Who pays for treatment and rehabilitation when you are injured in a motor vehicle accident?
Not every person involved in a motor vehicle accident will suffer an injury. If they do, it is not uncommon for them to have to undergo treatment and rehabilitation. The services can be expensive, and we are commonly asked who is responsible for paying these expenses?
The good news is you may be able to have your treatment and rehabilitation expenses funded by:
the insurer of the at-fault vehicle, i.e. the CTP insurer; or
your employer’s workers’ compensation insurer if the accident in work related, for example, an accident on the way to or from your workplace
This article deals only with funding for claims against a CTP insurer for accidents unrelated to work.
If you have lodged a claim against the insurer and they have either:
accepted liability for the claim; or
agreed to fund the costs despite not yet determining liability
the insurer will be obligated to fund treatment and rehabilitation expenses. This obligation is set out in the Motor Accident Insurance Act.
The insurer is only obligated to fund expenses for treatment and rehabilitation that is reasonable and appropriate. There is also an exception if you are a participant in the National Injury Insurance Scheme due to suffering a serious injury as defined under relevant legislation.
Some examples of the types of services that may be funded include, but at not limited to:
specialist consultations
surgery and associated costs
rehabilitation including physiotherapy and hydrotherapy
counselling, psychological consultations and psychiatrist consultations
medications
aids and equipment including prosthesis
The financial stress that can be caused by self-funding treatment and rehabilitation can impact your road to recovery. To ensure you have peace of mind regarding the funding of services it is important to obtain the insurer’s approval for the services before you undertaken them.
The insurer will usually require your treatment provider to submit a detailed request for funding approval, which sets out the recommended treatment or rehabilitation, why it is required and the anticipated costs. Once approved, your treatment provider can invoice the insurer directly.
If you have already incurred expenses for treatment and rehabilitation you may still be able to get the costs reimbursed to you.
If you have engaged a lawyer to assist you with your claim they can assist you in seeking recovering of expenses you have already incurred and liaise with your treatment providers and the insurer to help ensure you are receiving the maximum benefit to which you are entitled.
If you have any questions regarding the content of this article please give one of our friendly team members a call. We wish you well on your road to recovery!
