plan
- Photographs of the vehicle and any visible damage at the scene
- A police report, if one was filed
- Details of any witnesses to the accident
- Records of travel to and from medical appointments, particularly if services are located far from the claimant’s residence
In rural and remote areas, claimants may need to travel long distances for treatment. The CTP insurer must cover reasonable travel costs for medical appointments, including fuel, accommodation, and meal allowances, where appropriate. These costs must be documented and submitted with a claim for reimbursement.
Time Limits and Dispute Resolution
There are time limits for making a CTP claim. You must notify the CTP insurer within 6 months of the accident date, or within 6 months of the date you first became aware of a personal injury arising from the accident. Failure to notify within this period may result in the claim being barred, unless an extension is granted by the Motor Accidents Authority.
If the insurer refuses to fund treatment, or disputes the extent of the injury or the need for care, you may request a review. You can also apply to the Motor Accidents Commission for a determination. In cases involving remote locations, the Commission may consider the practical difficulties of accessing care and the impact of travel on recovery when assessing claims.
Hypothetical Example
A 42-year-old woman was a passenger in a car that collided with a tree on a rural road in northern NSW. She was not wearing a seatbelt and sustained a whiplash injury and a minor concussion. She was taken to a regional hospital, where she received initial treatment. Over the next six weeks, she attended a physiotherapist in a nearby town and saw a psychologist for anxiety related to the crash. Her travel to these appointments required two hours each way. The CTP insurer initially refused to fund the travel costs, arguing that not wearing a seatbelt contributed to her injury. However, a medical report confirmed that the injury was caused by the impact and not by the absence of a seatbelt. After a review, the insurer agreed to fund all treatment and travel costs.
When to Seek Independent Advice
While the CTP scheme provides coverage for treatment and care benefits regardless of seatbelt use, the process of claiming can be complex, especially in remote areas where medical records may be stored in different locations or where travel and accommodation costs are significant. If your claim is disputed, or if you are unsure whether a treatment is covered, it is advisable to seek independent legal advice.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.