TAC claim eligibility
The TAC will pay compensation to a person who is injured, or to the dependant of a person who dies as a result of a motor vehicle accident that occurs in Victoria or interstate with a Victorian registered vehicle and the injured person is a Victorian resident or was an occupant of a Victorian based vehicle.
Who is eligible to claim TAC benefits?
In order to claim TAC benefits, you’ll need to show:
- That a transport accident occurred
- That you suffered injury as a result of the accident (or, that you had a pre-existing condition that has been aggravated by the accident).
- The accident occurred in Victoria, or
- The accident occurred outside of Victoria in a vehicle registered in Victoria and you are a Victorian resident, or you were an occupant of a Victorian based vehicle.
TAC claim time limit
You have 12 months from the date of your accident to lodge a TAC claim.
Alternatively, you have 12 months from the date that an injury from your accident first becomes evident.
In some circumstances, the TAC can consider a claim made outside the 12 month period if it is made within three years of the accident.
Or the date from when the injury first manifested itself and that reasonable grounds exist for the delay in making a claim.
If a claim is not made for a person under the age of 18 by their parent or guardian within the appropriate time, that person can make a claim until the day before they reach the age of 21.
What does TAC cover?
There are four general entitlements under the TAC scheme.
These are;
- the payment of medical expenses
- the payment of income payments
- an impairment benefit lump sum
- a common-law claim for damages.
1. Medical expenses
The TAC can pay for the reasonable cost of any medical expenses incurred as a consequence of the motor vehicle accident.
The TAC will cover all reasonable medical, hospital, nursing, personal and household, occupational, rehabilitation and ambulance services.
Doctor, chemist, physiotherapy, and chiropractor bills are covered, as are appointments to see your specialist, and surgery (if approved by the TAC).
Mobility devices and special equipment, home and car modifcations and transportation costs are also covered (again, if approved by the TAC).
There is no set time limit on how long your entitlement to medical expenses will run for.
TAC medical excess
In 2018, the TAC made some changes to the way that it approves treatment for people who are injured in a motor vehicle accident.
Prior to this, the TAC used to have a medical excess scheme which meant that an injured person needed to pay a minimum amount for medical treatment before the TAC started paying medical expenses.
However this is no longer the case. The TAC will be responsible for paying your medical treatment expenses as soon as your claim is accepted.
Keep in mind however that if you’re injured before the medical excess was removed (14 February 2018) you may still be required to pay for the medical excess.
This means that you will need to pay for any medical treatment yourself and then provide proof of payment and treatment (totalling $651) to the TAC before they will pay your medical expenses.
You can read more about the medical excess here.
2. Income payments
If your injuries prevent you from being able to do your job properly, whether that’s because you can’t work at all or can only do some of what do you normally would, then you’ll likely be entitled to income payments from the TAC.
To get payments from the TAC you will need to obtain a certificate of capacity from your GP or other health practitioner.
Most health professionals can provide you with TAC certificates other than psychologists.
It’s a good idea to have your GP write your certificates as you probably see them on a regular basis.
In terms of how payments are calculated, they’re based on an average of your wage of the 12 months prior to the injury (with a few exceptions).
This is called your pre-injury average weekly earnings. You’ll sometimes see this is referred to as PIAWE.
How long can these payments go for?
Here’s a summary;
- If your income (gross) is less than $708 a week, the TAC will pay you 100% percent of your income.
- If 80% of your gross income is less than $708 a week, they will pay you $708 a week.
- If your income is between $708 and $1430 a week, they will pay you 80% of your income a week.
- If 80% of income is more than $1430 a week, they will pay $1430 a week.
What happens at the three year period?
There’s a significant change in the eligibility test for weekly payments at the three year mark.
Before then, you need to show that you can’t do your old job in an unrestricted way.
After the three mark however, you need to show that you have a 50% or greater whole person impairment rating. There’s not a lot of people off weekly payments because 50% is a very significant whole person impairment rating that very few people reach.
3. Impairment lump sum
Some people also choose to pursue an impairment lump sum claim. This is lump sum compensation for permanent impairment.
In order to pursue an impairment claim it doesn’t matter whether someone was at fault or not or whether you were at fault for the accident.
Anyone that is injured on the road is entitled to pursue an impairment benefit if they have suffered a permanent impairment.
A key to success in an impairment claim is to make sure that all of the injuries that you suffered on the road are assessed by specialist doctors.
These doctors will grade all of the injuries and conditions that relate to the motor vehicle accident. They will put figures on them.
These percentage figures will then get combined into one overall figure.
The higher the overall figure, the greater the chance of success in the claim and the more that the claim is worth.
As of 2021, the minimum amount payable was $8040 and the maximum amount was $366,900.
These figures change at the end of each financial year.
4. Common law lump sum
Some people are also entitled to claim a second lump sum called a common law claim.
This is the claim we you’re suing another party for their negligence in contributing to the accident.
Just being involved in a motor vehicle accident doesn’t automatically entitle you to a common law claim for damages. You need to show that someone else was negligent and it was their negligence that caused or contributed to the accident.
If you cannot show that someone else was negligent you will not succeed in this claim.
The second thing that you need to succeed in a common law claim for damages is that you have suffered a serious injury. This is a legal term.
If you succeed in your case, you can get compensated for the pain and suffering you’ve gone through and will go through and the loss of earnings of experience because of the accident and will experience.
As far as the pain and suffering side of things is concerned, it is calculated based on previous cases that have come before yours. So part of a lawyers job is to work out where your pain and suffering consequences fit based on previous cases.
In relation to loss of earnings, this aims to compensate you for the lost earnings that you experience to date and will experience into the future.
However calculating loss of earnings isn’t as simple as working out what you’ve lost or are likely to lose on a dollar for dollar basis.
It is calculated taking into account the risks of life – such that you might not have worked until retirement age or that you might not even live until retirement age. There’s certain formula that are used to calculate loss of earnings.
Keep in mind that these common law claims must be initiated within six years from the date of your injury. There are some exceptions to this but as a general rule, six years is all you get.
How to make a TAC claim
There are three ways in which you can lodge a TAC claim after accident.
1. TAC claim contact
Call the TAC on 1300 654 329
They’re available Monday to Friday between the hours of 8:30 am and 5:30 pm.
Tell the person that you speak to that you have been involved in an accident and that you wish to lodge a new TAC claim.
The person will ask you a number of questions about how the accident happened, your contact information, details of any vehicles involved and details of any police attendance (see later on in this article for the information that you should have prior to lodging a claim).
Generally speaking the call should take between 15 and 30 minutes.
When the call has finished, you’ll be provided with a TAC claim number.
You will also receive some correspondence which include some forms that you should sign and return.
If you have a lawyer there will be a form that will include an authority document that lets the TAC know you’re legally represented.
The TAC will determine whether to accept or deny the claim within 21 days.
If they require further information in order to process the claim, they will contact you during this period.
If your claim is accepted then you are entitled to the TAC benefits as mentioned above.
If they reject your claim then there are appeal avenues that you can access.
2. TAC claim online lodgement
This form will ask you a number of questions. Once all of the questions have been answered, you can submit the form online.
Keep in mind however that if you don’t have all the information that you need to complete the form, you may not be able to lodge your claim online.
3. Hospital lodgement
The final way for a claim to be lodged is by a hospital.
Sometimes if you’ve been hospitalised after an accident, the hospital will lodge a TAC claim on your behalf. They do this because they want to ensure that they get paid for the treatment that they provide to you.
You often won’t be told that the hospital has lodged a claim on your behalf.
To find out whether they have lodged a claim in your matter, you can call the TAC and ask them, or alternatively you can contact the hospital.
Before lodging a claim, you should have the following information:
- Your preferred contact information
- Details of the accident – how it occurred, where it occurred.
- What injuries suffered
- The name of any doctors why the health practitioners that you’ve seen
- Details of any hospital you attended
- Details of any police attendance or if placed in the tender seen, details of where the accident was reported
- Details of any witnesses
- Registration numbers of any relevant vehicles involved
- Employment and income details if you’ve lost income and earnings as a consequence of the accident
- Your bank account details (the bank account we will payment to be made).
If the accident involved public transport, insure also to have the following;
- Name of public transport operator (e.g. metro trains)
- Details of any person that you reported the accident to
- Details of your trip including where you were travelling to and where you were travelling from, The date of accident.
- Details of any vehicle number or identifying number.
Conclusion
The TAC claim eligibility is this:
The TAC will pay benefits to a person who suffers injury in a motor vehicle accident, or to the dependant of a person who dies as a result of a motor vehicle accident that occurs in Victoria.
They will also pay benefits if the accident occurred interstate with a Victorian registered vehicle and the injured person is a Victorian resident or was an occupant of a Victorian registered vehicle.
