How SIRA Determines Travel and Accommodation Costs for 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).
If you’ve been injured in a motor vehicle accident in NSW and need to travel for medical treatment, you may be eligible for compensation for travel and overnight accommodation costs. Under the NSW Compulsory Third Party (CTP) scheme, these expenses are covered if they are reasonably necessary for your treatment. The State Insurance Regulatory Authority (SIRA) oversees how these costs are assessed and paid.
What Travel and Accommodation Costs Are Covered?
Under the Motor Accident Injuries Act 2017, you can claim for:
- Travel costs to and from medical appointments, including public transport fares, taxi receipts, and car parking fees.
- Overnight accommodation if your treatment requires overnight stays, such as specialist consultations or overnight rehabilitation.
- Transport costs for dependants who need to accompany you to treatment.
SIRA does not cover travel or accommodation for non-essential visits, such as social trips or leisure activities. The key requirement is that the expense must be directly related to your medical treatment.
How SIRA Assesses the Amount Payable
SIRA uses the Motor Accident Guidelines to determine what is reasonably necessary. For example:
- Travel costs are typically limited to the cost of the most economical transport option (e.g., public transport over taxi unless a taxi is medically necessary).
- Accommodation costs are capped at the standard rate for the location, with no additional payment for luxury or private rooms.
- Dependants’ travel is limited to one adult per claimant, with no additional costs for children.
A hypothetical example: If you need to travel 50km for a specialist appointment, SIRA would cover the cost of a bus or train ticket. If your treatment requires an overnight stay in Auburn, they would cover the standard hotel rate for one night.
Evidence Required to Support Your Claim
To claim travel and accommodation costs, you must provide:
- Medical records confirming the necessity of your travel (e.g., a doctor’s note stating your treatment requires travel).
- Receipts for travel and accommodation expenses.
- Accident reports or police statements if your travel was necessitated by the accident.
- Proof of dependant travel (e.g., a letter from your doctor stating your dependant must accompany you).
Time Limits and Dispute Resolution
You must submit your claim within 52 weeks of the accident if your injuries are classified as threshold injuries (soft tissue injuries meeting the spinal nerve-root criteria). For more severe injuries, there is no strict time limit, but claims must be submitted within the statutory period (usually 52 weeks) for benefits.
If your claim is disputed, you can request a review by SIRA or seek independent legal advice. It’s important to act quickly, as delays can reduce your chances of receiving full compensation.
When to Seek Legal Advice
While SIRA provides clear guidelines, interpreting them correctly requires legal expertise. A solicitor can help you:
- Navigate complex SIRA assessments.
- Challenge decisions if your claim is rejected.
- Ensure you receive all entitlements under the CTP scheme.
Next Steps
If you’re unsure whether your travel and accommodation costs qualify for compensation, contact a legal professional. Every claim depends on its own facts, and SIRA’s rules can be nuanced.
Complete the quick, no obligation enquiry form to request contact about your circumstances.