What travel and accommodation costs are covered under NSW CTP for medical assessments?
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 the NSW Compulsory Third Party (CTP) scheme, injured motorists can claim reasonable travel and accommodation expenses related to medical assessments. These costs are funded by the at-fault driver’s insurer. The Motor Accident Injuries Act 2017 and SIRA guidelines define what is covered, including travel to and from appointments, overnight stays for assessments, and transportation for dependants.
Travel costs include public transport fares, taxi or ride-share expenses, and car parking fees. For overnight stays, accommodation costs like hotel or motel expenses are reimbursed if the assessment requires an overnight stay. SIRA’s guidelines state that these claims must be 'reasonable' and directly related to the medical assessment.
How to claim travel and accommodation expenses for CTP medical assessments?
To claim these costs, injured motorists must notify their insurer of the medical assessment. This is typically done through the insurer’s claims process managed by S/WIRA. The injured person must provide evidence of the travel and accommodation expenses, such as receipts, invoices, or transport tickets. For example, a taxi receipt showing the date, time, and destination of a trip to a medical assessment would be required.
If the assessment requires an overnight stay, the injured person must document the necessity of the stay. This could include a letter from the medical practitioner explaining why the assessment cannot be completed during the day. SIRA’s guidelines also require that the accommodation be 'reasonable', for instance, a hotel stay in Auburn would be covered, but luxury accommodations or extended stays beyond the assessment’s needs would not.
What documentation is required to support these claims under SIRA guidelines?
SIRA requires specific evidence to support travel and accommodation claims. Medical records confirming the assessment’s date and location are essential. For travel costs, receipts, tickets, or a log of transport usage must be provided. For accommodation, invoices from hotels or motels, along with a statement from the medical provider justifying the overnight stay, are necessary. In cases where the injured person is a child or dependent, additional documentation such as a parent’s travel receipt or a care provider’s note may be required.
The SIRA guidelines also emphasize that claims must be submitted promptly. Delays in submitting evidence could result in the insurer refusing to cover the costs. For example, if a medical assessment is scheduled for 10 AM and the injured person travels at 9 AM, the travel cost is covered, but a 9 AM departure without a valid reason might be challenged.
Time limits and when to seek advice
Under the Motor Accident Injuries Act 2017, injured persons have 52 weeks from the date of the accident to claim certain benefits, including travel and accommodation costs. However, this time limit does not apply to all claims. For instance, if the injured person is seeking compensation for long-term care or ongoing treatment, they may need to submit claims beyond this period. It is crucial to submit evidence within the 52-week window to avoid being excluded from benefits.
If the insurer disputes a claim, the injured person can request a review by SIRA. In cases where the dispute involves complex medical or legal issues, such as whether a particular travel cost is 'reasonable', seeking independent legal advice is advisable. For example, if the insurer refuses to cover a taxi ride to a specialist appointment, the injured person may need to provide additional evidence, such as a letter from the specialist confirming the necessity of the trip.
Next steps
If you are preparing for a medical assessment and need to claim travel or accommodation costs, it is essential to gather all required evidence promptly. Time limits apply, and disputes can arise if claims are not submitted correctly. For personalized advice, complete the quick, no obligation enquiry form to request contact about your circumstances.