Injured and unsure who foots the bill?
Navigating life after a car accident can be overwhelming, especially when medical bills start to pile up. One of the most common questions we get asked is: “Who pays for my treatment?” The good news is that there are avenues for compensation, but knowing your rights early on can make a huge difference in your recovery and peace of mind.
When Does the At-Fault Driver’s Insurance Pay?
In South Australia, the at-fault driver’s CTP insurer generally covers the costs of injury claims. If fault is shared, compensation may be adjusted accordingly. If liability is disputed, investigations and assessments will determine who is legally responsible.
This means that even if you weren’t the driver, you may still be able to claim under their CTP policy if you were a passenger or pedestrian affected by their negligence.
How to Start the Claims Process
If you’re unsure how to start, here are the typical steps:
- Report the accident to policeThis is essential for all accidents resulting in injury.
- Seek medical treatment immediatelyEnsure your injuries are assessed and documented from the beginning.
- Lodge an Injury Claim FormComplete and submit this to the CTP insurer of the at-fault vehicle.
- Keep a record of all expensesIncluding receipts, invoices, and travel logs.
- Engage a personal injury lawyerThis helps to ensure your claim is properly assessed and negotiated.
Key Tip: Don’t wait to get legal advice.
Getting help early can ensure you don’t miss out on entitlements or run into problems with documentation or delays.
When Does the At-Fault Driver’s Insurance Pay?
In South Australia, the at-fault driver’s CTP insurer generally covers the costs of injury claims. If fault is shared, compensation may be adjusted accordingly. If liability is disputed, investigations and assessments will determine who is legally responsible.
This means that even if you weren’t the driver, you may still be able to claim under their CTP policy if you were a passenger or pedestrian affected by their negligence.
How to Start the Claims Process
If you’re unsure how to start, here are the typical steps:
- Report the accident to policeThis is essential for all accidents resulting in injury.
- Seek medical treatment immediatelyEnsure your injuries are assessed and documented from the beginning.
- Lodge an Injury Claim FormComplete and submit this to the CTP insurer of the at-fault vehicle.
- Keep a record of all expensesIncluding receipts, invoices, and travel logs.
- Engage a personal injury lawyerThis helps to ensure your claim is properly assessed and negotiated.
Key Tip: Don’t wait to get legal advice.
Getting help early can ensure you don’t miss out on entitlements or run into problems with documentation or delays.
Does Medicare Cover My Costs While My Claim is Processed?
Yes — initially, Medicare may cover eligible treatments. However, if you’re successful in your claim, the insurer may need to repay Medicare for any outlays made. This is called a Medicare refund or reimbursement.
Your private health insurance may also provide interim cover, but any payments made on your behalf may be recovered from your final settlement.
What if My Claim Is Rejected?
If your claim is denied or disputed, all is not lost. With legal help, you may be able to:
- Appeal the decision
- Provide further evidence or reports
- Negotiate a partial settlement
- Escalate to the South Australian Civil and Administrative Tribunal (SACAT) or courts, if necessary
Being rejected doesn’t mean the end of the road. Many claims are rejected due to missing paperwork, late filing, or miscommunication — all of which can often be remedied.
Medical Expenses After an Accident
Time limits vary depending on the type of injury and your age at the time of the accident — but the sooner you act, the better.
It varies. Some expenses may be reimbursed within weeks, while larger settlements can take months depending on the complexity of your case.
Time limits vary depending on the type of injury and your age at the time of the accident — but the sooner you act, the better.
Roberto and the team took the weight off my shoulders. I could focus on healing while they handled the paperwork and negotiations. I genuinely don’t know how I would’ve navigated it all without them.
Nicholas Client
