Travel and Accommodation Costs in NSW CTP Claims
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).
A threshold injury under the Motor Accident Injuries Act 2017 (NSW) includes a soft tissue injury and a psychological or psychiatric injury that is not a recognised psychiatric illness (adjustment disorder and acute stress disorder are the usual examples; s 1.6 and Motor Accident Guidelines Part 5).
Under New South Wales Compulsory Third Party (CTP) insurance, injured motorists can claim reimbursement for travel and accommodation expenses related to medical treatment. However, many people in Western Sydney make errors that delay or reduce their compensation. This article explains what costs are covered, how to avoid common mistakes, and what evidence insurers require.
What Travel and Accommodation Costs Are Covered?
NSW CTP insurance covers travel and accommodation expenses if they are necessary for medical treatment. This includes:
- Travel to and from medical appointments, including specialist visits
- Overnight stays at hospitals or treatment facilities
- Transportation to and from rehabilitation services
- Travel for follow-up appointments or therapy sessions
The Motor Accident Injuries Act 2017 (s 4.4) specifies that benefits are limited to injuries resulting from the accident. If your injuries are below the 'threshold injury' level, you may not be eligible for these costs.
Common Mistakes to Avoid
- Not Documenting Necessity - Insurers require clear evidence that travel/accommodation was essential for treatment. Failing to show a direct link between the expense and medical care can lead to rejection.
- Missing Receipts or Records - Without proper documentation, claims may be denied. Keep receipts for travel, accommodation, and medical records showing the necessity of the expense.
- Not Understanding Time Limits - Most CTP claims must be submitted within 52 weeks of the accident. Delays can result in lost benefits.
- Ignoring Specific Guidelines - SIRA's Motor Accident Guidelines outline what constitutes a 'threshold injury.' If your injury doesn't meet these criteria, you may not be eligible for certain costs.
How to Properly Document Your Claim
To support your claim, gather:
- Medical records confirming the need for travel/accommodation
- Receipts for travel (e.g., taxi invoices, train tickets)
- Hotel or accommodation receipts with dates
- Proof of income if you're claiming lost wages
- A statement from your treating medical practitioner explaining the necessity of the expense
Insurers often dispute claims by questioning whether the travel was 'necessary' or 'reasonable.' For example, a patient might need to travel 50km for a specialist appointment but fail to document the specialist's recommendation, leading to a denied claim.
Time Limits and Dispute Options
Most CTP claims must be submitted within 52 weeks of the accident. If you miss this deadline, you may lose your right to claim benefits. If your insurer disputes your claim, you can:
- Request a review of the decision
- Seek mediation through the NSW Civil and Administrative Tribunal (NCAT)
- Consult a solicitor for further options
When to Seek Legal Advice
If your claim is denied or you're unsure about your eligibility, it's important to seek professional advice. A solicitor can help you:
- Review your claim for errors
- Challenge an insurer's decision
- Ensure you meet all documentation requirements
Final Steps
Claiming travel and accommodation costs under NSW CTP requires careful attention to detail. By understanding what is covered, avoiding common mistakes, and gathering proper evidence, you can maximise your chances of a successful claim. If you need assistance with your specific circumstances, complete the quick, no obligation enquiry form to request contact about your case.