Liverpool & Fairfield · CTP claim denied

Denied CTP claim in Bossley Park: the review path

Calm, clear steps for a refused claim, stopped payments or a threshold decision you disagree with.

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 Bossley Park 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: 2176

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  • Helping people in Bossley Park & Greenfield Park

Your review path

Here's the usual route when you disagree with an insurer's decision. Not every dispute needs every step, and some decisions have their own rules, but this is the general shape.

  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

    For most decisions, you can ask the insurer for an internal review, generally within 28 days of receiving the decision. Say what you disagree with and include any new evidence.

  3. 14 to 28 days

    The insurer decides

    Expect a review decision in about 14 days in most cases, 21 days for some medical and miscellaneous matters, and up to 28 days where the insurer needs more information.

  4. If you still disagree

    Apply to the Personal Injury Commission

    If internal review leaves the decision in place, the next step is generally an application to the Personal Injury Commission, an independent tribunal. What you're disputing decides which of its paths applies, such as merit review or medical assessment.

  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.

Disputing a claim while living in Bossley Park

If a truck on the Hume Highway or the M5 was involved and fault is disputed, evidence matters. Ask for an internal review within 28 days and include police details, photos and any witness statements. Bossley Park is about 7 km north-west of Liverpool, but challenging a decision doesn't mean travelling there. Internal reviews are generally requested in writing, and our claim check runs by phone and online. People in Bossley Park, within Fairfield City Council, follow the same dispute path as everyone else in NSW: internal review first, generally within 28 days, then the Personal Injury Commission. Where you live doesn't change the deadlines.

Region
Liverpool & Fairfield
Postcode
2176
Distance to Liverpool
~7 km
Local government area
Fairfield City Council

You can ask for a second look

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?

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 crash is being treated as a work injury
  • Weekly payments were stopped or reduced
  • Your pre-accident earnings were set lower than you expected
  • The insurer says the injury wasn't caused by the crash

Read next:Claim denied? Quick check

The IRO and what it handles

A dispute is about a decision, such as whether your claim is accepted. A complaint is about conduct, such as delays, unanswered calls or unclear letters. Complaints about the conduct of CTP insurers go to the Independent Review Office (IRO) on 13 94 76, 8:30am to 5:30pm weekdays, or online at iro.nsw.gov.au. The IRO doesn't fund lawyers for CTP claims.

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Reviewing alone or with legal help

Some reviews are simple: supply the missing evidence and ask again. Others turn on legal questions or high stakes. Here's a general guide to which is which.

Often worth talking to a lawyer

  • The dispute is heading to the Personal Injury Commission
  • You've missed the review deadline
  • The whole claim has been refused
  • Weekly payments were stopped and you can't work

You may not need one

  • Your doctor can clearly answer the insurer's question in a report
  • You mainly want to complain about delays or communication
  • You agree with the decision once it's explained

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?

  • If you're not sure a dispute is worth taking on with legal help, the CTP lawyer page explains when a lawyer tends to be worth it. CTP lawyer in Bossley Park
  • When the real argument is how serious your injury is, the injury compensation page for Bossley Park covers impairment and the threshold line. Injury compensation lawyer in Bossley Park
  • If nothing has been decided yet and your claim is still being set up, the CTP claims page covers the lodging steps instead. CTP claims in Bossley Park

What the Commission does

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

Making your internal review count

Reviews are often decided on the papers, so what you send matters. If the decision was about your injury, ask your treating doctor to explain their findings in writing. If it was about earnings, send payslips or tax records. If it was about fault, include police details, photos and witness contacts.

Don't wait until the last days of the window to start. Specialist reports and records can take time to arrive, and a rushed request is usually weaker. If some evidence won't be ready in time, lodge the request within the deadline anyway and tell the insurer what else is on its way.

The 28-day window

The clock generally runs for 28 days from the day the decision reached you. Note the date the letter arrived, not just the date printed on it.

Read next:Insurer stopped my weekly payments

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”

Paying for help with a review

In a dispute about statutory benefits, legal costs work differently from what many people expect. Costs are recoverable only where the Regulation or the Personal Injury Commission allows, the insurer pays whatever is recoverable, and in some disputes nothing can be recovered at all. So before you engage a lawyer for a review, ask how their fees would work for this particular dispute, and get the answer in writing.

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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