Liverpool & Fairfield · CTP claim denied

Starting a CTP dispute from Casula

Internal review first, then the Personal Injury Commission. Check your options free, by phone or online.

Denied, cut off or classified as a threshold injury? Start by reading the decision carefully and noting the date you received it. The internal review window is generally 28 days. People in Casula can handle much of a review in writing, and an independent CTP lawyer can help if the stakes are high. Our free claim check is a quick way to find out where you stand.

Postcode: 2170

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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

    Read the letter twice: once for what was decided, once for why. Write down the date you received it. If the reasons aren't clear, ask the insurer to explain them in writing.

  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

    Medical assessment certificates can generally be reviewed, but the window is short: generally 28 days from the date the certificate is issued. Get advice quickly if you're considering it.

  6. Any time

    Conduct complaints go to the IRO

    Unhappy with the insurer's conduct rather than its decision? Contact the Independent Review Office on 13 94 76, 8:30am to 5:30pm weekdays, or online. It's a separate path from a review.

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 Casula

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. There's no need to get to Liverpool, or anywhere else, to dispute a decision. From Casula, review requests are generally made in writing, the lawyer you speak with can advise by phone, and the claim check works by phone and online too. Coming under Liverpool City Council makes no difference to a CTP dispute. The same review steps and deadlines apply in Casula as in any other part of NSW, because the scheme is statewide.

Region
Liverpool & Fairfield
Postcode
2170
Distance to Liverpool
~4 km
Local government area
Liverpool 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?

How to request a review

A good review request is short and specific. Quote the decision and its date. Explain in plain terms where you think the insurer got it wrong, with reference to the evidence. If there's something the insurer didn't have, such as a specialist report, include it. Keep a copy and note when you sent it.

After you ask, the insurer usually has 14 days to decide. Some medical and miscellaneous matters allow 21 days, and up to 28 days if the insurer needs more information. While you wait, keep sending updated Certificates of Fitness if you're off work, and keep a record of every contact about the review.

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

Complaints versus disputes

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.

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When a dispute calls for 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

  • Weekly payments were stopped and you can't work
  • You've missed the review deadline
  • You were driving for work and the insurer has refused on that basis
  • The dispute is heading to the Personal Injury Commission

You may not need one

  • Your doctor can clearly answer the insurer's question in a report
  • A treatment request was declined for lack of information you can supply
  • The decision was about a small, one-off expense

Many disputes turn on medical evidence. If you need a clear report on your diagnosis, or an up-to-date Certificate of Fitness, we can point you to doctors and allied health familiar with CTP claims.

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 Casula
  • 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 Casula
  • 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 Casula

Taking a dispute further

If an internal review doesn't resolve your dispute, the Personal Injury Commission is generally the next step. It's independent of the insurer. Depending on the dispute, a member may review the decision on its merits, a medical assessor may assess your injury, or the Commission may assess a damages claim. The type of dispute decides which path applies.

Read next:The Personal Injury CommissionPIC disputes explained

Disputing a threshold-injury decision

A threshold decision about a psychological injury can be disputed like any other. If the insurer has classified yours as threshold and your treating practitioner disagrees, their written opinion is the starting point for an internal review. If the review doesn't resolve it, the dispute can go on to medical assessment at the Personal Injury Commission, where the 28-day window for a certificate review applies.

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

Decisions people often ask about

Not every decision is a flat refusal. Sometimes the claim is accepted but limited: benefits capped at 52 weeks, weekly payments set lower than you expected, or a particular treatment declined. These partial decisions can matter as much as a refusal over time, and most can be reviewed in the same way.

  • The injury was classed as a threshold injury
  • You were found wholly or mostly at fault
  • A treatment request was declined
  • The insurer says the injury wasn't caused by the crash

Read next:Claim denied? Quick check

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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