This fact sheet provides information for people injured in motor accidents who may be transitioning early to the CTP Care program (within 5 years after the motor accident). It applies to claims made under the Motor Accident Injuries Act 2017 for motor accidents occurring on and after 1 December 2017. The fact sheet includes information about whether transitioning into the CTP Care program will affect your Compulsory Third Party (CTP) benefits.
The CTP Care program (CTP Care) is administered by the Lifetime Care and Support Authority (LTCSA) within the CTP Scheme, under the Motor Accident Injuries Act 2017 (the Act).
People injured in a motor accident in NSW from 1 December 2017 who still have treatment and care needs five years after the motor accident will have their statutory benefits for treatment and care met through CTP Care.
CTP Care will assume responsibility for the management of treatment and care more than five years from the date of accident, or earlier in some circumstances.
Early Transition to CTP Care
CTP Care may start earlier than five years from the date of the accident if the licensed CTP insurer (licensed insurer) and CTP Care both agree that your motor accident injuries are likely to have an ongoing treatment and care need more than five years from the date of accident.
The licensed insurer and CTP Care will work together and consider all claims information to decide if you are suitable for an early transition to CTP Care. If it is agreed that you are suitable to transition early, the licensed insurer will confirm this agreement and the expected date that CTP Care will assume responsibility for the management of your treatment and care.
An early transition to CTP Care means that CTP Care will receive information about your injury needs sooner after your accident. It also means that planning and supporting your long-term treatment and care needs can begin early with CTP Care.
CTP Care will write to you within 5 business days after the transition date to confirm that the transition has taken place and provide contact details for the CTP Care contact. CTP Care will also notify your treatment and/or care providers.
The licensed insurer will provide CTP Care with copies of all information relevant to the management of your treatment and care needs.
An early transition to CTP Care will not have an impact on damages claims, weekly benefits, or treatment and care. There will be no change to your entitlements.
Weekly benefits and CTP Care
If you are receiving weekly payments of statutory benefits, your licensed insurer will continue to manage the payment of your weekly statutory benefits. Your licensed insurer will contact you if it requires information to continue your weekly benefits.
CTP Care will be responsible for providing statutory benefits for treatment and care and will contact you if it requires information about your treatment and care benefits.
Claims for damages and CTP Care
Your transition to CTP Care will have no effect on your claim for damages. The licensed insurer will continue to manage your damages claim and keep in contact with you about that claim.
The types of damages that can be claimed, the eligibility criteria, and timeframes for lodging a claim all remain the same. Because treatment and care is covered as a statutory benefit, there is no compensation for treatment and care in a damages claim, which is why it will not be affected by the early transition to CTP Care.
CTP Care is not responsible for the assessment or payment of your claim for damages.
Treatment and care expenses under CTP Care
CTP Care will determine treatment and care requests in the same way that licensed insurers review and determine requests and in accordance with section 3.24 of the Act.
On receipt of a treatment or care request, CTP Care will advise you and your treatment or care provider whether the request for treatment and care is approved, and the agreed costs, within 10 calendar days of receiving the request.
CTP Care will pay the invoice as soon as possible but within 30 days of receipt.
If a request for treatment or care has been declined or partially declined, CTP Care will include information about how you can request an internal review of the decision, in accordance with Motor Accident Guidelines requirements.
More information about CTP Care and your entitlements can be found on SIRA’s website. You can also contact CTP Assist for assistance in relation to any aspect of your claim.
- Visit SIRA website
- Call CTP Assist – an independent support and advisory service provided by SIRA on 1300 656 919 or email email@example.com.
- Contact the CTP insurer’s claims officer for further information
- Contact CTP Care on 1300 738 586
A pdf version of this fact sheet is available.