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).
In New South Wales, the Personal Injury Commission (PIC) covers travel and accommodation costs for CTP claimants when medical treatment is necessary. However, disputes over these costs are common, especially in rural and remote areas where transport options are limited. This article explains what the PIC expects in such disputes, the evidence required, and how to navigate challenges.
What Travel and Accommodation Costs Are Covered?
Under the Motor Accident Injuries Act 2017, claimants may claim reasonable travel and accommodation expenses to attend medical appointments or treatment. This includes:
- Transportation to and from medical facilities
- Overnight stays if treatment requires multiple days
- Travel to specialist consultations not available locally
The PIC assesses costs based on the necessity of the travel. For example, a claimant in a remote area may need to travel long distances for specialist care, which the PIC must consider as reasonable.
How Are Disputes Resolved in Rural Areas?
Disputes over travel/accommodation costs are resolved through the PIC's internal review process. In rural areas, the PIC may place greater weight on evidence of limited local medical resources. Claimants should:
- Document the reason for travel (e.g., specialist consultation not available locally)
- Provide receipts for travel expenses
- Explain why alternative local options were unavailable
The PIC may also consider the cost of alternative transport, such as ambulance services or car hire, if applicable.
Evidence Required for Claims
To support a claim, claimants must provide:
- Medical records confirming the need for travel
- Travel receipts (e.g., fuel, tolls, accommodation invoices)
- Proof of distance traveled (e.g., GPS data, maps)
- Evidence of limited local medical options (e.g., hospital records, GP notes)
In disputes, the PIC may request additional information or consult with medical professionals to verify the necessity of travel.
The PIC's Location and Cost Assessment
In rural areas, the PIC may have fewer resources to verify claims, making it crucial to provide clear evidence. For example, a claimant needing a specialist in a regional city may have higher travel costs than someone in Sydney. The PIC must consider these differences when assessing reasonableness.
Dispute Resolution Process
If a claimant disagrees with the PIC's decision, they can request an internal review. This involves:
- Submitting a written appeal with new evidence
- Having the case reviewed by a senior PIC officer
- Receiving a final decision within 28 days (per PIC guidelines)
It's important to note that a challenge does not guarantee a changed decision. The PIC must be convinced that the original assessment was incorrect.
Practical Steps for Rural Claimants
- Keep detailed records of all travel and accommodation expenses
- Consult with your treating medical practitioner to confirm the need for travel
- Contact the PIC's rural support team if available
- Seek legal advice if disputes escalate
Time Limits and Next Steps
Claimants must notify the PIC of travel/accommodation costs within 52 weeks of the accident (per s 3.28 of the Motor Accident Injuries Act 2017). However, this period may be extended for ongoing treatment. If you're facing a dispute over travel costs, act promptly to submit evidence.
Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.