Blue Mountains · How a car accident solicitor runs a claim

How a car accident solicitor runs your claim, Wentworth Falls

A damages file generally takes years, not weeks. Here's why, and what happens at each stage.

Some people start their CTP claim on their own and bring in a solicitor later, often when a decision goes against them or a damages claim comes into view. Others engage one early. Either way, the file runs through the same stages. People from Wentworth Falls can use our free claim check to see where their file is up to and what the next stage involves.

Postcode: 2782

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Wentworth Falls: records, hospitals and the file

Crashes on the Great Western Highway or Bells Line of Road in poor weather sometimes lead to arguments about liability. The file review notes early whether the insurer has accepted or disputed it. For people in Blue Mountains City 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. Hospital records from Blue Mountains District ANZAC Memorial 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
Blue Mountains
Postcode
2782
Local government area
Blue Mountains City Council
Main roads
Great Western Highway · Falls Road
Nearest public hospital
Blue Mountains District ANZAC Memorial Hospital

Taking on the file: what the solicitor checks first

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.

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

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

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

  • You started the claim yourself and it has become complicated
  • The insurer has disputed liability for your damages claim
  • Your earnings are irregular and proving lost income will take work
  • The insurer wants you to sign a release or deed

You may not need one

  • Your injury has been accepted as a threshold injury and you agree with it
  • You accept that you were mostly at fault and your benefits are flowing
  • 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

    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

    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

    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 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.

Offers, conferences and settling the file

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

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 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

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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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