The Personal Injury Commission (PIC) Explained

The Personal Injury Commission (PIC) is the independent NSW tribunal that resolves disputes in the CTP scheme once internal review with the insurer hasn't fixed the problem. It started operating on 1 March 2021, replacing the previous mix of dispute bodies with a single specialist commission. For an overview of how a CTP dispute gets there, see the Personal Injury Commission in our CTP claims series.

What kinds of disputes the PIC handles

• Merit review — disputes about certain statutory benefits decisions, such as how your weekly payments were calculated.
• Medical assessment — disputes about medical questions, including whole person impairment and threshold injury classification.
• Miscellaneous claims assessment — a range of other procedural and eligibility disputes within the scheme.
• Damages claims assessment — assessment and resolution of common law damages disputes.

Getting to the PIC: internal review comes first

Most disputes need to go through the insurer's internal review process first. You generally have 28 days from receiving a decision to ask for that review, and the insurer usually has 14 days to decide (up to 21 days for some medical and miscellaneous matters, or 28 days if more information is genuinely needed). If internal review doesn't resolve things, the PIC is the next step.

What to expect at the PIC

The PIC has its own forms, processes and time limits, and while it's designed to be more accessible than a court, the procedural requirements can still trip up someone unfamiliar with them. Lawyers routinely run PIC matters and know the process; self-represented people can genuinely struggle with the procedural side, even when their underlying claim is strong.

Preparing for a PIC dispute

• Line up your medical records and certificates chronologically before lodging.
• Request copies of any independent medical reports the insurer relied on.
• Note every deadline in the process — missing one can affect your options.
• Get legal advice early rather than after a preliminary step has already gone against you.

How long PIC disputes take

Timeframes vary with the type and complexity of the dispute. Medical assessment disputes can sometimes move relatively quickly; damages claims assessment can take considerably longer, particularly if further evidence or hearings are required. A lawyer running the matter can give you a realistic estimate once they understand the specifics.

Costs of a PIC dispute

Legal costs for PIC matters follow the same regulated framework as the rest of a CTP claim. In statutory benefits disputes, legal costs can only be recovered where the Regulation or the Commission allows it, and for some disputes they can't be recovered at all. For a damages claim, the regulated caps on legal costs still apply. Ask any lawyer how they charge for PIC work, in writing, before you agree to anything — see our guide to CTP lawyer costs.

What a hearing (if one happens) generally looks like

Not every PIC dispute involves a formal hearing — many are resolved on the papers, based on written submissions and medical evidence, without either side needing to attend in person. Where a hearing is required, it's generally less formal than a courtroom, though the outcome still carries real, binding weight. Your lawyer would typically prepare you for what to expect well before the date.