Treatment and care through your CTP claim

The rule: reasonable and necessary

The CTP insurer pays for treatment and care that is reasonable and necessary for your accident injuries, within the benefit periods that apply to you.

That can include reasonable and necessary medical, dental, pharmaceutical and rehabilitation expenses, and travel to and from treatment.

It isn't a promise that every treatment will be paid for. The insurer decides what's approved, and its decisions can be reviewed.

Treatment before you lodge

Once you've told the insurer about your injury, it can approve some treatment before you lodge a full claim, usually a GP visit and two further treatment sessions such as physiotherapy. This is at the insurer's discretion and only within the first 28 days after the crash. For more treatment you need to lodge a claim.

Not sure which insurer to tell? See find your CTP insurer.

Getting treatment approved

• Ask the insurer before you start ongoing treatment, such as a course of physiotherapy.
• Your doctor or provider can send the insurer a request or treatment plan that explains what's proposed and why it's needed for your accident injuries.
• The insurer must decide a request as soon as possible and within 10 business days. Approved accounts should be paid within 20 days.
• If the insurer declines a request because it needs more information, it must tell you what it needs and give you a reasonable chance to provide it.
• Give your providers the insurer's name and your claim number, so bills go to the insurer.
• Keep every receipt and invoice, and a note of what was approved and when.

Ask the insurer before ongoing treatment starts

Ambulance and hospital

Ambulance and much of your public hospital treatment (such as accommodation, X-rays, blood tests and nursing) are covered by the Fund levy paid with every CTP Green Slip, whether or not you make a claim or were at fault. Some public hospital doctors' bills aren't covered. If you make a CTP claim, send those bills to the insurer. It pays them if you're eligible and the treatment is reasonable and necessary.

How long treatment and care lasts

• Threshold injury: for accidents on or after 1 April 2023, treatment and care generally lasts up to 52 weeks after the accident (generally 26 weeks for accidents between 1 December 2017 and 31 March 2023). Treatment may sometimes be allowed beyond that in limited circumstances.
• Wholly or mostly at fault: statutory benefits generally stop after 52 weeks (accidents from 1 April 2023).
• Children: children who were 16 or under at the time of the accident can receive treatment and care for as long as they need it, regardless of fault.
• Other injuries: treatment and care that is reasonable and necessary can generally continue for longer.
• After 5 years: if you still need treatment and care five years after the crash, responsibility for paying for it moves from your CTP insurer to CTP Care, run by the Lifetime Care and Support Authority. Your insurer should tell you about 6 months before the move.
• Catastrophic injuries: people catastrophically injured in a road crash (for example a spinal cord injury or severe brain injury) may be covered by the separate no-fault Lifetime Care and Support Scheme.

If you also have a damages claim, treatment and care isn't paid as part of the lump sum. Reasonable and necessary treatment and care can continue after a damages claim settles.

Help at home

If you need it while you recover, your claim can cover paid domestic help and personal care (commercial attendant care).

Paid domestic services and home maintenance are available for threshold injuries too, but the hours are limited in the first 52 weeks. The insurer can agree to more hours if the restrictions in your Certificate of Fitness stop you doing your usual household tasks.

Unpaid care from family or friends (gratuitous care) is generally not paid as a statutory benefit.

Bills, Medicare and health funds

If you have a CTP claim, the CTP insurer, not Medicare, should generally pay for your accident-related treatment. If Medicare did pay for related treatment and you later receive compensation of more than $5,000, you may have to repay it.

Send treatment bills to the CTP insurer rather than your health fund. If you decide not to make a CTP claim, you can ask your private health insurer whether it will pay, or pay the bill yourself. Health funds have their own rules about injuries where compensation may be payable, so check with your fund first.

If a request is refused

Read the letter for the reasons. If the insurer said it needed more information, send it.

If you disagree with the decision, you can generally ask the insurer for an internal review within 28 days of receiving it. If you're still unhappy after that, the Personal Injury Commission can decide disputes, including whether treatment is reasonable and necessary.

The CTP Legal Advisory Service can advise on statutory benefits questions such as treatment costs, for accidents from 1 December 2017. You check you're eligible through SIRA's CTP Assist line, 1300 656 919.

Step by step: insurer decisions and reviews.

Choosing your doctor and providers

You can keep seeing your own GP. Your first Certificate of Fitness must come from your treating medical practitioner, usually your GP. See Certificate of Fitness.

Some people prefer a doctor experienced with CTP claims, who knows the certificates and the approval process. Treatment such as physiotherapy, psychology or exercise physiology can be covered if the insurer approves it as reasonable and necessary.

If you'd like, we can introduce you to a doctor experienced with CTP claims or allied health. It's your choice.

Check the current rules

Rules change. This page reflects the rules as we understand them in September 2026. General information, not legal advice.