What Travel and Accommodation Costs Are Covered Under 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).
Under the NSW Compulsory Third Party (CTP) scheme, claimants may be reimbursed for travel and accommodation costs incurred to attend medical appointments or treatment related to a motor accident. The Personal Injury Commission (PIC) assesses these expenses based on the Motor Accident Guidelines and SIRA’s interpretation of what is reasonable and necessary. Travel costs include public transport fares, taxi or ride-share expenses, and parking fees. Accommodation expenses cover overnight stays at hotels or motels if treatment requires overnight attendance. However, the PIC does not cover luxury accommodations or travel for non-essential purposes.
How SIRA Determines Reasonableness of Travel/Accommodation Costs
SIRA evaluates whether travel and accommodation expenses are reasonably necessary for treatment. For example, if a claimant requires a specialist consultation in a city 200km from their Central Coast home, the PIC will consider the distance, availability of local treatment, and the necessity of the trip. Expenses must be documented with receipts, medical records, and a clear link to the injury. SIRA also considers the claimant’s ability to travel independently and whether alternative arrangements (e.g., a local specialist) were viable.
Practical Steps to Support Your Claim on the Central Coast
To strengthen your claim, gather evidence such as:
- Medical records confirming the need for travel/accommodation
- Receipts for transport, hotels, and meals
- A letter from your treating medical practitioner explaining the necessity of the trip
- Proof of distance (e.g., Google Maps printout or public transport timetable)
Claimants should also notify their insurer promptly and keep records of all correspondence. If the PIC disputes the claim, SIRA’s What You Can Claim guide outlines the criteria for approval.
How PICs Resolve Disputes Over These Costs
Disputes often arise when the PIC questions whether the travel or accommodation was essential. For instance, if a claimant travels to a specialist in Sydney for a routine MRI that could have been done locally, the PIC may argue the cost is unreasonable. In such cases, claimants can submit additional evidence, such as a second opinion from a local doctor or proof of limited local treatment options. The PIC will weigh all evidence and apply the guidelines strictly.
A Hypothetical Example: Overnight Stay for Treatment
Consider a claimant injured on the Central Coast who requires a specialist surgery in Newcastle. The PIC may dispute the cost of a hotel stay if the surgery could have been completed in a local hospital. However, if the specialist is the only provider offering the treatment and the claimant’s condition necessitates overnight care, the PIC is more likely to approve the accommodation. This example highlights the importance of documenting the necessity of the trip and the lack of viable local alternatives.
Time Limits 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 the PIC rejects the claim, claimants have 28 days to request a review. For disputes beyond this period, claimants should seek legal advice promptly. Delays can result in lost entitlements, as the PIC may close the claim after the 52-week period.
Next Steps for Claimants
If you are disputing travel or accommodation costs under your CTP claim, it is essential to act quickly. Gather all relevant evidence, submit your claim within the 52-week timeframe, and request a review if necessary. For personalized guidance on navigating disputes on the Central Coast, complete the quick, no obligation enquiry form to request contact about your circumstances.