Travel and Accommodation Costs Under NSW CTP Scheme
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 been injured in a motor accident in Newcastle or Hunter and need to travel for medical treatment or stay overnight, the NSW Compulsory Third Party (CTP) scheme may cover these costs. The scheme allows for reimbursement of reasonable travel and accommodation expenses directly related to your injury treatment. This guide explains what is covered, how to claim, and the legal boundaries of eligibility under the scheme.
What Travel and Accommodation Costs Are Covered?
The NSW CTP scheme covers travel and accommodation costs if they are necessary for your medical treatment. This includes:
- Travel costs for attending medical appointments, therapy sessions, or specialist consultations.
- Accommodation costs for overnight stays required to receive treatment, such as hospital stays or overnight rehabilitation.
- Transportation costs for family members accompanying you to medical appointments, where applicable.
The scheme does not cover travel or accommodation for non-essential purposes, such as leisure trips or visits unrelated to your injury. Costs must be reasonable and directly related to your treatment.
How to Claim Travel and Accommodation Costs
To claim these expenses, you must:
- Notify your insurer of your injury and the need for travel or accommodation. This must be done within 52 weeks of the accident date.
- Provide evidence of your expenses, including:
- Medical records confirming the necessity of travel or accommodation.
- Receipts or invoices for travel and accommodation costs.
- Proof of the date and location of your medical appointments.
- Submit your claim through the insurer or the Scheme Authority (SIRA) if the insurer fails to respond.
Eligibility Criteria for Travel and Accommodation Claims
To be eligible for travel and accommodation benefits under the CTP scheme, your injury must meet the following criteria:
- Threshold injury - Your injury must be classified as a 'threshold injury' under the Motor Accident Guidelines. This includes injuries such as whiplash, soft tissue injuries, or spinal nerve-root injuries with neurological signs.
- Necessity of travel - The travel or accommodation must be essential for your treatment. For example, if you need to travel 200km for a specialist consultation, this would typically qualify.
- No contributory fault - You must not have contributed to the accident. If you were at fault, you may not be eligible for benefits.
Time Limits and Dispute Resolution
Claims must be submitted within 52 weeks of the accident date. If you fail to notify your insurer within this period, you may lose your right to claim benefits. If your claim is disputed, you can:
- Request a review from the insurer.
- Contact the Scheme Authority (SIRA) for mediation.
- Seek legal advice if the dispute escalates.
Example Scenario
Consider a person injured in a car accident in Newcastle who requires a specialist consultation in Sydney. The travel cost to attend the consultation and overnight accommodation would be eligible for reimbursement under the CTP scheme, provided the medical records confirm the necessity of the trip.
When to Seek Legal Advice
If your claim is denied, or if you're unsure about your eligibility, it's important to seek legal advice. A solicitor can help you understand your rights, ensure your claim is submitted correctly, and challenge any incorrect decisions.
Next Steps
Understanding your eligibility for travel and accommodation costs under the NSW CTP scheme is critical. If you're unsure about your circumstances, complete the quick, no obligation enquiry form to request contact about your case. Every claim depends on its own facts.