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s 120

Deciding whether treatment and care is reasonable and necessary

In force
Chapter 2Motor accident injuries—defined benefits
Part 2.5Defined benefits—treatment and care benefits
Division 2.5.2Treatment and care benefits—entitlement

120 Deciding whether treatment and care is reasonable and necessary

In deciding whether treatment and care for an injured person is reasonable and necessary, the relevant insurer for the motor accident must consider the following:

(a)

whether the treatment and care is reasonable and necessary in the circumstances;

(b)

whether the treatment and care—

(i)

is directly related to the person’s injury; and

(ii)

is appropriate for the injury; and

(iii)

will benefit the person;

(c)

the appropriateness of a provider of the treatment and care;

(d)

whether the treatment and care is cost effective;

(e)

the MAI guidelines.

Division 2.5.3 Treatment and care benefits—assessment

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