The Motor Accidents Compensation Regulations (2005 and 2015) place limits on the fees, costs and charges for a range of services associated with motor accident personal injury claims.
These services can include:
- settlement amounts and related legal costs (it should be noted that fee limits do not apply in all cases)
- medico-legal assessment services
- fees payable for treatment (included on the Australian Medical Association list of medical services )
- travel costs
The Motor Accidents Compensation Regulation 2015 started on 1 April 2015 and applies to all new claims lodged on or after 1 April 2015, except for the costs disclosure provisions.
Some of the new provisions also apply to existing claims where a specified event occurs on or after 1 April 2015.
The links below provide a summary of the provisions in the 2015 Regulation, a brief description of any changes and when each of those provisions begins.
- 2015 regulation commencement timing table
- 2015 regulation detailed changes and commencement timing table
For legal professionals
Changes to legal fees for minor injury CTP claims
The Motor Accidents Compensation Regulation 2015 has been amended to cap legal costs for CTP Green Slip claims made on or after 1 November 2016, regardless of a prior costs agreement.
- Prohibit contracting out of maximum solicitor-client costs for claims for a settlement or award of not more than $50,000.
- Protect the first $50,000 of a settlement or award from solicitor-client costs. (This means that the maximum solicitor-client costs cannot be more than party-party costs plus the difference between the settlement/award and $50,000).
- Limit legal costs to $5,000 for claims made by children under 18 years of age where the settlement or award amount is not more than $25,000 or if the same legal practice is bringing a claim on behalf of another occupant of the same vehicle
- Limit legal costs to $10,000 for claims made by children under 18 years of age where the settlement or award amount is between $25,000 and $50,000.
Claims cost disclosure
All legal professionals representing a CTP claimant must provide us with a breakdown of costs for that claim when the claim is finalised.
This breakdown must include:
- the total amount the claim was resolved for
- all deductions (including all legal costs and disbursements) and paybacks in relation to the claim
- the total amount paid to the claimant
To help you do this, we developed a claims cost disclosure form in consultation with legal professionals and the Law Society of NSW .
The process for disclosing claims costs involves:
- you ensure the insurer has your correct and current email address
- after claim settlement we send you an email containing a secure link to an online form
- you have 20 days (from the date of the email) to complete and submit the online form to us. We will monitor compliance.
- after we receive the form, we’ll send you a confirmation email containing a PDF copy of the completed form
We have developed a damages and costs calculator to help calculating costs under the provisions of both the 2005 and 2015 Regulation.
Allied health professional fees
Insurers pay for reasonable and necessary treatment, rehabilitation and care services for eligible claimants.
We currently do not have gazetted fees for allied health services, with the exception of a $35.60 (plus GST) fee for the initial allied health recovery request. Subsequent allied health recovery requests do not attract a fee and should be completed as part of the standard consultation cost.
As the allied health professional you can negotiate with the insurer:
- agreed fees and costs for providing approved treatment
- payment for any request for additional reports or opinions on a claimant’s treatment or progress
- payment for completion of the rehabilitation services request, attendant care request, equipment request or agreed goals of rehabilitation.
If the insurer denies liability, or declines a treatment request because it does not meet reasonable and necessary criteria (for example, treatment prescribed that is not for the injury sustained in the crash), the patient is personally responsible for payment of accounts.
That’s why if you’re an allied health professional you should:
- confirm your patient has submitted either an accident notification form or personal injury claim form
- seek approval from the insurer before starting treatment
- confirm the process for submitting invoices directly to them for payment.
Our allied health professionals section has more information on providing treatment in the CTP Scheme.
For more information on the claims process, visit making a claim.
Medical assessment and claims assessment fees and costs
We help people injured in motor vehicle accidents to resolve medical and claims disputes with insurers.
These processes include the setting of specific fees and costs for the medical and legal experts involved.
For more information on the medical and claims assessment processes, see our disputes section.
For more detailed information of the limits upon recoverable costs read: