Liverpool & Fairfield · CTP claim denied

Starting a CTP dispute from Chipping Norton

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

A refused claim is a decision, not a verdict. Under the NSW CTP scheme, most insurer decisions can be reviewed, and there's an independent body, the Personal Injury Commission, if an internal review doesn't resolve things. Our free claim check helps people in Chipping Norton understand the decision, the deadlines and whether an independent lawyer would help.

Postcode: 2170

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What a review looks like from Chipping Norton

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. Coming under Liverpool City Council makes no difference to a CTP dispute. The same review steps and deadlines apply in Chipping Norton as in any other part of NSW, because the scheme is statewide. There's no need to get to Liverpool, or anywhere else, to dispute a decision. From Chipping Norton, 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.

Region
Liverpool & Fairfield
Postcode
2170
Local government area
Liverpool City Council
Distance to Liverpool
~3 km

Most decisions can be challenged

Insurers make decisions under the scheme rules: whether to accept a claim, how much to pay, which benefits to approve, whether an injury is threshold. Most of them can be challenged. The first step is an internal review, which you generally need to request within 28 days of the decision reaching you. If that doesn't resolve it, the Personal Injury Commission can decide.

Read next:CTP claim denied?

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: an updated report, payslips, photos or witness details.

Don't wait until the last days of the window to start. 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.

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Threshold and assessment disputes

Disputes about injuries often come down to evidence. If the insurer says your injury is threshold, or that treatment and care isn't reasonable and necessary, the answer is usually a clear written report that deals with the insurer's reasons. If the dispute reaches medical assessment at the Commission, a certificate review must generally be sought within 28 days of issue.

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

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Decisions people often ask about

The reasons vary, but some patterns are familiar. If you were driving for work, the insurer may say workers compensation comes first. If the claim was more than 3 months late, it may say your explanation isn't enough. If the evidence shows only soft tissue injury, it may classify it as threshold. Knowing the reason tells you what evidence to gather.

  • The claim was lodged late
  • The injury was classed as a threshold injury
  • The crash is being treated as a work injury
  • Your pre-accident earnings were set lower than you expected

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Taking a dispute further

Applying to the Commission is more formal than an internal review. There are forms, timeframes and evidence rules, and the insurer will usually have its own representatives. Many people get legal advice at this stage. Keep in mind that SIRA's free CTP Legal Advisory Service doesn't cover matters already at the Commission.

Read next:The Personal Injury CommissionPIC disputes explained

When your issue is how you were treated

It helps to keep a dispute and a complaint apart. If the problem is the outcome, use internal review and then the Personal Injury Commission. If the problem is the way the insurer is handling your claim, the Independent Review Office can take a complaint. Sometimes both apply, and it's fine to use each path for a different part of the problem.

Legal costs in a dispute

Because some disputes don't allow legal costs to be recovered, it's worth asking early whether paying for help makes sense in yours. For a straightforward review, you may manage alone with good evidence. For a threshold dispute that affects a damages claim, or a refusal of the whole claim, advice is more often worth it.

Read next:What does a CTP lawyer cost?

From decision letter to the Commission

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

    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 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

    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.

When a dispute calls for legal help

Many people handle an internal review themselves. Disputes that reach the Personal Injury Commission, or that affect a damages claim, are where legal advice more often helps.

Often worth talking to a lawyer

  • You've missed the review deadline
  • You've been found mostly at fault
  • The refusal is based on your claim being late
  • A medical assessment certificate seems wrong

You may not need one

  • A request was declined only because some information was missing
  • The decision matches what your own paperwork shows
  • The insurer asked for a document you can easily provide

Start with the decision letter. Note the date it reached you, because the 28-day window for an internal review generally runs from then, and ask in writing for the reasons if they aren't clear. CTP claim denied

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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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