How CTP Insurers Fund Treatment Costs for Modified Vehicle Injuries
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).
If you've suffered a disabling injury in a motor vehicle accident involving modifications like hand controls or vehicle aids in Bathurst, NSW, you may be entitled to treatment costs funded by the Compulsory Third Party (CTP) scheme. This article explains how SIRA assesses funding for these claims, what evidence is required, and key considerations for regional claimants.
NSW CTP Rules for Modified Vehicle Injuries
Under the Motor Accident Injuries Act 2017, CTP insurers must cover treatment costs for injuries caused by motor vehicle accidents, including those requiring modifications. SIRA's guidelines state that funding covers:
- Medical treatment for injuries
- Specialist equipment like hand controls or mobility aids
- Rehabilitation services
For modified vehicles, SIRA evaluates whether the injury meets the 'threshold injury' criteria under the Motor Accident Guidelines. This includes assessing neurological signs and functional impairments. If the injury is classified as a threshold injury, treatment costs are funded under the CTP scheme.
Practical Steps and Evidence for Funding Claims
To support your treatment cost claim, you'll need to provide:
- Medical records confirming the injury and need for modifications
- A report from a medical practitioner detailing treatment requirements
- Evidence of the vehicle modification (e.g., receipts, invoices)
- Accident details including the date, location, and circumstances
SIRA may request a medical assessment to confirm the injury's severity and treatment needs. For example, if you require hand controls after a spinal injury, your doctor must prove the modification is medically necessary.
Time Limits and Dispute Resolution
CTP claims must be made within 52 weeks of the accident, unless an extension is granted. If your claim is disputed, you can:
- Request a review from SIRA
- Seek independent medical opinion
- Lodge a complaint with the NSW Civil and Administrative Tribunal (NCAT)
In regional areas like Bathurst, delays in accessing specialists or documentation can affect claims. It's crucial to act promptly and consult a legal professional if you face disputes over treatment funding.
When to Seek Legal Advice
CTP funding rules can be complex, especially for modified vehicles. A solicitor can help you:
- Navigate SIRA's assessment process
- Challenge denied claims
- Ensure all documentation meets CTP requirements
If you're unsure whether your treatment costs qualify, seek legal advice before deadlines expire.
Next Steps
CTP funding for vehicle modifications depends on proving the injury's severity and treatment necessity. In Bathurst, regional factors like specialist access may influence your claim. To request contact about your circumstances, complete the quick, no obligation enquiry form.