Compulsory Third Party (CTP) Rehabilitation Funding – What you need to know!

This blog is to provide some basic information regarding the obligations of Compulsory Third Party (CTP) Insurers to fund reasonable and appropriate rehabilitation. This is particularly relevant in motor vehicle accidents.

Every person that owns a car in Queensland must pay registration fees.  As part of our registration fees, we pay for Compulsory Third Party (CTP) Insurance.  This can include a component for a CTP insurer called the Nominal Defendant which is a government insurer set up for those involved in a road accident with either an unregistered vehicle or an unknown vehicle (ie a ‘hit and run’).

The Motor Accident Insurance Commission (“MAIC”) is the regulatory body set up with the responsibility for managing the CTP scheme in Queensland.

It publishes various information brochures and guides about the CTP scheme in Queensland.

This includes a “Road to Recovery” brochure which can be found here https://maic.qld.gov.au/wp-content/uploads/2017/05/MAIC-Road-to-Recovery-Brochure-May-2017.pdf.

In simple terms, if you commence a CTP claim for injuries which you sustained in a road accident (which was not your fault), the CTP Insurer has an obligation to fund the reasonable and appropriate rehabilitation that you need in order to assist in your recovery.

It should be noted that the CTP Insurer does not have this obligation until it admits liability for your injuries (that is admits that their driver was the ‘at fault’ driver) which could be up to 6 months after you delivery your ‘Notice of Accident’ claim form.

However, in practice, the majority of the time, the CTP insurer will agree to pay the reasonable and appropriate rehabilitation before this step happens.  Also, it is quite common that in a road accident claim, it is easy to establish liability and the CTP insurer will not take very long to send their admissions.

But what is “reasonable and appropriate rehabilitation”.

Well this could depend on a number of factors, including: –

  • What is nature and extent your injury? Ie do you need specialist assessment, surgery, etc
  • Is it a catastrophic or serious personal injury – like a spinal cord injury? Maybe you need occupational therapy to assist in learning to use a wheelchair, toileting, getting around your home, you will need home modifications. Potentially all of these things could be reasonable and appropriate rehabilitation;
  • What is your treating doctors recommended allied health rehabilitation programs.
  • Some people just rehabilitate or recover at different speeds. Some people might recover quicker than others.
  • Maybe there is a psychiatric/psychological component which needs addressing that might assist in any physical recovery.

It is vital to talk to your doctor about ALL your injuries, complaints or other symptoms so that your treating medical providers can complete a full and accurate assessment.

The CTP Rehabilitation funding scheme operates on a ‘GP referral’ based scheme.  Basically, you need to see your GP (usually your first point of contact), talk to them about your injuries or other complaints symptoms and ask them for their advice about what you need.

Rehabilitation could be a referral to a specialist surgeon (ie an Orthopaedic surgeon), for physiotherapy, for counselling.  You might also need medication (like pain relief).  This can also be funded or reimbursed.  You might also incur costs of travel to and from your medical providers.  Maybe you can’t drive as a result of your injuries and you need to get an Uber or a taxi.  You could ask for this to be reimbursed!

What is reasonable and appropriate, is arguably anything that your treating doctor recommends for your recovery from injuries that have occurred in your accident.

Remember – 2 important rules: –

  1. Tell your doctor about every complaint, symptom or other issue which has arisen after your accident AS SOON AS POSSIBLE. The earlier you tell your doctor the easier it is to prove it was caused by your road accident;
  2. keep your receipts! This is the best way to establish your claim to have these costs reimbursed!

And remember – the sooner you get treatment and rehabilitation for your injuries the better your long term recover should be.

You should talk to our experienced Compensation Lawyers about commencing a CTP claim and your rights and entitlements to funding for your recommended recovery program

 

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