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s 222

Application for future treatment payment

In force
Chapter 4Payment of future medical treatment expenses

222 Application for future treatment payment

(1)

This section applies to a person injured in a motor accident if—

(a)

at the relevant date for the motor accident, the person is receiving treatment and care benefits for treatment and care expenses related to medical treatment; and

(b)

has, immediately before the relevant date for the motor accident, been receiving medical treatment continuously for at least 2 years and 6 months; and

(c)

was not the driver at fault, or is not taken to be the driver at fault, in the motor accident; and

(d)

is not entitled to make a motor accident claim.

(2)

The injured person may apply to the relevant insurer for the motor accident for payment of an amount (a future treatment payment) to cover expenses for approved medical treatment the person receives—

(a)

after the person’s entitlement to defined benefits for treatment and care ends; and

(b)

not later than 10 years after the date of the motor accident.

(3)

The application must be made—

(a)

not earlier than the relevant date for the motor accident; and

(b)

not later than 5 years after the date of the motor accident.

(4)

In this section:

approved medical treatment, for a person injured in a motor accident, means medical treatment that is of the same kind that—

(a)

the person received in the 6-month period following the 4th anniversary of the motor accident; and

(b)

the relevant insurer for the motor accident has paid or agreed to pay.

continuous—an injured person is receiving medical treatment continuously if the injured person is receiving medical treatment at least monthly.

expenses, of an injured person, does not include expenses for medical treatment—

(a)

received before the date of the application; or

(b)

for which the relevant insurer has previously refused to pay.

Example—par (b) the medical treatment was not reasonable and necessary in the circumstances relevant date, for a motor accident, means the date that is 4 years and 6 months after the date of the motor accident.

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