Blacktown & Mount Druitt · CTP claim denied

CTP claim rejected? Review options for Bidwill

The insurer's decision is rarely the last word. The first deadline is generally 28 days, so start now.

Not every refused claim needs a lawyer. Some decisions are simple to challenge with better evidence, and some are right under the rules. What matters is acting within the deadline. If you're in Bidwill and have received a decision you disagree with, our free claim check looks at what was decided, why, and what your realistic options are.

Postcode: 2770

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  • Helping people in Bidwill & Blackett

How to challenge a CTP decision, step by step

Insurers make decisions under the scheme rules, and the scheme also sets out how to challenge them. These are the main steps and the timeframes that generally apply.

  1. Step 1

    Read the decision letter

    Note the date you received it, what was decided and the reasons given. The date matters, because the time to ask for a review generally runs from when you receive the decision.

  2. Within 28 days

    Ask for an internal review

    Request the review in writing, inside the 28-day window that generally applies. The insurer looks at the decision again, so explain clearly why you think it's wrong and attach anything it didn't have.

  3. 14 to 28 days

    The insurer decides

    The insurer usually has 14 days to decide the review. For some medical and miscellaneous matters it's 21 days, and up to 28 days if it needs more information from you.

  4. If you still disagree

    Apply to the Personal Injury Commission

    If the internal review doesn't resolve things, you can generally apply to the Personal Injury Commission. It's independent of the insurer and decides disputes under the scheme rules.

  5. 28 days from a certificate

    Medical assessment review

    If your dispute goes to medical assessment and you think the certificate is wrong, a review must generally be sought within 28 days of the certificate being issued.

  6. Any time

    Conduct complaints go to the IRO

    If your concern is how the insurer has treated you, such as delays or poor communication, that's a complaint, not a dispute. The Independent Review Office handles those complaints on 13 94 76.

General information, not legal advice. Timeframes are general, and some decisions follow different rules. Check your decision letter and get advice quickly.

Bidwill: reviews without the travel

If Blacktown Hospital, Mount Druitt Hospital or Westmead Hospital treated you, those records can support a review of a threshold or treatment decision. Request them promptly, since the review window is generally 28 days. At around 39 km from the Sydney CBD, living in Bidwill is no disadvantage in a dispute. Review requests generally go in writing, many Personal Injury Commission steps can happen by phone or online, and our claim check works the same way. Coming under Blacktown City Council makes no difference to a CTP dispute. The same review steps and deadlines apply in Bidwill as in any other part of NSW, because the scheme is statewide.

Region
Blacktown & Mount Druitt
Postcode
2770
Distance to Blacktown
~9 km
Local government area
Blacktown City Council

A refusal isn't the end of the road

It's easy to read a refusal as the final word. Under the NSW CTP scheme, it's usually the first. Most decisions carry a right to internal review, and beyond that an independent tribunal, the Personal Injury Commission. What you need is a clear understanding of the decision and enough time to respond, which is why the 28-day window matters.

Read next:CTP claim denied?

The IRO and what it handles

CTP Assist and the IRO are different services with different roles. CTP Assist, on 1300 656 919, gives information and support about claims. The IRO, on 13 94 76, handles complaints about how CTP insurers behave. Neither decides disputes about your entitlements; that's the job of internal review and the Personal Injury Commission.

Asking for an internal review

An internal review is a fresh look at the decision by the insurer. Ask in writing, generally within 28 days of receiving the decision. Say which decision you disagree with, why you think it's wrong and what outcome you want. Attach anything new: a report from your doctor, hospital records, payslips or witness details.

If the review confirms the original decision, that isn't the end. You can generally take most disputes to the Personal Injury Commission. If the review changes the decision, check the new letter carefully to make sure it covers everything you raised, and ask about anything it leaves out.

The 28-day window

The review deadline is short: generally 28 days from receiving the decision. If you're unsure which date counts, work from the earlier one.

Read next:Insurer stopped my weekly payments

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Free claim check

Disagree with a decision? Start here

No office visit and no charge for the check. A quick claim check by phone or online tells you whether a review is worth pursuing.

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Reviewing alone or with legal help

Whether you need a lawyer depends on what was decided and what's at stake. Use these lists to get a sense of it, then get a free claim check for your own situation.

Often worth talking to a lawyer

  • The refusal is based on your claim being late
  • You've been found mostly at fault
  • The whole claim has been refused
  • The dispute is heading to the Personal Injury Commission

You may not need one

  • The insurer asked for a document you can easily provide
  • Your doctor can clearly answer the insurer's question in a report
  • The decision was about a small, one-off expense

If your threshold dispute depends on whether there's nerve damage or a tear, the right assessment matters. Ask us about doctors and allied health experienced with CTP claims, from diagnosis to the Certificate of Fitness.

Not quite your situation?

  • For the wider question of whether a lawyer is worth it on a CTP claim at all, the CTP lawyer page for Bidwill is the better fit. CTP lawyer in Bidwill
  • If the dispute turns on whether your injury is more than threshold, the injury compensation page explains what the medical evidence needs to show. Injury compensation lawyer in Bidwill
  • If you haven't had a decision yet and are still getting the claim in, start with the CTP claims page for Bidwill. CTP claims in Bidwill

Medical and threshold disputes

A threshold decision limits statutory benefits to 52 weeks for accidents from 1 April 2023, and it rules out a damages claim. A threshold injury is generally soft tissue, and it doesn't include nerve damage or a full or partial tear of a tendon, ligament, meniscus or cartilage. If your medical evidence shows one of those, the classification may be wrong.

Read next:Threshold injury disputesWhen the insurer says “threshold injury”

Common reasons a claim is refused or limited

Some decisions come up again and again. A claim may be refused because it was lodged late, or limited because the insurer says the injury is threshold or that you were mostly at fault. Weekly payments may stop, or a treatment request may be declined. Each raises its own evidence questions, and each can generally be reviewed.

  • The claim was lodged late
  • You were found wholly or mostly at fault
  • The crash is being treated as a work injury
  • A treatment request was declined

Read next:Claim denied? Quick check

The Personal Injury Commission

The Personal Injury Commission, or PIC, is an independent tribunal that started on 1 March 2021. In the CTP scheme it handles merit review, medical assessment, miscellaneous claims assessment and claims assessment of damages claims. It replaced the older dispute bodies, so older material that sends you elsewhere is out of date.

Read next:The Personal Injury CommissionPIC disputes explained

Paying for help with a review

Free help is limited once a dispute is under way. The CTP Legal Advisory Service that SIRA funds stops short of matters already at internal review or before the Personal Injury Commission. CTP Assist can still give general information. For advice on the dispute itself, you'll generally need an independent lawyer.

Read next:What does a CTP lawyer cost?

Frequently asked questions

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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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