Central Coast · How a car accident solicitor runs a claim

How a car accident solicitor runs your claim, Somersby

The stages of a NSW CTP file, the rules that set its pace, and what you do along the way.

One way to understand a car accident claim is to follow the file. It opens with a review of dates and decisions, moves through statutory benefits and medical evidence, and, if a damages claim is open to you, ends in settlement or assessment. We're not a law firm. For people in Somersby, we explain the path and can introduce you to an independent solicitor if it would help.

Postcode: 2250

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Somersby: records, hospitals and the file

Gosford Hospital and Wyong Hospital treat most Central Coast crash injuries. Their records, with your GP's, are the starting point for the medical evidence a solicitor builds on the file. If your crash happened on a local road in the Central Coast Council area, the police event number and any nearby camera footage may become part of the file. A solicitor usually checks early whether those records exist and are being kept. Where the crash happened is fixed on the file early. It matters for the police record, for any witnesses and, occasionally, for which scheme applies near a border.

Region
Central Coast
Postcode
2250
Local government area
Central Coast Council
Public hospital in the region
Gosford Hospital

Taking on the file: what the solicitor checks first

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.

Building the medical side of 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

The damages claim: timing and content

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.

After the damages claim goes in, there can be long stretches with little visible progress while evidence is exchanged. The insurer may request further information or arrange another medical examination. Keep the solicitor told of any change in your work, treatment or symptoms, and answer requests promptly, because an up-to-date file is easier to resolve.

Read next:CTP damages claims

Do you need a solicitor to run your CTP file?

Many CTP claims never reach the damages stage, and plenty of people manage the statutory benefits side on their own. A solicitor-run file makes more sense once a damages claim is possible or a decision needs challenging.

Often worth talking to a lawyer

  • The insurer has disputed liability for your damages claim
  • An offer has arrived and you don't know how to weigh it
  • A settlement conference or claims assessment is coming up
  • Your earnings are irregular and proving lost income will take work

You may not need one

  • Your injury has been accepted as a threshold injury and you agree with it
  • Your injuries are healing and no damages claim is likely
  • Statutory benefits are being paid and nothing has been disputed

Consistent treatment makes for a clearer file. Ask us about doctors and allied health, such as GPs, physiotherapists and psychologists, who understand CTP claims and complete the Certificate of Fitness.

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How a CTP file runs: six stages

Every CTP file is different, but most follow the same order. Here are the six stages a solicitor generally works through, with the timing rules that apply. Some files end early, for example when no damages claim is open.

  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

    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

    Once your injuries have stabilised, the solicitor may arrange medico-legal reports from independent doctors, and the insurer may ask you to attend its own examination. Whole person impairment may be assessed, which matters if it could be more than 10%.

  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

    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 damages claim generally can't settle within 2 years of the accident unless impairment is more than 10%. If negotiation doesn't produce an agreement, the Personal Injury Commission can assess the claim, and some claims go to court instead.

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

Negotiation and settlement

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

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

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.

Already lodged your claim? How a solicitor steps in

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

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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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