Vehicle Modifications and the PIC's Assessment in CTP Claims
If you've suffered a disabling injury and require vehicle modifications to maintain mobility, the Personal Injury Commission (PIC) will assess whether these changes are necessary and reasonable. The PIC evaluates claims under the Motor Accident Injuries Act 2017 and SIRA guidelines, focusing on medical necessity, cost-effectiveness, and alignment with the injury's impact. Understanding what evidence the PIC expects can help resolve disputes over modifications.
Key CTP Rules Behind Vehicle Modification Claims
Under NSW law, vehicle modifications are considered part of the 'treatment and care benefits' outlined in the Motor Accident Injuries Act 2017. SIRA guidelines state that modifications must be:
- Medically necessary - directly related to the injury's impact on mobility or function
- Reasonable in cost - aligned with standard industry pricing
- Essential for daily living - enabling the injured person to perform basic tasks
The PIC will review medical reports, rehabilitation plans, and evidence of how the modification improves quality of life. For example, hand controls or ramps must be shown to address specific mobility limitations caused by the accident.
Evidence Needed for Vehicle Modification Claims
To support your claim, gather:
- Detailed medical records showing the injury's effect on mobility
- Rehabilitation reports outlining the need for modifications
- Quotes from approved suppliers for the modification's cost
- Evidence of how the modification enables daily activities (e.g., cooking, dressing)
- Any previous correspondence with the PIC about the modification's necessity
The PIC may request independent medical opinions to verify the modification's relevance. For instance, if a claimant requests a vehicle lift, the PIC might require a doctor's statement confirming it's necessary for their injury.
Dispute Resolution for Vehicle Modifications
If the PIC disputes the necessity of a modification, you can:
- Request an internal review - the PIC will reassess the claim within 28 days of the decision
- Seek independent medical evidence - submit a second opinion from a registered medical practitioner
- Appeal through the NSW Civil and Administrative Tribunal (NCAT) - if the PIC's decision is overturned, NCAT can order a new assessment
Note that challenges don't guarantee a change. The PIC must be convinced the modification meets all three criteria: medical necessity, cost reasonableness, and functional benefit.
When to Seek Legal Advice
Contact a solicitor if:
- The PIC rejects your modification claim without explanation
- You disagree with the cost assessment of the modification
- You need help preparing evidence for an internal review
- You want to challenge the PIC's decision through NCAT
A lawyer can help you understand the PIC's reasoning and ensure your evidence meets all three criteria for approval.
Next Steps
CTP claims involving vehicle modifications require careful documentation to show the modification's necessity. If the PIC disputes your claim, you'll need to provide fresh evidence of medical need and cost reasonableness. Every claim depends on its own facts. To request contact about your circumstances, complete the quick, no obligation enquiry form.