Medical treatment and rehabilitation
Cover is available under the CTP scheme for medical treatment, rehabilitation and personal and home care and support if you have an accepted injury claim.
The insurer will need to collect medical information relevant to your claim. If it is not clear what services are required as a result of your injuries, you may require Independent Medical Examinations to determine your treatment and care needs (view more information on medical assessments and examinations).
The Scheme provides cover for reasonable and necessary treatment, care, and support services. Generally, once liability has been determined (when the insurer has decided who is at fault in the accident; see ‘How your claim is settled’ for more information), the CTP Insurer will pay your reasonable medical treatment and rehabilitation costs. If you have already paid these costs yourself, they will reimburse you on presentation of original receipts.
In some cases, the CTP Insurer may cover these costs on a without prejudice basis, before they have determined liability, depending on the evidence available at the time.
What you can claim
Costs may include (for example):
- medical treatment
- ambulance transfers
- hospital care
- physiotherapy, and
- chiropractic treatment.
Please note that not all types of health care, therapy and support services are covered by the Scheme. It is best to contact your CTP Insurer and discuss your treatment requirements with your claims consultant before undertaking alternative treatments. Generally, all providers of medical and allied health services must be appropriately qualified for your expenses to be covered by the Scheme.
There are limits to the amount that CTP Insurers can pay for treatment. The limits are set under the South Australian Return to Work Scheme (see the ReturnToWorkSA fee schedules and Section 32 of the Return to Work Act 2014 [SA]).
You may also be able to claim:
- future treatment and care requirements that you may require as a result of the ongoing effects of your injury, and
- travel expenses to and from injury-related treatment and assessments.
Sometimes, particularly if you have limitations in your usual activities arising from your injuries, it may be reasonable and necessary for you to use paid commercial services. If this is the case, talk with the CTP Insurer handling your claim.
These reasonable and necessary costs will be covered by the CTP Insurer if you need the paid care because of your accident-related injuries. If you have a pre-existing injury, illness or condition that contributed to your need for the paid care, there may be a reduction in the amount the CTP Insurer will pay.
The CTP Insurer must encourage early and appropriate treatment and rehabilitation for your injuries. See more information about supporting your recovery and download the “Recovering from your motor vehicle accident injuries” brochure.