What travel and accommodation costs are covered under NSW CTP insurance?
In a motor accident in New South Wales, you may be entitled to claim travel and accommodation expenses if they are directly related to receiving medical treatment for injuries sustained in the accident. These costs are not automatically payable but must be shown to be reasonable and necessary. The insurer will assess whether the travel was required for treatment, and whether the accommodation was appropriate and cost-effective. This includes travel to and from medical appointments, specialist assessments, rehabilitation services, and overnight stays when treatment is not available locally.
What factors do insurers consider when assessing travel and accommodation claims?
Insurers assess travel and accommodation claims based on the principle that expenses must be reasonable and necessary. The Motor Accident Injuries Act 2017 and the Motor Accident Injuries Regulation 2017 set the legal framework, but insurers rely on guidance from the State Insurance Regulatory Authority (SIRA) to determine what is acceptable.
Key factors include:
- Whether the travel was required for treatment that is not available in the claimant’s local area.
- Whether the accommodation was appropriate for the purpose (e.g. a standard hotel room, not a luxury suite).
- Whether the cost of travel and accommodation was reasonable compared to available options, including public transport, carpooling, or lower-cost lodging.
- Whether the claimant provided evidence of actual expenses, such as receipts, invoices, or travel itineraries.
SIRA’s guidance confirms that insurers must consider the claimant’s circumstances, including distance, mode of transport, and the nature of the medical treatment. For example, a long-distance trip to a specialist in Sydney may be reasonable if local treatment is not available, but a claim for a hotel stay in a major city for a routine follow-up may not be.
What evidence supports a claim for travel and accommodation costs?
To have your travel and accommodation claim approved, you must provide clear and verifiable evidence. Insurers will not accept estimates or assumptions. The following documents are typically required:
- Itemised receipts for travel (e.g. train tickets, petrol receipts, taxi fares, or flight itineraries).
- Invoices or receipts for accommodation, including dates of stay and total cost.
- A letter from your medical practitioner confirming the treatment was necessary and not available locally.
- A record of the travel route and purpose, including appointment dates and times.
Photographs of the accommodation or travel mode may help, but are not a substitute for written proof. If you used a private vehicle, you may need to provide a log of kilometres travelled, supported by a vehicle registration and a record of the journey.
How do SIRA guidelines influence insurer decisions?
SIRA provides detailed guidance on what constitutes a reasonable travel and accommodation expense under the CTP scheme. While insurers have discretion in assessing claims, they must follow SIRA’s principles, which are based on fairness, reasonableness, and proportionality.
SIRA’s position is that travel and accommodation must be directly linked to treatment and not for convenience or personal preference. For example, a claim for a hotel stay in a city centre for a weekend visit unrelated to treatment will not be approved. However, a stay in a regional hotel for a week to attend a specialist rehabilitation program may be approved if supported by medical evidence.
SIRA also advises that insurers should consider alternatives, such as using public transport or staying with family, where feasible. If a claimant chooses a more expensive option without justification, the insurer may only reimburse a reasonable rate.
What should you do if your claim is denied or limited?
If an insurer denies or limits your claim for travel and accommodation, you may request a review. You can ask the insurer to reconsider their decision, providing additional evidence such as updated medical letters or alternative travel options.
If the insurer maintains their decision, you may apply to the NSW Civil and Administrative Tribunal (NCAT) for a review. NCAT has jurisdiction to determine whether a travel or accommodation expense was reasonable under the Motor Accident Injuries Act 2017.
A common example: A claimant in Wagga Wagga needed to travel to Sydney for a spinal assessment. The insurer initially refused to cover a hotel stay, arguing the claimant could stay with a relative. The claimant provided a medical letter confirming the treatment was urgent and that no suitable accommodation was available locally. After submitting the letter and a hotel invoice, the insurer agreed to cover the reasonable cost of a standard room for two nights.
Time limits and procedural steps
There is no fixed deadline for claiming travel and accommodation costs, but it is best to notify your insurer as soon as possible after incurring the expense. Delays may make it harder to obtain evidence, particularly if receipts are lost.
If you are claiming under a CTP policy that covers treatment and care benefits, you must ensure that travel and accommodation are not already included in another benefit. For example, if you received a weekly income payment, you cannot claim travel costs for a medical appointment that occurred during a period of paid leave.
When to seek independent advice
Travel and accommodation claims can be complex, particularly when the claimant lives in a regional or remote area, or when treatment requires multiple trips. The decision to claim, the type of evidence to collect, and the insurer’s response may depend on your location, injury type, and treatment plan.
If you are unsure whether your claim is reasonable, or if your insurer has denied or limited your claim, it is advisable to seek independent legal advice. An experienced solicitor can help you understand your rights under the Motor Accident Injuries Act 2017 and assist in presenting a strong case to the insurer or NCAT.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.