Blue Mountains · How a car accident solicitor runs a claim

From review to settlement: a CTP solicitor for Yellow Rock

Statutory benefits first, damages later: how the two stages fit together on one file.

A CTP file has two halves. The first is the statutory benefits stage, with weekly payments and treatment while you recover. The second, for some people, is a damages claim, lodged later and resolved by negotiation, a settlement conference or a claims assessment. If you're near Yellow Rock and working out how a solicitor would run your file, this page walks through it in order.

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Yellow Rock: 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. Living in the Blue Mountains City 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. Crashes on busy routes like Yellow Rock Road, Singles Ridge Road and Hawkesbury Road often involve several vehicles. A solicitor reviewing the file checks which insurer accepted the claim and whether liability for damages has been admitted, denied or not yet decided.

Hospitals serving the area include Springwood Hospital and Nepean Hospital. Hospital, GP and specialist records together form the medical history the insurer and any assessor will rely on, so a solicitor keeps track of them throughout the file.

Region
Blue Mountains
Postcode
2777
Local government area
Blue Mountains City Council
Main roads
Yellow Rock Road · Singles Ridge Road
Nearest public hospital
Springwood Hospital

The first review of your claim

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.

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

When a claim settles, you'll usually sign a release or deed that ends the claim in exchange for the agreed amount. Read it carefully and ask what it covers before you sign, including what happens to any benefits still being paid. A signed settlement is very hard to undo, which is why solicitors generally advise against settling before your injuries have stabilised.

Read next:CTP settlements

Solicitor-run or self-run: which suits your claim?

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

  • Your impairment may be more than 10% and that could change the timing
  • Your earnings are irregular and proving lost income will take work
  • You started the claim yourself and it has become complicated
  • The insurer has disputed liability for your damages claim

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
  • 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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Six stages of a solicitor-run CTP claim

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

    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

    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

    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

    A damages claim generally can't be made before 20 months after the accident, unless whole person impairment is more than 10%. It must generally be made within 3 years, and within 2 years if you want weekly payments to continue beyond 2 years.

  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.

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

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

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.

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

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

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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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