Insurer Stopped My Weekly Payments — What Now?

Having weekly payments stop or reduce unexpectedly is one of the most stressful moments in a CTP claim — it's often income you're relying on. It's also one of the most common triggers for a formal dispute, and there's a clear process for challenging it.

Step 1: Understand exactly why

Insurers are generally required to explain why they decided what they decided, and what review rights you have. If you only received a phone call, ask for the decision in writing — the specific reason matters for what you do next, whether it's a certificate lapsing, a change in assessed capacity, or a broader liability or classification decision.

Common reasons payments stop or reduce

• Your Certificate of Fitness lapsed or wasn't renewed on time.
• An independent medical examination assessed your capacity differently from your treating team.
• You've reached the 52-week or 104-week benefit period markers, and no pending damages claim extends it.
• Your injury was classified as a threshold injury, affecting how long benefits can run.
• A change in your earnings information changed the calculated amount.

Step 2: Internal review

You generally have 28 days from receiving the decision to request an internal review. This is where updated medical evidence, a clarified certificate, or corrected earnings information can make a real difference — the insurer usually has 14 days to decide (21 days for some medical and miscellaneous matters, and up to 28 days if it needs more information).

Step 3: The Personal Injury Commission

If internal review doesn't resolve it, this is exactly the kind of dispute the Personal Injury Commission's merit review process handles. See our guide to the Personal Injury Commission for what that process looks like.

In the meantime

A stopped payment doesn't mean the claim is over — but it does mean acting quickly matters, both for the 28-day review window and for your immediate financial position. Keep every letter, request an updated Certificate of Fitness from your treating doctor if that's the issue (see doctors and allied health for CTP claims if you need one), and consider getting legal advice sooner rather than later if the amount at stake is significant.

Managing the financial pressure while you wait

A stopped payment often arrives at the worst possible time financially, and the review process — even moving efficiently — takes real weeks, not days. If you're in genuine hardship, it's worth being upfront with essential creditors (rent, utilities, loans) about the situation; many have hardship provisions for exactly this kind of circumstance. It's not a substitute for the review process itself, but it can relieve some pressure while the dispute works through properly rather than being rushed.

Don't let the dispute distract from your treatment

It's natural for a stopped payment to dominate your attention, but continuing your treatment as recommended — and keeping certificates current throughout the dispute — actually strengthens your position, since it demonstrates your ongoing genuine need rather than giving the insurer a gap to point to. The two things, disputing the payment decision and staying on top of treatment, work best done together, not instead of each other.