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).
Under NSW's Compulsory Third Party (CTP) scheme, injured claimants may be entitled to cover travel and accommodation costs related to medical treatment. This guide explains what expenses are eligible, how to document them, and how SIRA assesses claims in Balmain. Practical examples clarify how to substantiate your claim.
What Travel and Accommodation Costs Are Covered?
NSW CTP rules allow claimants to claim reasonable travel and accommodation expenses incurred for medical treatment. This includes:
- Transport to and from appointments (e.g., taxi, bus, or train fares)
- Overnight stays at hotels or motels for treatment
- Travel costs for family members accompanying the injured person
SIRA's guidelines specify that expenses must be:
- Directly related to medical treatment
- Reasonable in amount
- Documented with receipts or other proof
For example, if you need to travel from Balmain to a specialist in Sydney for treatment, the cost of a train ticket or taxi fare may be recoverable. Overnight stays must be shown as necessary for treatment, not for leisure.
How to Document Travel Expenses
To claim travel costs, you must provide:
- A record of the journey (e.g., train tickets, taxi receipts, or a log of travel dates)
- A medical certificate confirming the necessity of the travel
- Evidence of the travel's connection to your treatment
For instance, if you need to attend a physiotherapy session in Balmain but live in nearby Wollongong, you must show that the travel was essential for your recovery. Keep all receipts and note the date, time, and purpose of each trip.
Evidence for Accommodation Claims
Accommodation costs are only recoverable if:
- The treatment requires overnight stays
- The stay is directly connected to medical care
- You can prove the cost (e.g., hotel receipts)
SIRA typically requires:
- A medical report stating the need for overnight treatment
- Proof of the accommodation cost
- A statement explaining why the stay was necessary
For example, if you need to stay overnight in Balmain for a specialist appointment, you must provide a doctor's note confirming the necessity of the overnight stay and a receipt for the hotel.
How SIRA Assesses Claims in Balmain
SIRA evaluates claims based on the 'reasonable necessity' test. This means:
- Expenses must be directly related to your treatment
- Costs must be reasonable for the service received
- Documentation must clearly link the expense to your injury
In Balmain, claimants should:
- Submit claims promptly to avoid delays
- Provide all requested evidence within the specified timeframe
- Seek clarification if unsure about eligibility
A hypothetical example: Maria, a Balmain resident, needs to travel to a hospital in Sydney for a MRI scan. She claims the train fare and a hotel stay. SIRA would assess whether the MRI was essential for her treatment and whether the travel was the most practical option.
Time Limits and When to Seek Advice
CTP claims must be submitted within 52 weeks of the accident if they involve only threshold injuries. For more serious injuries, there is no strict time limit, but delays can complicate claims. Always:
- Notify your insurer promptly
- Keep all medical records and receipts
- Seek legal advice if disputes arise
Next Steps
CTP entitlements depend on the accident date, injury type, and claim history. To discuss your circumstances, complete the quick, no obligation enquiry form. Every claim depends on its own facts.