What you are covered for
The Scheme provides compensation for necessary and reasonable hospital, medical and other treatment costs. These include (but are not limited to) the following costs:
- medical treatment;
- physiotherapy; and
Please note that not all types of health care, therapy and support services are covered by the CTP Insurance scheme. It is best to contact your Approved 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 CTP Insurance scheme.
In addition to immediate health care and treatment costs, compensation may also cover the items listed below:
- an allowance for any non-economic loss (pain and suffering) experienced by you as a result of your injuries;
- loss of earning capacity (past and future), excluding the first week’s loss;
- future treatment and care requirements;
- travel expenses to and from treatment; and
- an allowance for any homecare and personal care services you may require as a result of your injuries (eg cleaning and gardening).
These payments are only made for claims in certain circumstances where fault has been established on the part of a South Australian registered motor vehicle or where you qualify for compensation under the Nominal Defendant Scheme. There are a number of legal requirements that must be met before these payments are made, which include satisfying certain thresholds determined by the seriousness of your injury.
For example, your injury should have stabilised, and your entitlement to damages for non-economic loss must meet a threshold based on an Injury Scale Value (ISV) reflecting the severity of the injuries sustained that assigns a value between a range of 0 and 100. The ISV range aligns to a monetary sum that represents the amount of damages for a fixed sum of compensation for the compensable injury. The Table of ISVs is available here. You can also view the Table for Gratuitous Services and Prescribed Maximum Economic Loss.