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A Comprehensive Guide to Making a TAC Claim: Navigating No-Fault Benefits, Medical Expenses, and More

Accidents on the road can leave a lasting impact, affecting not only your physical well-being but also your financial stability. In Victoria, Australia, the Transport Accident Commission (TAC) offers vital support for individuals who have suffered injuries in road accidents, providing ‘no-fault benefits’, coverage for medical expenses, and more. In this comprehensive guide, we’ll take you through the process of making a TAC claim, empowering you with the knowledge you need to understand your entitlements and rights every step of the way.

Unlocking No-Fault Benefits and Medical Expense Coverage

No matter the circumstances of your accident – whether it involved a car, truck, motorbike, public transport, bicycle, or you were a pedestrian – you are eligible for certain benefits, regardless of fault. These benefits are referred to as ‘no-fault benefits’.

Within Victoria, the TAC is mandated to cover reasonable medical expenses for victims of road accidents. This encompasses everything from ambulance and hospital costs to X-rays, surgeries, and specialized treatments such as physiotherapy, psychology, and rehabilitation.

In the past, the TAC required injured individuals to reach a certain ‘medical excess’ threshold before covering medical expenses. Fortunately, recent changes have abolished this requirement. The TAC now promptly covers reasonable medical expenses, including hospital stays, surgical procedures, and even support from specialists like physiotherapists, psychologists, and rehabilitation physicians.

Moreover, the TAC takes responsibility for funding equipment and services designed to aid in your recovery journey. This includes wheelchairs, home assistance, gym memberships, and travel expenses related to medical appointments.

Navigating Challenges in Medical Expense Coverage

Although the law mandates the TAC to cover reasonable medical expenses, disputes can arise, leading to financial stress for the injured party. If the TAC denies coverage or refuses to cover the full cost of necessary treatments, immediate action is crucial. You have just 12 months to challenge their decision. By seeking expert legal assistance, you can ensure your rights are upheld, and you receive the rightful compensation required for your recovery.

Claiming Loss of Earnings

If your injuries prevent you from working, the TAC offers ‘loss of earnings benefits’. These benefits are provided without considering who was at fault in the accident. Your employment status (full-time, part-time, casual) is irrelevant, and even if you weren’t employed at the time of the accident, you may still be eligible if you were employed in the year prior or had accepted a job offer.

For the initial five days off work, the TAC generally doesn’t provide coverage. Sick leave entitlements can be used during this period. Afterward, as long as medical certificates confirm your inability to work fully or partially, the TAC should pay you 80% of your gross income, up to a maximum of $1,350 per week. These benefits can extend for up to three years post-accident, potentially longer for severe injuries.

Challenges in Compensation Claims

Complications often arise during loss of earnings assessments, where the TAC may miscalculate entitlements, resulting in underpayment. Or, they may disagree with your doctor’s assessment, leading to support being cut off despite medical advice suggesting otherwise.

In cases of unfair decisions, our expert transport accident compensation lawyers can assist you in challenging them. However, remember that you have only twelve months from the date of the decision to take action. Seeking legal advice promptly is crucial to ensuring your rights are protected.

Addressing Liability Denials by the TAC

The TAC might attempt to deny liability for injuries sustained in an accident. They may argue that injuries were pre-existing and therefore not eligible for compensation. However, the TAC is liable for aggravations to pre-existing conditions, provided it’s established that the transport accident caused the aggravation.

To safeguard your rights

  1. Mention all injuries sustained in the accident when making your initial claim with the TAC.
  2. Disclose any pre-existing conditions that were aggravated due to the accident.
  3. Promptly report all injuries, both physical and mental, to your medical practitioners.
  4. Seek legal representation if the TAC denies liability for your injuries.

Navigating the Common Law Option

In cases where another party is responsible for the accident, you may be eligible for common law claims alongside TAC no-fault benefits. These claims involve suing the negligent party, with the TAC acting as the insurer.

Engaging an expert RCT road injury lawyer is essential, as common law claims often involve disputes about fault. The TAC may conduct investigations, scrutinize your social media accounts, or even hire private investigators to challenge your claims. Having skilled legal support ensures your rights are protected.

Establishing Serious Injury Certification

In Victoria, fault alone is insufficient for a common law claim. You must also demonstrate a ‘serious injury’, defined as an impairment of 30% or more or an injury with substantial consequences. These consequences could include an inability to work in your usual capacity or limitations in enjoying personal activities.

To obtain a ‘serious injury certificate’, a detailed application must be prepared and lodged with the TAC. RCT’s lawyers possess expertise in preparing such applications, giving you the best chance at securing permission for a common law claim. Our litigation experience is invaluable in case of TAC refusal, with our team standing by you in court if needed.

Calculating Compensation for Pain and Suffering

In common law claims, compensation for pain and suffering hinges on the severity of the injury and its impact on your life. The maximum payable for pain and suffering in Victoria is $547,550. To achieve a fair settlement without court intervention, meticulous case preparation is crucial. At RCT, we work diligently to present evidence of the accident’s impact on your life, striving for a just resolution.

Protecting Loss of Earnings Claims

As part of a common law claim, you can seek compensation for both past and future loss of earnings. If your injury has significantly affected your ability to work and progress your career, this claim can be substantial. However, the TAC may attempt to diminish your economic loss claim using surveillance or downplaying your injuries. RCT lawyers are steadfast in safeguarding your interests, maximizing your claim to secure your financial future.

Navigating Social Media Challenges

Opposing lawyers often scrutinize social media posts to challenge your credibility. Innocent posts can be misconstrued to weaken your case. Expert legal advice helps you use social media safely during your claim to avoid unintentional complications.

Timelines and TAC Correspondence

While the general time limit for common law claims is six years, an accepted TAC claim must be lodged within 12 months of the accident date. Seeking legal advice promptly allows for potential extensions. Remember, TAC-invited conferences may not offer legal representation, and it’s wise to consult a professional legal team to ensure your claim is maximized.

Support for Grieving Families: Death Benefits

Tragedy affects families profoundly. The TAC offers support for funeral costs, family counseling, and mental injury assistance. Financially dependent family members can receive lump sum and ongoing payments.

Empowering You in the TAC Claim Process

In the aftermath of a road accident, understanding your rights and accessing support is essential. The TAC provides crucial compensation avenues for medical expenses, loss of earnings, and more. To navigate the complexities of the TAC claim process and secure rightful compensation, early engagement with expert legal representation is paramount. At RCT, we stand by you throughout your journey, ensuring your interests are protected and your rights upheld.