Mid North Coast · How a car accident solicitor runs a claim

A CTP solicitor's work on your file, for people in Port Macquarie

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 Port Macquarie, we explain each stage and connect you with an independent solicitor when your claim needs one.

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Local records that end up on a file from Port Macquarie

A crash on the Pacific Highway is claimed under the NSW scheme whoever was driving and wherever they live. The file review confirms the insurer and the dates that set the timetable. Living in the Port Macquarie-Hastings Council area doesn't change how a CTP file runs. The scheme is statewide, and the stages, the timing rules and the Personal Injury Commission's role are the same wherever in NSW you live. Hospital records from Port Macquarie Base Hospital, GP notes and specialist reports build up over the life of a file. A solicitor usually waits until your injuries settle before relying on them for the damages claim.

Region
Mid North Coast
Postcode
2444
Local government area
Port Macquarie-Hastings Council
Main roads
Pacific Highway · Oxley Highway
Nearest public hospital
Port Macquarie Base Hospital

Taking on the file: what the solicitor checks first

When a solicitor takes on a car accident claim, the first job is a review of what has already happened. That means the accident date, which sets the rules that apply; the date the claim was lodged; each decision the insurer has made; and any deadline already running, such as the 28 days to seek internal review of a decision. Nothing else is planned until those dates are clear.

How a damages file usually settles

Damages claims are most often resolved by negotiation. The insurer and the solicitor exchange evidence and offers, sometimes at a settlement conference with you present or available. You'll hear what each offer means against the evidence, and what going further could risk. You decide whether to accept. If an offer seems low, the solicitor can generally answer it with further evidence rather than a flat refusal.

Read next:CTP settlements

The statutory benefits stage

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.

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.

If you're self-employed or your income varies, proving lost earnings takes more work. Business records, business activity statements and an accountant's reports may all be needed, and gathering them can take time. The solicitor will usually start collecting them well before the damages claim is due, so missing documents don't put the timing rules at risk.

Read next:CTP damages claims

If the claim doesn't settle: the PIC

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

Medical evidence and impairment on the file

Your role in the medical stage is steady: keep up treatment, attend reviews, and tell your doctors about every ongoing symptom. The solicitor's role is to decide when the evidence is complete enough to act on. That may involve reports from specialists and, where impairment could exceed 10%, an assessment that can change when the damages claim is lodged.

Read next:Independent medical examinations: what to expect

Bringing a solicitor into a claim that's already running

Many people lodge a CTP claim themselves and only look for a solicitor later, often after a decision goes against them or when a damages claim comes into view. That's common and generally not a problem. The solicitor notifies the insurer, obtains your claim file and reviews what has happened so far. The time limits keep running throughout, so earlier is better than later.

Read next:Free claim check

The file from review to resolution

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

    First comes a review: what happened, which insurer has the claim, what it has decided and which dates matter. You should also be given written information about costs before significant work starts, and you can ask questions about it.

  2. The first months

    The statutory benefits stage

    Statutory benefits run from early in the claim. For threshold injuries they generally end at 52 weeks, for accidents from 1 April 2023; otherwise weekly payments can generally continue for up to 104 weeks. The solicitor tracks these limits and the decisions that affect them.

  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

    Timing here is set by law. The earliest point is generally 20 months after the accident, or sooner with impairment above 10%. The latest is generally 3 years. Lodging within 2 years keeps weekly payments available past the 2-year mark while the claim is pending.

  5. After lodgement

    Negotiation with the insurer

    Negotiation usually involves offers going back and forth, sometimes over months. The solicitor explains each offer against the evidence and the risks, but the decision to accept or reject it is yours.

  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?

Whether a solicitor should run your file depends on which stage it's at. Early on, you may not need one. Later, when timing rules and evidence start to shape the result, many people with a damages claim find one helpful.

Often worth talking to a lawyer

  • An offer has arrived and you don't know how to weigh it
  • Your impairment may be more than 10% and that could change the timing
  • The insurer has disputed liability for your damages claim
  • A threshold decision could close off the damages stage

You may not need one

  • You only need help with a treatment approval
  • Your injury has been accepted as a threshold injury and you agree with it
  • What you need most right now is medical care, not a file review

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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CTP Lawyer is not a law firm. This page is general information, not legal advice; the independent lawyer you speak with can advise on your own situation.

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