Canterbury-Bankstown · CTP claim denied

CTP disputes and reviews for Condell Park

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

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 Condell Park 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: 2200

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Disputing a claim while living in Condell Park

A crash on the Hume Highway, Canterbury Road or the M5 can end in a fault finding you disagree with. If the insurer's view of fault goes against you, the review window is generally 28 days, so gather police details and photos early. Coming under the City of Canterbury-Bankstown makes no difference to a CTP dispute. The same review steps and deadlines apply in Condell Park as in any other part of NSW, because the scheme is statewide. Around Condell Park, Arabic can be heard in many homes. Disputes turn on detail, so don't guess at what a letter means. Call CTP Assist on 1300 656 919 and ask for an interpreter to help you understand the decision.

At around 20 km from the Sydney CBD, living in Condell Park 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.

Region
Canterbury-Bankstown
Postcode
2200
Local government area
City of Canterbury-Bankstown
Community languages
Arabic
From the Sydney CBD
~20 km

You can ask for a second look

A decision you disagree with is a reason to act, not to give up. Start with the reasons in the letter. Some refusals turn on missing information you can supply. Others turn on a legal question, such as fault or the threshold definition, where advice helps. Either way, the review path is open for most decisions.

Read next:CTP claim denied?

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.

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

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Common reasons a claim is refused or limited

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 crash is being treated as a work injury
  • A treatment and care request was declined
  • The insurer says the injury wasn't caused by the crash

Read next:Claim denied? Quick check

Asking for an internal review

Reviews are often decided on the papers, so what you send matters. If the decision was about your injury, send any report that deals with the point the insurer relied on. If it was about earnings, send payslips or tax records. If it was about fault, include police details, photos and witness contacts.

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

Threshold and assessment 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 the 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

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?

How to challenge a CTP decision, step by step

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

    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

    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

    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.

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
  • Weekly payments were stopped and you can't work
  • You've missed the review deadline
  • Your injury was classed as threshold and it affects a damages claim

You may not need one

  • A request was declined only because some information was missing
  • You agree with the decision once it's explained
  • The decision matches what your own paperwork shows

For statutory benefits disputes on accidents from 1 December 2017, SIRA's free CTP Legal Advisory Service can help before internal review starts. CTP Assist on 1300 656 919 can connect you with it. The Personal Injury Commission

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 Condell Park
  • If the dispute turns on whether your injury is more than threshold, the injury compensation page explains what the evidence needs to show. Injury compensation lawyer in Condell Park
  • If you haven't had a decision yet and are still getting the claim in, start with the CTP claims page for Condell Park. CTP claims in Condell Park

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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