Motor Accidents Compensation

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1 Motor Accidents Compensation Medical, Hospital and Rehabilitation Benefits Information is current as at February 2012

2 Medical, Hospital and Rehabilitation Benefits TIO will pay for medical treatment and other necessary services if you are injured in a motor vehicle accident. TIO is guided by the Australian Medical Association (AMA) when assessing your medical needs and determining reasonable treatment. We consider a service to be reasonable if it contributes to your recovery and rehabilitation. If your claim for Medical and Rehabilitation expenses has been approved by TIO, compensation is payable for the reasonable costs of treatment reasonably required for your accident-related injuries. The range of medical, rehabilitation and associated costs that TIO will pay for to get your health back on track after an accident include: Ambulance services: transport from the accident to the hospital in an ambulance and, where required, from one hospital to another. This may include air ambulance services. Hospital services: treatment at a public or private hospital within Australia for surgery, X-rays or other medical imaging, and other hospital costs. Medical services: costs to treat your accident-related injuries by a doctor or specialist. Medical rehabilitation (inpatient or outpatient): post-accident treatment in a rehabilitation facility. Rehabilitation/Therapy services: physiotherapy, occupational therapy, chiropractic and psychological treatment. 2

3 Pharmacy expenses: medications to treat your injuries. Dental services: dental treatment for teeth damaged in an accident. Nursing services (not including attendant care services): home visits may be covered if you require nursing treatment after your accident. Return to work programs: when you need help to get back to work. Equipment or Appliances: required as a result of your accident such as home or motor vehicle alterations recommended by a qualified health provider. These all require pre-approval by TIO. Attendant Care services: Short term benefits may be payable if you are unable to undertake your own personal care needs. Long term benefits may be payable if you suffer a permanent impairment as a result of your injury, and the degree of impairment is assessed at 60% or more. Emergency Travel benefit: Benefits may be payable if a close family member(s) is required to travel at least 1,000 km to be near you following the accident. For more information please contact TIO. 3

4 Your Treatment TIO will support you in your recovery after an accident. We understand it can be a difficult and challenging time and will ensure that you receive the right treatment to return to health. TIO will pay for the reasonable medical treatment you need as a result of your motor vehicle accident. A service is deemed reasonable if it contributes to your recovery and rehabilitation. A doctor will be able to determine what treatments are appropriate for your injuries. Specialist medical and rehabilitation treatments will require a referral from your doctor. TIO will continue to pay for these services as long as they improve your condition. Payment will stop when you have recovered, no further progress is being made or no benefit has been shown. We are also unable to pay for treatment or services outside of Australia, or by inappropriately or unqualified service providers. Payment for Treatment Contact us before starting treatment to confirm that the service is included in your treatment plan to be paid by TIO. Your medical and rehabilitation costs can be paid directly by TIO if you have the service provider bill us or you can be reimbursed. If you choose to pay upfront, the tax invoice must be provided to TIO for reimbursement. 4

5 Travel Costs TIO can reimburse you for the reasonable cost of travelling to and from your accident-related medical and rehabilitation appointments. This includes travel by public transport, by private vehicle and, in some circumstances, by taxi if pre-approved by your Claims Officer. TIO has a set rate per kilometre to reimburse people who travel by private vehicle. You will need to complete a Travel Reimbursement Claim Form, which can be obtained from your Claims Officer on request. Important Information TIO will support you in your recovery, but the most important person for a successful return to health is you. You must actively participate in your treatment and/or rehabilitation. Failure to do so may result in the suspension of your benefit payments. If you are unable to attend any medical or rehabilitative appointments please advise us immediately, as non-attendance fees may be charged. If your condition is not improving talk to your doctor or health professional. All invoices and reimbursement claims related to your accident injuries need to be sent to TIO for payment. They cannot be claimed under Medicare. Any outstanding invoices can be sent to your TIO Claims Officer to review for reimbursement. Please include your name and claim number on all correspondence. 5

6 Privacy of Your Information TIO is committed to protecting the privacy and confidentiality of your personal information. We act in accordance with the Information Privacy Principles of the Northern Territory Information Act. TIO collects your personal information for the primary purpose of evaluating and administering your claim. Generally we receive your personal information directly from you however there may be times when we collect personal information from other sources. You can apply for access to your personal information that has been collected and held by TIO. For information about access to or correcting your personal information, or if you would like a copy of our full Privacy Policy document, please contact us on or visit our website at tiofi.com.au. 6

7 7

8 Contact Us For More Information (then choose Option 3 ). Phone Monday to Friday: 8.30am 5.00pm. Write GPO Box 770 Darwin NT Fax (08) TIO is Government guaranteed and not regulated by APRA. TIO ABN MHRE0212

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