How SIRA determines travel and accommodation costs for NSW CTP claims
If you've been injured in a motor accident in NSW and need to travel for medical treatment, the Compulsory Third Party (CTP) scheme may cover your travel and accommodation expenses. The SIRA (State Insurance Regulatory Authority) provides clear guidelines on what is eligible. This article explains how SIRA assesses these costs, what evidence you need, and when to seek legal advice.
What SIRA covers for travel and accommodation
Under the Motor Accident Injuries Act 2017, CTP claims in NSW cover travel and accommodation costs that are reasonable and necessary for treatment. SIRA defines this as:
- Travel costs: Expenses for transport to and from medical appointments, including taxi fares, bus tickets, or car travel. You must show the travel was required for treatment, not for convenience.
- Accommodation costs: Overnight stays at a hotel or other lodging if you need to stay overnight for treatment. SIRA requires evidence that the stay was essential, not just a convenience.
SIRA’s guidelines (https://www.sira.nsw.gov.au/claims/motor-accidents/what-you-can-claim) state that claims must be supported by medical necessity. For example, if you need to travel 200km for specialist treatment, the cost of a taxi or train ticket would be covered. However, if you could attend a local appointment, travel costs may not be approved.
Evidence needed to claim travel and accommodation
To support your claim, you must provide:
- Medical records: A doctor’s note confirming the necessity of travel for treatment.
- Receipts: Proof of travel and accommodation expenses (e.g., taxi invoices, hotel bills).
- Accident details: Documentation showing the date and location of the accident, and how it led to the need for travel.
SIRA may also require a statement of necessity from your treating medical practitioner. For example, if a specialist is only available in Sydney and you live in Newcastle, the travel cost would be justified.
Time limits and when to seek advice
CTP claims must be submitted within five years of the accident, as per the Motor Accident Injuries Act 2017. However, delays can reduce the chances of approval, especially if medical records are unavailable or evidence is lost.
- If your claim is denied, you may need to appeal to the
- NSW Civil and Administrative Tribunal* (NCAT). SIRA provides a
- formal review process* for disputes, but many claimants benefit from legal advice to navigate this.
Example: When is travel considered necessary?
Consider a claimant who was in a car accident and required surgery in a regional hospital. The doctor advised a 10-day recovery period, during which the claimant needed to stay overnight for follow-up appointments. SIRA would cover:
- Taxi fares to the hospital.
- Hotel accommodation for the 10 days.
- Transport to and from the hospital during the recovery period.
However, if the claimant could have stayed with a relative locally, the accommodation cost might be denied.
What to do next
If you’re unsure whether your travel and accommodation costs are covered, or if your claim has been rejected, contact a legal professional. While SIRA provides guidelines, individual claims depend on the facts of your case. Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.