Recovery from injury
Treatment and rehabilitation
Most people recover from their injuries and resume normal activities after treatment.
However, some people may need rehabilitation services. The severity of injury is the main indicator for rehabilitation intervention. The need for rehabilitation services will vary from one individual to another and be influenced by many other factors such as age, education, job demands, motivation and personal circumstance.
There are two facets to rehabilitation. The first is that of restoring, as far as reasonably able, the injured person's pre-injury function. Secondly, where function cannot be restored, rehabilitation is aimed at the acquisition of adaptive skills to replace those lost.
It is widely recognised that if rehabilitation is needed, it must be provided as soon as possible after the injury and preferably in accordance with a rehabilitation plan. A rehabilitation provider and/or a medical practitioner may prepare rehabilitation plans.
Information provided on the medical certificate will generally indicate to the insurer if rehabilitation is needed. If rehabilitation is indicated, the CTP insurer will contact you (or your solicitor if you are legally represented) to discuss your rehabilitation needs. Alternatively, you or your solicitor may contact the insurer to discuss the need for rehabilitation services (See Licensed Insurers.)
If your treating doctor or allied health provider recommends any treatment and/or rehabilitation action, it will assist the insurer in the decision making process if those recommendations are in writing.
Payment of treatment/rehabilitation expenses
If treatment is provided at a public hospital, the services are covered by the Hospital and Emergency Services levy which is included in the CTP premium and you should not be billed.
If you receive treatment and/or rehabilitation at a private hospital, or from a doctor or an allied health professional such as a physiotherapist, you may incur a cost. If the insurer has accepted liability for your claim, you do not have to wait until your claim is settled for these expenses to be paid. The insurer will pay expenses provided they are:
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reasonable and appropriate;
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relate to the injuries resulting from the accident; and
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are properly verified.
If liability has been accepted, you may pay the cost of any treatment and be reimbursed by the insurer once costs are over $200, or, if the insurer has given prior approval, have the accounts sent directly to the insurer. It should not be assumed that an insurer will continue to meet the ongoing cost of a service.
If the insurer denies liability, you are responsible for your own treatment and rehabilitation expenses. You may be reimbursed these costs if you are successful in a court action. In the meantime you may be able to claim some or all of the costs from Medicare or through private health insurance and/or other personal injury insurance.
Mediation
For rehabilitation disputes, which cannot be settled by direct negotiation between the insurer and claimant, mediation can be arranged through the Motor Accident Insurance Commission by contacting the CTP Helpline on 1300 302 568. Mediation is voluntary and both parties must be willing to mediate. If a dispute cannot be settled by mediation or direct negotiation, either party to the dispute may make application to the Court to decide what rehabilitation in the circumstances are reasonable and appropriate.
For more information
Please phone:
- CTP Helpline 1300 302 568
Read Road to Recovery - Rehabilitation following a motor vehicle accident.
Last reviewed 29 June 2009
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