What you can Claim

Special Damages

If liability for your claim is accepted, we will give consideration to payment of expenses for ongoing medical and associated treatment.

Special Damages are classified as:

• Ambulance - emergency transport for persons in a crash (involving a Western Australian licensed vehicle) from the scene of the crash to the nearest government hospital or nursing post is paid regardless of liability. Emergency transport is defined as transport within 48 hours of the crash. Transport by ambulance for any other purpose forms part of the claim, is subject to any apportionment of the claim and as to whether it is reasonable and crash related.
• Doctors - including X-rays and pathology tests.
• Hospitals - an arrangement exists between the Insurance Commission and the WA Health Department whereby accommodation costs are met by the Insurance Commission for persons injured as a result of a crash involving two or more vehicles, with at least one of these vehicles being licensed in Western Australia. If hospitalisation results from a single vehicle crash, and the vehicle is licensed in Western Australia, the passenger's accommodation expenses are met. However, the drivers expenses will not be accepted unless it is determined the injuries are life threatening or there is the possibility of loss of limb unless treatment is undertaken.
  Accommodation and associated expense at a private hospital is subject to liability for your claim being agreed.
• Sundries - included in this are physiotherapy, chiropractic, massage therapy, rehabilitation expenses, gymnasium expenses and travel expenses.

Loss of Earnings Capacity

If you are unable to return to work as a result of your crash related injuries, you are entitled to compensation (at the rate of your normal nett income) for the period you were unable to earn that income. It is not compensation for loss of earnings, but compensation for the loss of capacity to earn.

This means that any compensation paid to you of this nature, does not need to be declared to the Australian Taxation Office.

For us to consider a loss of earning capacity claim, we may require one or a number of the following supporting documents:

• Medical records/certificates to confirm the incapacity
• Taxation returns pre and post crash
• Sick leave records
• A letter from your employer confirming employment details and that you did not receive any income for the period claimed.
• Log books/ledgers
• Business taxation returns including Profit and Loss Statements.

Who pays for my treatment?

The Insurance Commission is not liable to pay or reimburse any medical costs until settlement of a personal injury claim. However, appreciating that medical treatment costs can be substantial and that settlement of a personal injury claim can take some time, in order to alleviate any potential financial hardship on claimants, their families and treatment providers, as a matter of policy, we will make progressive payments of treatment costs, provided:

• Liability for a claim is accepted or agreed; and
• The costs are reasonable and have been reasonably incurred.

The Insurance Commission pays Australian Medical Association recommended rates for medical treatment costs and WorkCover WA rates for most other types of treatment. We suggest you discuss the cost of treatment with your treatment provider as there may be a gap between the charge and the reimbursement, which may not be met by us.

The interim payment policy also applies to reimbursement of treatment costs paid by claimants direct. In such instances, receipts and/or itemised accounts in support of the claim for reimbursement must be provided.

General Damages

General Damages (also know as non pecuniary loss) - is the name given to a lump sum payment of money awarded to an injured party as compensation.

General damages include:

• Pain and suffering
• Loss of amenities of life
• Loss of enjoyment of life
• Curtailment of expection of life
• Bodily or mental harm
• Future loss of earning capacity
• Future medical treatment; and
• Gratuitous services

There are limits on compensation for General Damages.

Amount A: is the maximum payable for Non Pecuniary Loss ($309,000)
Amount B: is the amount to be deducted (deductible/threshold) $15,500
Amount C: is the amount at which the deductible begins to decrease ($47,000)
No deductible applies after $62,500
Amount D: a threshold applicable to Gratuitous Services ($5,500)

For a full list of threshold amounts, click here.

For further clarification of the above table or any associated questions, contact the office of the Insurance Commission of WA