NSW CTP Greenslip FAQ
Lifetime Care & Support- What is Lifetime Care & Support?
- What is the MCIS levy?
- Lifetime Care & Support for Catastrophically Injured People
- Who Can Claim
- Claims could be for economic loss and/or non-economic loss
- How To Claim
- Claims Process
NSW CTP GreenSlip
Q. What is a Green Slip?
A Green Slip is an insurance policy linked to your vehicle that provides cover for compulsory third party (CTP) personal injury insurance when you or the person driving your vehicle is the driver at fault in an accident, and in certain circumstances regardless of who was at fault.
CTP Insurance is compulsory, and must be taken out when registering a motor vehicle. Wherever you live in New South Wales, your Green Slip will only cover your vehicle if it is registered. If it is not registered you may be personally liable for any injuries you cause in a motor vehicle accident.
Australia wide, 24 hours a day, your CTP insurance covers:
- your passengers
- other road users, such as drivers, passengers, pedestrians, cyclists, motor cyclists and pillion passengers
- injuries caused through the use of a trailer
(Source maa.nsw.gov.au September 2009)
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Q. What is not covered by CTP Greenslip?
It does not cover:
- damage to property or other vehicles
Improvements made to the Green Slip scheme since October 2006 provide even greater protection and benefits in certain circumstances regardless of who was at fault. These improvements include:
- a special children’s benefit that means all children injured in car accidents in NSW receive the necessary treatment, rehabilitation and care to assist in their recovery, regardless of who was at fault.
- introduction of the Lifetime Care and Support scheme that provides medical care, treatment, rehabilitation, attendant care and support to anyone catastrophically injured (such as severe spinal cord and/or a traumatic brain injury) in a motor vehicle accident for the rest of their life.
- coverage for people injured in motor accidents where no one is considered to have been at fault including accidents caused by a driver suffering a sudden illness, such as a heart attack or stroke or accidents caused by an unexplained mechanical or vehicle failure.
(Source maa.nsw.gov.au September 2009)
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Q. CTP and public liability insurance
The Motor Accidents Compensation Act 1999 expressly prescribes the terms and scope of cover of a New South Wales CTP (Green Slip) policy, so policy coverage is the same across New South Wales regardless of the insurer. This is not the case with public liability insurance policies as the terms and scope of the policy may vary between insurers. The Motor Accidents Authority recommends people holding both public liability and Green Slip insurance contact their public liability broker/insurer to confirm that there is no gap in their public liability cover for incidents involving motor vehicles, that are not included in their Green Slip cover.
(Source maa.nsw.gov.au September 2009)
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Lifetime Care & Support
Q. What is Lifetime Care & Support?
The Lifetime Care and Support Authority of NSW is a statutory corporation established under the Motor Accidents (Lifetime Care and Support) Act 2006.
The Authority is responsible for the administration of the Lifetime Care and Support Scheme ('The Scheme').
The Scheme provides lifelong treatment, rehabilitation and attendant care for people who have a spinal cord injury, a moderate to severe brain injury, multiple amputations, serious burns or blindness from a motor accident in NSW.
It applies to children under 16 years of age who are injured in a motor accident from 1 October 2006, and to adults from 1 October 2007.
It is funded by a levy collected through Compulsory Third Party (CTP) insurance.
The Lifetime Care and Support Authority website can be accessed at www.lifetimecare.nsw.gov.au or contact the Authority on:
- Phone: 1300 738 586
- Fax: 1300 738 583
- enquiries@lifetimecare.nsw.gov.au
(Source maa.nsw.gov.au September 2009)
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Q. What is the MCIS levy?
All Green Slips now show the MCIS (Medical Care and Injury Services) Levy as a separate item.
The MCIS Levy first appeared as a separate item on Green Slips in 2006 with the introduction of the Lifetime Care and Support scheme. This scheme provides medical care, treatment, rehabilitation, attendant care and support to anyone catastrophically injured (such as severe spinal cord and/or a traumatic brain injury) for the rest of their life.
The MCIS Levy also includes a contribution for ambulance, hospital and other services for people injured in a motor vehicle accident. These costs have always been included in your Green Slip premium, but were not listed as a separate item in the past.
The MCIS Levy is calculated as a percentage of the base premium charged by the Green Slip insurer. The MCIS Levy is GST free.
The percentage of the levy differs between vehicle classes and geographic zones based on accident and injury rates for the selected vehicle type and zone.
The following table shows the MCIS levy, at 15 August 2009, in each zone for the three common vehicle types.
|
Vehicle
Class |
Sydney Metropolitan
(% of CTP premium) |
Outer Metropolitan
(% of CTP premium) |
Newcastle/
Central Coast (% of CTP premium) |
Wollongong
(% of CTP premium) |
Country
(% of CTP premium) |
|
Motor car
|
32.0%
|
37.0%
|
39.5%
|
36.3%
|
40.5%
|
|
Motor cycle
(over 300cc) |
44.6%
|
45.5%
|
44.3%
|
44.3%
|
49.1%
|
|
Light goods carrying vehicle
(up to 4.5t GVM) |
34.3%
|
34.3%
|
33.4%
|
31.9%
|
36.1%
|
(Source maa.nsw.gov.au September 2009)
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Q. Lifetime Care & Support for Catastrophically Injured People
The Lifetime Care and Support Authority of NSW is a statutory corporation established under the Motor Accidents (Lifetime Care and Support) Act 2006. The Authority is responsible for the administration of the Lifetime Care and Support Scheme (the Scheme).
The Scheme provides lifelong treatment, rehabilitation and attendant care for people who have a spinal cord injury, a moderate to severe brain injury, multiple amputations, serious burns or blindness from a motor accident in NSW.
It applies to children under 16 years of age who are injured in a motor accident from 1 October 2006, and to adults from 1 October 2007. It is funded by a levy collected through Compulsory Third Party (CTP) insurance.
Click here to view the Lifetime Care and Support Authority website or contact the Authority
Phone: 1300 738 586
Fax: 1300 738 583
enquiries@lifetimecare.nsw.gov.au
If you have been severely injured in an accident where you were not at fault, you may also be able to claim for other types of compensation from the CTP insurer of the vehicle at fault.
(Source maa.nsw.gov.au September 2009)
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GreenSlip Claims
Q. Who Can Claim
If you have been injured in a motor vehicle accident in NSW, there are a number of circumstances in which you may be eligible to make a claim for personal injury compensation.
Other driver or owner at fault
If you have been injured in a motor vehicle accident and you can show that a driver or owner of a vehicle, other than you, was partially or completely at fault you can make a claim for personal injury compensation.
Any kind of road user can make a claim including a driver, passenger, pedestrian, cyclist, motorcyclist or pillion passenger.
If you were partly at fault in causing your own injuries, you may still be able to make a claim, but the compensation you receive will be less than it would have been if you were not partly at fault. Examples of where you may be partly at fault include:
- not wearing a seatbelt
- driving under the influence of drugs or alcohol
- travelling in a vehicle where you know the driver to be under the influence of drugs or alcohol
- driving at an unsafe speed
- not wearing a helmet when riding a motorcycle or bicycle
If you were 16 years or older, and were completely at fault in the accident in which you were injured, you may not be able to make a claim for personal injury compensation.
Special benefit for children injured in accidents on or after 1 October 2006
If you were under 16 years old and a resident of NSW at the time of the accident, you can make a claim for the children’s special benefit regardless of who caused the accident. The children’s special benefit provides for hospital, medical, rehabilitation, pharmacy, respite care and attendant care expenses.
If the accident was caused, either partially or completely, by the driver or owner of a motor vehicle you may also be able to claim for other types of compensation.
Blameless accidents from 1 October 2007
If you were injured in a blameless accident on or after 1 October 2007, you can make a claim for personal injury compensation. A blameless accident is an accident where a driver or owner of a motor vehicle is not at fault. Examples of blameless accidents may include:
- accidents caused by a driver suffering a sudden illness, such as a heart attack or stroke
- accidents caused by an unexplained mechanical or vehicle failure, such as brake failure
- accidents caused by an unavoidable collision with an animal on the road
Any road user can make a claim for a blameless accident, however, there are restrictions that apply to drivers (including motorcycle riders) injured in blameless accidents.
Drivers may not be able to make a claim if they were injured in a single vehicle accident or if they were driving the vehicle that caused the accident, i.e. they were the driver that suffered the heart attack or they were the driver of the vehicle that failed resulting in the accident.
You may also be able to claim compensation if you are a close relative of a person killed in a motor vehicle accident caused by the fault of another driver.
For more information about who can make a claim, contact the MAA's Claims Advisory Service on 1300 656 919 or visit www.maa.nsw.gov.au
(Source maa.nsw.gov.au September 2009)
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Q. Claims could be for economic loss and/or non-economic loss
Your compensation depends on the types of injuries you sustained and your circumstances at the time of the accident. As far as possible, any form of compensation is aimed at returning the person injured to their pre-injury state. Your claim could be for economic loss and/or non-economic loss.
Economic loss
Economic loss includes:
- reasonable and necessary hospital, medical, rehabilitation and pharmaceutical expenses (past/future)
- reasonable and necessary attendant care and respite care expenses
- loss of income
- loss of ability to earn income
- other reasonable and necessary expenses and losses you suffer as a result of your injuries.
You will need to show:
- that the amount claimed is reasonable
- receipts for expenses
- that the treatment relates directly to the injuries and losses caused by the accident.
Medical expenses
If the insurer accepts liability for your claim it will pay your reasonable and necessary hospital, medical, rehabilitation and travel expenses. You don't have to wait for the claim to be finalised for these expenses to be paid. The insurer is obliged to pay these expenses on an 'as incurred' basis only if they are reasonable and necessary, properly verified and relate to the injuries from the motor vehicle accident. Original receipts or accounts should be sent to the insurer and you should keep a copy of all these documents.
The insurer cannot be expected to continue to pay accounts unless improvement is evident. An insurer will look for therapeutic benefits in assessing whether treatment will be reasonable and necessary, and hence, if you cannot agree with the insurer on medical issues about past or future treatment then the dispute can be referred to the Medical Assessment Service.
The insurer cannot be expected to continue to pay accounts unless improvement is evident. An insurer will look for therapeutic benefits in assessing whether treatment will be reasonable and necessary, and hence, if you cannot agree with the insurer on medical issues about past or future treatment then the dispute can be referred to the Medical Assessment Service.
Lost earnings
There is a limit (40kb) to the amount that can be claimed for lost income which is indexed annually on 1 October. The insurer will want evidence of any losses. For past losses, they may want:
- a letter or statement from your employer
- tax returns
- sick leave records
- medical evidence to show that you were unfit for work because of the injuries arising out of the accident (e.g. a doctor's certificate)
- any other proof you have that you have suffered an actual loss of wages
- if you were self-employed, they will want verification from your accountant.
Give the insurer copies and keep any original documents.
Before you can be awarded an amount of damages for future lost earnings you will have to establish that the claim is real and reasonable. You will have to show that you would have had this earning capacity if not for the accident. Payment is made for lost earnings when your claim is settled.
Before you can be awarded an amount of damages for future lost earnings you will have to establish that the claim is real and reasonable. You will have to show that you would have had this earning capacity if not for the accident. Payment is made for lost earnings when your claim is settled.
Non-economic loss
Non-economic loss (or general damages) is for the pain and suffering and loss of enjoyment of life that you have experienced as a result of the accident. While most people injured in motor vehicle accidents experience some degree of pain and distress, there are limits on who can claim compensation for non-economic loss and how much compensation they get. You will only get non-economic loss damages if you have a whole-person permanent impairment of more than 10 per cent as a result of your accident. Permanent impairment is assessed according to the MAA Permanent Impairment Guidelines (1 October 2007).
The permanent impairment arising from each injury is assessed separately. The impairments arising from multiple physical injuries can be added together to get more than 10 per cent but you can't add a physical and psychological injury together to reach more than 10 per cent. If a person is assessed at more than 10 per cent permanent impairment, damages may be payable depending on the seriousness of the injury. Amounts which can be awarded are indexed annually and are listed in the Indexation of Damages (40kb).
Summaries of cases (116kb) where non-economic loss damages have been assessed by CARS provide an indication of the type of injuries and permanent impairments that entitle claimants to non-economic loss damages.
The permanent impairment arising from each injury is assessed separately. The impairments arising from multiple physical injuries can be added together to get more than 10 per cent but you can't add a physical and psychological injury together to reach more than 10 per cent. If a person is assessed at more than 10 per cent permanent impairment, damages may be payable depending on the seriousness of the injury. Amounts which can be awarded are indexed annually and are listed in the Indexation of Damages (40kb).
Summaries of cases (116kb) where non-economic loss damages have been assessed by CARS provide an indication of the type of injuries and permanent impairments that entitle claimants to non-economic loss damages.
(Source maa.nsw.gov.au September 2009)
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Q. How To Claim
Complete and lodge an Accident Notification Form to claim up to $5000 in early medical treatment and lost earnings. You can get this form from here, hospitals, your doctor, or by calling the Claims Advisory Service on 1300 656 919.
- How to complete and lodge the Accident Notification Form
If you wish to claim any compensation over $5000 or for expenses or losses that continue for more than six months after the accident you need to complete and lodge a Personal Injury Claim Form. - How to complete and lodge the Personal Injury Claim Form
Claims Advisory Service 1300 656 919 or email cas@maa.nsw.gov.au
If you think you may need legal advice, phone the NSW Law Society on (02) 9926 0333.(Source maa.nsw.gov.au September 2009)
For help understanding the requirements of the Motor Accidents Compensation Scheme, phone the
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Q. Claims Process
Once you have lodged a Personal Injury Claim Form with an insurer, the insurer will send you a letter saying your claim has been received. It will include a claim number that you must use when you write to the insurer about the claim and the name and phone number of the officer handling your claim.
The insurer will then investigate your claim. You may be required to give the insurer specific information (photos, documents, records etc) to help them with the investigation.
As part of the investigation, the insurer will normally get a copy of the police accident report. You may be required to speak to an investigator about your claim.
Liability
The insurer will investigate the accident and injury to find out whether liability for the claim will be accepted. By accepting liability the insurer agrees that the vehicle insured was at fault in the accident. The insurer must advise you within three months of receiving the claim whether they have accepted liability.
When an insurer makes a decision on your claim you will receive a 'Section 81 Notice'. This notice may make reference to an admission or denial of liability or an admission or denial that the insured driver had breached duty of care.
When an insurer makes a decision on your claim you will receive a 'Section 81 Notice'. This notice may make reference to an admission or denial of liability or an admission or denial that the insured driver had breached duty of care.
Insurer guidelines
Green Slip insurers are bound by the MAA Claims Handling Guidelines (October 2008) (70kb). These guidelines ensure that claims are handled fairly and equitably. (The MAA monitors insurer compliance with the Claims Handling Guidelines).
Treatment and rehabilitation
You may require treatment after a motor vehicle accident. A health provider such as a hospital, doctor or a physiotherapist may provide this treatment.
Most people recover from their injuries after receiving initial treatment but some people need rehabilitation to help them recover. Rehabilitation aims to return the injured person to a level of function and quality of life comparable with their pre-injury level. When function cannot be restored, rehabilitation tries to help the injured person learn new skills, to adjust to any ongoing disability and to be as independent as possible.
Most people recover from their injuries after receiving initial treatment but some people need rehabilitation to help them recover. Rehabilitation aims to return the injured person to a level of function and quality of life comparable with their pre-injury level. When function cannot be restored, rehabilitation tries to help the injured person learn new skills, to adjust to any ongoing disability and to be as independent as possible.
If you are likely to have long term problems, it is important that you start a rehabilitation program as soon as possible. A rehabilitation program can form part of your compensation and your treating doctor or therapist will help you decide which is best for you. The insurer will be involved by approving payment for treatment.
Under the Scheme you must make every reasonable attempt to recover from your injuries by:
- having appropriate medical treatment
- participating in an appropriate rehabilitation program
- looking for alternative job opportunities
- returning to work when possible.
Whether the insurer pays for your treatment depends on the type of treatment expense, whether it is considered reasonable and necessary, and the insurer has admitted liability for the claim.
Medical expenses
If the insurer accepts liability for your claim it will then pay for reasonable and necessary hospital, medical, rehabilitation and travel expenses. You do not have to wait until your claim is finalised for these expenses to be paid.
Insurers are only obliged to pay for reasonable and necessary expenses. The maximum amount the insurer is required to pay for a particular treatment is the amount set out in the Australian Medical Association List of Medical Services and Fees. Set fees may also apply for other services. You may be responsible for any costs over these set fees.
To be sure that the insurer will pay your accounts, you should obtain the approval of the insurer before you start your treatment or rehabilitation program.
Original accounts and receipts should be sent directly to the insurer. You should keep a record of all your expenses and a copy of any bills or receipts.
The insurer cannot be expected to pay accounts for continuing treatment unless improvement can be shown.
Most services provided by a public hospital are covered by an agreement between CTP insurers and the hospitals. You are not usually billed for public hospital care in New South Wales, but do not assume the services will always be free.
Payment for treatment by a doctor or therapist is not the insurer's responsibility unless the insurer has accepted liability for your claim. You may pay these expenses and be reimbursed by the insurer if liability is accepted later or the health provider may agree to wait for payment until the insurer decides liability. You will be personally liable for paying these accounts if the insurer later denies liability.
The insurer may be prepared to pay your medical, therapy and rehabilitation expenses without accepting liability. These are 'without prejudice' payments. Approval should be sought from the insurer before the services are provided.
If the insurance company denies liability on your claim you are responsible for your expenses. You may be able to claim part or all of your expenses from Medicare, private health insurance or from a personal accident insurance policy. You should notify these organisations that the expenses are for a CTP claim.
How your claim is settled
As part of the investigation of your claim, the insurer will need information regarding your medical condition. The insurer may get this from your treating doctor or by arranging for you to be assessed by another medical specialist. You must provide the insurer with full details of:
- your injuries
- your impairment and disabilities arising from these injuries
- your anticipated recovery if any of your injuries have not stabilised
- any economic or non-economic losses you are claiming.
You can settle your claim at any time. Once your injuries have stabilised and you have given the insurer full details of your claim the insurer should be in a position to make you an offer of settlement.
An offer of settlement is money (compensation) to cover the reasonable and necessary expenses and losses of income you have suffered as a result of your injuries. For people with more severe injuries the offer of settlement may also include an amount for non-economic loss. An offer made by an insurer should include a breakdown of all the components being paid. If you don't agree with the offer you should discuss it with the insurer or make a counter offer. You or your legal representative may negotiate with the insurer on settling your claim in a number of ways, including by letter and by settlement conference.
If you accept an offer of settlement from the insurer your claim is finalised.
If you do not agree with the insurer
A dispute can happen at any point along the way. A dispute may be about any aspect of your claim from payment for medical treatment provided, or to be provided, to the amount of the settlement.
For more information about how to resolve disputes with insurers, see:
For more information about how to resolve disputes with insurers, see:
(Source maa.nsw.gov.au September 2009)
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