The TAC Medical Excess may apply to medical services performed interstate
The TAC will consider funding a range of services for a client assessed as eligible as a result of a transport accident in accordance with the Guidelines below.
Transport Accident Act 1986 reference: s.60
The TAC can fund services provided and received by a client who has a claim for compensation accepted by the TAC, outside of the State of Victoria, ie. in the Australian Capital Territory, Queensland, New South Wales, Western Australia, South Australia, Tasmania, and Northern Territory, in accordance with the provisions of the Transport Accident Act 1986 (TAA 1986). The list of services the TAC can consider funding interstate can be located in the 'What the TAC can fund' and the 'For Health and Service Providers' section on the TAC's website.
When will the TAC fund interstate services to a client?
The TAC will consider funding interstate services to a client who has a claim for compensation accepted by the TAC. For information on who is eligible for TAC compensation refer to the Eligibility for Benefits policy. The three main instances when a person with an accepted claim is likely to claim funding of interstate services from the TAC include:
- When Victorian residents have accidents interstate and are in Victorian registered vehicles, ie. as the driver or passenger, or the person is a pedestrian and the accident involves a Victorian registered vehicle, eg. a Victorian resident was standing by the side of the road when struck by the Victorian registered vehicle.
- When interstate residents have accidents interstate and are in Victorian registered vehicles, ie. as the driver or passenger.
- When interstate residents have accidents in Victoria and continue to receive services as a result of the accident upon their return interstate.
Transport Accident Act 1986 reference: s.35(1)
Please note the TAC must cease funding interstate services within 28 calendar days, if a further claim for the same accident is made with an interstate insurer. The Accidents in Another State or Territory policy identifies the circumstances when funding will cease.
Transport Accident Act 1986 reference: s.42
How much will the TAC pay for interstate services?
The payment of interstate services will be in line with the TAC's Schedule of Fees.
How long from the 'date of service' is a bill to be submitted for payment?
All bills should be submitted to the TAC on a regular basis. However, providers and clients have two years from the date of providing the service to submit the bill. Please note that under the TAA 1986 the TAC is unable to pay bills that fall outside the two year statutory time limit for submitting a bill for TAC related services. Also refer to the Time Limit to Apply for the payment of Medical and Like Expenses policy.
Transport Accident Act 1986 reference: s.60(1A)
Can the TAC fund services performed by a member of a client's immediate family?
What will the TAC not fund?
The TAC will not fund:
- treatment or services for a person other than the injured client
- treatment or services not authorised by the TAC to be disability or rehabilitation services under Section 23 of the TAA 1986. See Guidelines located in the Authorised Disability Services and Authorised Rehabilitation Services lists
- fees associated with non-attendance
- treatment or services where there is no clinical justification for the service or where there is no objective evidence the treatment or service is safe and effective
- treatment, services or equipment where there is no published evidence in a recent peer-reviewed journal article that the treatment, service or equipment is safe and effective. Refer to the Non Established, New or Emerging Treatment and Services policy
- treatment or services for a condition that existed before the transport accident or that is not a direct result of the transport accident
- the cost of telephone calls and telephone consultations between providers and clients, and between other providers, including hospitals
- treatment or services received outside the Commonwealth of Australia
- treatment or services not in line with the Guidelines located in the A-Z list of Treatment and support services
- treatment or services provided more than 2 years prior to the request for funding except where the request for payment is made within 3 years of the transport accident. Refer to the Time Limit to Apply for the Payment of Medical and Like Expenses policy.