Blacktown & Mount Druitt · CTP claim denied

CTP disputes and reviews for Marayong

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

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 Marayong 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: 2148

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  • Helping people in Marayong & Kings Park

Disputing a claim while living in Marayong

Hurt on Sunnyholt Road or Rooty Hill Road? Legal costs in a dispute are tightly regulated, and for some statutory benefits disputes they can't be recovered at all. Ask about costs before you commit to a lawyer. Your review rights don't depend on your council, whether that's Blacktown City Council or any other. Internal reviews and the Personal Injury Commission work the same way across NSW. At around 32 km from the Sydney CBD, living in Marayong 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
Blacktown & Mount Druitt
Postcode
2148
Local government area
Blacktown City Council
From the Sydney CBD
~32 km

A refusal isn't the end of the road

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?

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

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 crash is being treated as a work injury
  • Weekly payments were stopped or reduced
  • A treatment and care request was declined
  • Your pre-accident earnings were set lower than you expected

Read next:Claim denied? Quick check

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Making your internal review count

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 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

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”

The IRO and what it handles

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.

Legal costs in a dispute

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?

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

    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

    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

    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

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
  • Your injury was classed as threshold and it affects a damages claim
  • A medical assessment certificate seems wrong
  • You've missed the review deadline

You may not need one

  • You agree with the decision once it's explained
  • A request was declined only because some information was missing
  • The decision was about a small, one-off expense

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

Not quite your situation?

  • For the wider question of whether a lawyer is worth it on a CTP claim at all, the CTP lawyer page for Marayong is the better fit. CTP lawyer in Marayong
  • 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 Marayong
  • 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 Marayong

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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