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What you can claim

What you can claim depends on your injury and your life circumstances (eg whether you were working at the time).

It also depends on whether you were at fault or not.

If you were injured and the driver at fault, you may claim for up to $5,000 for treatment costs and lost income incurred in the first six months after an accident.

If you were not at fault for the accident you may be able to claim for:

Treatment and rehabilitation expenses

The insurer will pay for reasonable and necessary treatment expenses related to the accident.  This includes hospital, medical, pharmaceutical and rehabilitation expenses like physiotherapy.

Reasonable and necessary treatment is:

  • directly related to your injuries
  • going to help you get back to your usual activities
  • right for your type of injury
  • provided by appropriately qualified health professionals
  • cost effective

You can also claim for the cost of travelling to and from appointments.

For serious injuries, the insurer may also pay for injury-related support services (like the cost of help at home).

In some cases a specialist case manager or rehabilitation provider may work with you, your family, health professionals, your workplace and the insurer to coordinate a recovery plan.

Talk to your insurer first before undergoing treatment (excluding emergencies). That way you know beforehand if they pay for the treatment.

You must send the insurer accounts for payment. If you have already paid for treatment, send the insurer the receipt so you can be paid back.

Lost income

You may be able to claim for lost income for any time that you are unable to work.

This is usually paid as a lump sum when the claim is finalised.

Lost income payments are capped at a maximum of $4,777 net per week (as at 1 October 2016), and adjusted annually. Your pre injury income will be taken into consideration.

To work out your lost income the insurer may:

  • obtain a report from your doctor to confirm that you couldn't work because of your injuries
  • ask your employer for a letter
  • if you're self-employed,  ask you for a letter from your accountant
  • ask you for your tax returns

Loss of future income

Most people are able to return to their previous work.

If you have a serious injury you may be able to claim for loss of future income if you can show that your injury will have an ongoing effect on your future earnings

Payment for loss of future income will be made when your claim is finalised.

Pain and suffering (called non-economic loss)

These are payments made for pain and suffering and loss of enjoyment of life.

You have to have a serious injury resulting in permanent damage to be eligible. You are only entitled to this payment if your permanent impairment is assessed as more than 10 per cent.

The amount paid will depend on how your injuries are affecting your life.  The maximum payable from October 2016 is $521,000.

Payment for non-economic loss will be made when your claim is finalised.

Financial hardship

In cases of financial hardship you may be able to receive an advance payment.

Compensation when a relative dies

You may be able to claim compensation if a close relative dies in an accident (caused either partly or completely by another driver). A close relative could be:

  • your husband
  • your wife
  • your partner
  • your brother or sister
  • your half brother or sister
  • parent or child

You can claim for:

  • medical expenses
  • funeral costs
  • loss of financial support from the relative who died
  • loss of services, such as the care of a parent for a child
  • loss of earnings from your relative from their injury until their death

You may be able to claim even if the relative who died was partly at fault in the accident.

Everyone responds differently to the death of a loved one. Take care of yourself and allow others to support you. Friends and family, support groups and social workers and other health professionals can all help.

Our emotional recovery page has more information that might help you. We also have a guide for people who have lost a relative in a motor vehicle accident and fact sheets on:

Further information

If you can’t agree with your insurer

Sometimes there can be disputes about compensation.  If there’s a dispute, there’s help available. Our motor accidents disputes section has more information

Or call our Claims Advisory Service on 1300 656 919.