Medical Expenses and TAC Claims Victoria

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Medical expenses and the Transport Accident Commission

If you are injured in a transport accident in Victoria, the TAC will pay your reasonable medical and like expenses. Normally, you are required to pay the first $564.00 (as at May 2008) of medical expenses. Once this ‘medical excess’ has been reached, the TAC will then fund approved medical expenses. However, if you are an inpatient in hospital for one day or more, this excess is waived. Also, if one or more members of your immediate family were injured in the same transport accident, only one excess needs to be reached (i.e. $564.00 for the whole family).

You will often find that between visits to the General Practitioner, scans and medication, this medical excess is reached quite quickly. Treatment which is bulk billed is counted towards this medical excess. It is therefore important that you get a claims history statement from Medicare and retain all your receipts from the date of the accident, and forward these to the TAC with a completed ‘Medical Excess form’. If you are unsure what can be used to offset the medical excess, we suggest you contact a Victorian Car Accident Solicitor. Once the medical excess is reached, you can submit your receipts to the TAC for reimbursement.

It is important that you obtain prior approval for treatment from the TAC. Generally this is achieved by having a health professional make a written request for treatment to the TAC. The TAC will then make a decision as to whether or not they will pay for this treatment, and the quantity of such treatment. If you are experiencing any difficulties in having your treatment approved by the TAC, you should seek advice from a Victorian Car Accident Solicitor immediately.

Time limits apply for making a TAC claim

With any decision made by the TAC you have 12 months from the date of that decision to have it reviewed at the Victorian Civil and Administrative Tribunal. This is a strict time limit. If you are unhappy with any decision made by the TAC you should seek advice from a Victorian Car Accident Solicitor immediately. If you do not challenge this decision within this time frame, you will be barred from ever having it formally reviewed.

It is important to note that with any medical expense incurred, you only have a maximum of 2 years to seek reimbursement from the TAC. Once a period of 2 years has elapsed, the TAC is not obliged to consider reimbursement of the medical expenses incurred by you.

Examples of medical and related expenses

Examples of medical and like expenses include, but are not limited to:

Travel Costs- Any travel related costs associated with medical appointments for the TAC and obtaining treatment for injuries caused by the accident can be covered by the TAC. Examples of travel expenses covered: Public transport; Personal kilometres travelled in a private vehicle; Taxi costs; Airfares

Make sure you obtain prior authorisation from TAC that these travel expenses will be covered before you incur them. If your doctor is of the opinion that, because of your injuries, you require a taxi to transport you to and from medical appointments, ask them to write to the TAC seeking authorisation that they will cover this cost.

Rehabilitation and Disability Services-

Examples of rehabilitation and disability services:

• Physiotherapy
• Pain management
• Return to work program

Housekeeping and domestic services

When recovering from injury, simple day-to-day chores can often be extremely difficult, if not impossible. The TAC can provide support to assist you.  This help can range from a couple of hours per month, to several hours per week.

Examples of housekeeping and domestic services: