What travel and accommodation costs are covered in NSW CTP claims 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, claimants may be entitled to reimbursement for travel and overnight accommodation costs related to medical assessments. These expenses are typically covered if they are necessary for the assessment to proceed and are reasonable in the circumstances. For rural and remote areas, the NSW government’s State Insurance Regulatory Authority (SIRA) has clarified that travel costs must be directly connected to the medical evaluation, including time spent traveling to and from the assessment location.
Practical steps for rural and remote claimants preparing for medical assessments
Claimants in rural or remote NSW must take specific steps to ensure their travel and accommodation costs are eligible for reimbursement. First, keep detailed records of all travel-related expenses, including receipts for fuel, tolls, and vehicle maintenance. If the assessment requires overnight stays, document the necessity of the overnight stay and the cost of accommodation. SIRA guidelines emphasize that the travel must be essential to the assessment, so claimants should avoid unnecessary trips or excessive travel time.
For example, a claimant living in a remote area who needs to travel 150km for a medical assessment may be reimbursed for the cost of a taxi or bus fare, but not for a luxury hotel stay. Claimants should also ensure they have a confirmed appointment date and location before arranging travel. In some cases, SIRA may require a doctor’s note confirming the necessity of the travel.
Time limits, disputes and when to seek advice
Claimants must submit their travel and accommodation claims within 52 weeks of the accident, as per the Motor Accident Injuries Act 2017. If a claimant exceeds this period, they may need to provide a valid reason for the delay, such as a prolonged recovery period or a dispute over the assessment’s timing.
Disputes over travel costs are common. SIRA typically requires claimants to provide evidence that the travel was essential and that the costs were reasonable. If a claimant disagrees with a decision, they may request a review or seek mediation through SIRA.
How SIRA guidelines apply to travel expenses in remote areas
SIRA’s guidelines state that travel costs are only covered if they are directly related to the medical assessment. This includes travel to and from the assessment location, but does not cover incidental expenses such as meals or entertainment. In rural areas, claimants may need to provide additional evidence, such as a map showing the distance to the assessment location or a letter from their doctor explaining why the travel was necessary.
For instance, a claimant who needs to travel to a specialist in a regional city for a medical assessment may be reimbursed for the cost of a train ticket or a rental car, but not for a hotel stay unless the assessment requires overnight attendance. Claimants should also be aware that SIRA may require them to use public transport or approved transport services, depending on the circumstances.
When to seek legal advice
Claimants in rural and remote NSW should seek legal advice if they are unsure whether their travel and accommodation costs are covered, or if they face a dispute with SIRA. A legal professional can help ensure that all necessary documentation is submitted and that the claimant understands their rights under the CTP scheme.
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