Riverina & Murray · CTP claim denied

CTP disputes and reviews for Griffith

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

Insurers make decisions under the scheme rules, and sometimes those decisions go against you. For people in Griffith, the way to challenge them is the same as anywhere in NSW: ask for an internal review, generally within 28 days, then apply to the Personal Injury Commission if you still disagree. Our free claim check helps you work out whether a challenge is worth making and who can help.

Postcode: 2680

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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

    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

    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.

What a review looks like from Griffith

If the insurer says the crash was on the Victorian side of the Murray, check the location. Victoria has its own scheme, and whether NSW review rights apply depends on where it happened. At around 477 km from the Sydney CBD, living in Griffith 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. Your review rights don't depend on your council, whether that's Griffith City Council or any other. Internal reviews and the Personal Injury Commission work the same way across NSW.

Region
Riverina & Murray
Postcode
2680
From the Sydney CBD
~477 km
Local government area
Griffith City Council

Most decisions can be challenged

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?

Disputing a threshold-injury decision

Medical disputes often come down to evidence. If the insurer says your injury is threshold, or that treatment isn't reasonable and necessary, the answer is usually a clear report from your treating doctor or specialist explaining the diagnosis and the need. 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”

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

  • You've been found mostly at fault
  • A medical assessment certificate seems wrong
  • Your injury was classed as threshold and it affects a damages claim
  • 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
  • A treatment request was declined for lack of information you can supply

When treatment is declined, the fix is often a clearer explanation of why it's needed. We can connect you with doctors and allied health who know how the scheme assesses requests and what a Certificate of Fitness should record.

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 Griffith
  • When the real argument is how serious your injury is, the injury compensation page for Griffith covers impairment and the threshold line. Injury compensation lawyer in Griffith
  • If you haven't had a decision yet and are still getting the claim in, start with the CTP claims page for Griffith. CTP claims in Griffith

How to request a review

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.

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 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

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 claim was lodged late
  • The injury was classed as a threshold injury
  • You were found wholly or mostly at fault
  • The insurer says the injury wasn't caused by the crash

Read next:Claim denied? Quick check

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

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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