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

From review to settlement: a CTP solicitor for South West Rocks

What the solicitor does, what you provide, and when the big decisions come.

Most people have never watched a claim move from start to finish, so the long quiet stretches can be unsettling. For people from South West Rocks, we lay out what a solicitor generally does at each stage of a CTP file, what you'll be asked for, and when the key decisions arrive. It's general information, not legal advice, and our claim check is free.

Postcode: 2431

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Running a claim from South West Rocks: the practical side

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. For people in Kempsey 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. Whether it was on South West Rocks Road or a side street, 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.

If you were treated at Kempsey District Hospital, those records are usually among the first a solicitor obtains, with your authority. Emergency notes show your injuries on the day, which helps when the insurer later assesses them.

Region
Mid North Coast
Postcode
2431
Local government area
Kempsey Shire Council
Main roads
South West Rocks Road
Nearest public hospital
Kempsey District 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.

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

Reports, examinations and impairment

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

Claims assessment at the Personal Injury Commission

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 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.

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

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.

Taking over a claim you started yourself

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

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

    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

    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.

Handing your file to a car accident solicitor: when it helps

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

  • A damages claim is possible and the 2-year and 3-year points are approaching
  • A threshold decision could close off the damages stage
  • An offer has arrived and you don't know how to weigh it
  • A settlement conference or claims assessment is coming up

You may not need one

  • Your questions are about lodging, not about damages
  • Statutory benefits are being paid and nothing has been disputed
  • You accept that you were mostly at fault and your benefits are flowing

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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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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