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).
NSW CTP insurers assess travel and accommodation costs based on medical necessity, documented evidence, and SIRA guidelines. If you've incurred expenses for treatment in Ashfield, understanding how insurers evaluate these costs is critical to securing fair compensation. This article explains the legal framework, practical steps, and dispute options for claimants in NSW.
Legal Framework for Travel and Accommodation Claims
Under the Motor Accident Injuries Act 2017, claimants may claim reasonable travel and accommodation costs if they are necessary for medical treatment. SIRA’s guidelines clarify that these expenses must be directly related to the injury and approved by a medical practitioner. For example, travel costs for attending a specialist appointment in Ashfield are generally recoverable, but insurers will scrutinise whether the journey was essential and not avoidable.
Insurers assess travel costs by considering:
- The distance between your residence and the treatment location
- The mode of transport (e.g., taxi, bus, or private vehicle)
- Medical documentation confirming the necessity of travel
- Whether alternative transport options were available
Accommodation costs are limited to overnight stays required for treatment. Insurers will review:
- Medical records confirming the need for overnight care
- Receipts for lodging expenses
- Whether the stay was unavoidable and directly related to the injury
Practical Steps for Claimants in Ashfield
To support your claim, gather:
- A medical certificate detailing the necessity of travel or accommodation
- Receipts for transport and lodging expenses
- A record of the treatment dates and location
- Any correspondence with the insurer regarding your claim
Claimants should also note that insurers may request additional evidence, such as a doctor’s statement explaining why alternative transport was not feasible. For instance, if you needed to travel to a specialist in Ashfield but had no access to a car, this would strengthen your case.
Time Limits, Disputes and When to Seek Advice
CTP claims must be submitted within 52 weeks of the accident, though extensions may apply in exceptional circumstances. If an insurer rejects your travel or accommodation claim, you can:
- Request a review of their decision
- Submit additional evidence to support your case
- Seek independent legal advice to challenge the insurer’s assessment
Disputes often arise when insurers dispute the necessity of expenses. For example, an insurer might reject a claim for a taxi ride to a clinic, arguing that public transport was sufficient. In such cases, medical evidence showing that public transport was unavailable or impractical is crucial.
Example: A Claimant’s Experience in Ashfield
Consider a claimant who required overnight treatment at a hospital in Ashfield after a motor accident. Their insurer initially refused to cover accommodation costs, arguing that the stay was not medically necessary. The claimant submitted a doctor’s statement confirming that the overnight stay was required for post-operative care, which led to the insurer approving the claim. This example illustrates how medical documentation can resolve disputes.
Next Steps for Claimants
CTP insurers in NSW evaluate travel and accommodation costs based on strict legal criteria. If you’re unsure whether your expenses qualify, or if your claim has been rejected, it’s important to seek guidance. Time limits and procedural rules mean acting promptly is essential. For tailored advice, complete the quick, no obligation enquiry form to discuss your circumstances.