New South Wales Consolidated Acts

MOTOR ACCIDENTS COMPENSATION ACT 1999 - SECT 52

52 Treatment expenses where treatment contrary to guidelines or exceeds limit

(1) If the Motor Accidents Medical Guidelines approve particular treatment as appropriate treatment in respect of any matter and the treatment provided to an injured person in respect of the matter does not accord with that approved treatment, the insurer is not required to pay treatment expenses under this Part in respect of the treatment.

(2) Nothing in this Part prevents an insurer from--

(a) paying treatment expenses for treatment that did not accord with relevant treatment approved by Motor Accidents Medical Guidelines, or

(b) paying an amount of treatment expenses that exceeds the maximum amount payable by the insurer under this Part, or

(c) approving further treatment for the purposes of any claim.

(3) If the insurer makes a payment of treatment expenses under this Part but the injured person has incurred or is likely to incur additional treatment expenses, the insurer is required to inform the injured person of the right to make a claim in respect of those additional expenses. The insurer is required to do so in writing at the time or as soon as possible after making that payment.