Central Coast · How a car accident solicitor runs a claim

From review to settlement: a CTP solicitor for The Entrance

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

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The Entrance: 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. Living in the Central Coast 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. Whether it was on the Central Coast Highway 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.

Region
Central Coast
Postcode
2261
Local government area
Central Coast Council
Main roads
Central Coast Highway · The Entrance Road
Nearest public hospital
Gosford Hospital

Dates, decisions and deadlines: the file review

Some things about a CTP claim can't be fixed later, which is why the first review looks for them. A decision that wasn't reviewed in time, a damages claim approaching its 3-year limit, or weekly payments nearing an end all shape what happens next. A solicitor flags these early and tells you plainly which ones matter for your file.

The first stage of the file: benefits while you recover

For the first part of a CTP file, the claim is about statutory benefits: weekly payments if you can't work, and treatment and care that is reasonable and necessary. Much of this runs directly between you and your case manager. The solicitor's role is to watch the insurer's decisions and step in where one affects your entitlements or your later damages claim.

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

If the claim doesn't settle: the PIC

Some claims can go to court rather than, or after, claims assessment, for example where a claim is exempt from assessment or a party is entitled to take it further. This is less common in CTP files and depends on the facts. If it's possible in your case, the solicitor will explain the costs, the risks and the timing before any decision is made.

Read next:The Personal Injury Commission

When the damages claim goes in

Timing the damages claim is one of the solicitor's main decisions. Lodge within 2 years of the accident and weekly payments can continue beyond the 2-year point while the claim is pending. Lodge before 20 months only if impairment is more than 10%. Leave it past 3 years and the claim may only be allowed with a full and satisfactory explanation.

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

Medical evidence and impairment on the file

As your injuries settle, the medical side of the file takes shape. Your treating doctors' records come first. Reports written for the claim itself, by independent specialists the solicitor instructs, may follow, and the insurer can ask you to see a doctor of its choosing. If your whole person impairment could be more than 10%, it will be assessed once your condition has stabilised, which affects both timing and what can be claimed.

Read next:Independent medical examinations: what to expect

Taking over a claim you started yourself

If you've been dealing with the insurer on your own, keep doing what the claim needs until the solicitor confirms they've taken it on. Gather your claim number, every letter and decision, your Certificates of Fitness and any statements you've given. The solicitor uses them to rebuild the history of the claim and check whether anything needs urgent attention.

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

    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 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.

Do you need a solicitor to run your CTP file?

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

  • The insurer has disputed liability for your damages claim
  • A settlement conference or claims assessment is coming up
  • The insurer wants you to sign a release or deed
  • A threshold decision could close off the damages stage

You may not need one

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

The medical evidence on a file starts with your treating doctors. We can point you to doctors and allied health experienced with CTP claims, including the Certificate of Fitness the insurer relies on.

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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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