The Hills · How a car accident solicitor runs a claim

How a car accident solicitor runs your claim, Glenorie

Statutory benefits first, damages later: how the two stages fit together on one file.

Once a solicitor takes on a car accident claim, the file follows a fairly set path under NSW law. Statutory benefits come first. Medical evidence builds as your injuries settle. A damages claim generally can't be lodged before 20 months unless your impairment is more than 10%, and must generally be made within 3 years. For people in Glenorie, we explain each stage and connect you with an independent solicitor when your claim needs one.

Postcode: 2157

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Glenorie: records, hospitals and the file

Westmead Hospital and Hornsby Ku-ring-gai Hospital treat many people hurt on the M2, the M7 and Windsor Road. Those first records anchor the medical evidence a solicitor builds over the file. For people in The Hills Shire Council, as anywhere else, the file follows the dates of the crash, not where you live. The accident date sets which rules apply and when the damages claim can, and must, be lodged. Crashes on busy routes like Old Northern Road and Cattai Ridge Road often involve several vehicles. A solicitor reviewing the file checks which insurer accepted the claim and whether liability for damages has been admitted, denied or not yet decided.

Region
The Hills
Postcode
2157
Local government area
The Hills Shire Council
Main roads
Old Northern Road · Cattai Ridge Road
Nearest public hospital
Hornsby Ku-ring-gai Hospital

Dates, decisions and deadlines: the file review

The file review is less about the crash and more about the paper trail since. The solicitor reads the claim form, the insurer's letters and decisions, your Certificates of Fitness and any statements you've given. The aim is to see where the claim stands, what is still open, and whether any decision needs to be challenged before its time limit passes.

The first stage of the file: benefits while you recover

A key decision in this stage is whether the insurer treats your injury as a threshold injury. For accidents from 1 April 2023, threshold injuries generally have statutory benefits for up to 52 weeks, and they don't lead to damages. A solicitor looks closely at that decision, because a wrong threshold finding can close off the second half of the file.

How a damages file usually settles

Settlement talks often come to a head at a conference, in person or online, where the insurer and your solicitor try to close the gap. You'll usually be asked to attend or stay by the phone. The solicitor will go through the evidence with you beforehand and talk about what a reasonable result could look like. The final say on any figure is yours.

Read next:CTP settlements

When negotiation stalls

If the insurer and the solicitor can't agree, the damages claim can generally go to claims assessment at the Personal Injury Commission, the independent tribunal that has handled CTP disputes since 1 March 2021. An assessor considers the evidence and submissions from both sides and assesses the damages. The solicitor prepares the application and the material the assessor will rely on.

Read next:The Personal Injury Commission

Building the medical side of the file

The medical evidence on a file comes from what your treating doctors record, what independent specialists report, and how your injuries look once they've settled. The insurer may arrange its own examination. Impairment assessment usually waits until recovery has plateaued, because an early assessment can understate a lasting injury. How impairment is assessed is covered elsewhere; here it matters for timing.

Read next:Independent medical examinations: what to expect

When the damages claim goes in

A damages claim is separate from the statutory benefits claim. It can generally be made only if another driver was at fault, you weren't mostly at fault and your injury is more than a threshold injury. It generally can't be made before 20 months after the accident unless whole person impairment is more than 10%, and must generally be made within 3 years.

Once lodged, the insurer considers the claim and decides whether it accepts liability for damages. It may accept, dispute some parts, or deny liability altogether, for example if it says you were mostly at fault. The solicitor responds to each position with evidence. Your part is mainly to keep up treatment and tell the solicitor about any change in your work or health.

Read next:CTP damages claims

Bringing a solicitor into a claim that's already running

Taking over a running claim is mostly about catching up. The solicitor checks whether any decisions can still be reviewed, whether benefits are being paid correctly and when a damages claim can or must be made. Some steps you took yourself may need no change at all. Others, such as a threshold decision you didn't challenge, may need attention quickly if a time limit is still open.

Read next:Free claim check

How a CTP file runs: six stages

From the first review to the final settlement or assessment, a damages file usually runs for years rather than months. The six stages below are the general shape of it, in the order they usually come.

  1. At the start

    File review and costs disclosure

    The solicitor reviews your accident date, when the claim was lodged, every insurer decision and any deadline already running. Before substantial work begins, you'd generally expect written information explaining how fees are worked out.

  2. The first months

    The statutory benefits stage

    While you recover, weekly payments and treatment come through statutory benefits. The solicitor watches the insurer's decisions, such as whether your injury is treated as a threshold injury, and helps you challenge ones that seem wrong within the review time limits.

  3. As injuries settle

    Medical evidence and impairment

    The medical evidence builds over time: treating records, specialist opinions and, where needed, medico-legal reports. Impairment is usually assessed only when your condition has settled, so this stage can't be rushed.

  4. From 20 months

    The damages claim is lodged

    A damages claim generally can't be made before 20 months after the accident, unless whole person impairment is more than 10%. It must generally be made within 3 years, and within 2 years if you want weekly payments to continue beyond 2 years.

  5. After lodgement

    Negotiation with the insurer

    The insurer considers the damages claim and may accept or dispute parts of it. The solicitor exchanges evidence and offers with the insurer, and may take part in a settlement conference. You decide whether to accept any offer.

  6. Resolution

    Settlement, or assessment at the PIC

    A file ends with a settlement you agree to, a claims assessment at the Personal Injury Commission or, less often, court proceedings. Settling in the first 2 years after the crash generally isn't allowed unless impairment is above 10%.

General information, not legal advice. Every file is different, and the timing rules depend on your accident date. Time limits apply.

Solicitor-run or self-run: which suits your claim?

These points show when handing the file to a solicitor usually helps, and when you may be fine running it yourself. If you're unsure where yours sits, the free claim check can tell you.

Often worth talking to a lawyer

  • The insurer has disputed liability for your damages claim
  • A damages claim is possible and the 2-year and 3-year points are approaching
  • The insurer wants you to sign a release or deed
  • A settlement conference or claims assessment is coming up

You may not need one

  • You only need help with a treatment approval
  • You accept that you were mostly at fault and your benefits are flowing
  • Your injuries are healing and no damages claim is likely

Whatever stage your file is at, treatment continues alongside it. We can put you in touch with doctors and allied health who know how the Certificate of Fitness and CTP claims work.

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