Insurers make decisions under the scheme rules, and sometimes those decisions go against you. For people in Marrickville South, 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.
Inner West · CTP claim denied
Starting a CTP dispute from Marrickville South
Internal review first, then the Personal Injury Commission. Check your options free, by phone or online.
Postcode: 2204
- Free claim check, no obligation
- By phone & online, no office to visit
- Helping people in Marrickville South & Marrickville
Challenging a decision from Marrickville South
A crash on Parramatta Road, Victoria Road or in the WestConnex tunnels can lead to arguments about who was at fault. If the insurer's fault decision went against you, you can generally ask for an internal review within 28 days. Marrickville South is about 5 km south-east of Burwood, but challenging a decision doesn't mean travelling there. Internal reviews are generally requested in writing, and our claim check runs by phone and online. People in Marrickville South, within Inner West Council, follow the same dispute path as everyone else in NSW: internal review first, generally within 28 days, then the Personal Injury Commission. Where you live doesn't change the deadlines.
- Region
- Inner West
- Postcode
- 2204
- Distance to Burwood
- ~5 km
- Local government area
- Inner West Council
Most decisions can be challenged
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?
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
- You were found wholly or mostly at fault
- The crash is being treated as a work injury
- The insurer says the injury wasn't caused by the crash
Read next:Claim denied? Quick check
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.
Free claim check
Don't let the 28 days slip by
No office visit and no charge for the check. A quick claim check by phone or online tells you whether a review is worth pursuing.
Making your internal review count
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 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
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
Medical and threshold 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 your medical evidence shows one of those, the classification may be wrong.
Read next:Threshold injury disputesWhen the insurer says “threshold injury”
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.
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.
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.
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.
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.
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.
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
- You were driving for work and the insurer has refused on that basis
- A medical assessment certificate seems wrong
- The dispute is heading to the Personal Injury Commission
- You've missed the review deadline
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
- You mainly want to complain about delays or communication
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?
- For the wider question of whether a lawyer is worth it on a CTP claim at all, the CTP lawyer page for Marrickville South is the better fit. CTP lawyer in Marrickville South
- When the real argument is how serious your injury is, the injury compensation page for Marrickville South covers impairment and the threshold line. Injury compensation lawyer in Marrickville South
- If you haven't had a decision yet and are still getting the claim in, start with the CTP claims page for Marrickville South. CTP claims in Marrickville South
Frequently asked questions
The Independent Review Office (IRO) takes complaints about how CTP insurers behave: call 13 94 76, 8:30am to 5:30pm weekdays, or go to iro.nsw.gov.au. Typical complaints are delays, poor communication or requests that go unanswered. A complaint is different from a dispute about a decision, which goes through internal review and the Personal Injury Commission.
Not in the usual sense. If you were driving for work, or the crash otherwise happened in the course of your work, workers compensation through your employer's insurer is generally the claim to make first, and CTP statutory benefits are generally not payable where workers compensation is available. That's a question of which scheme applies, not a finding about your injury. A CTP damages claim against the at-fault driver's insurer may still be possible, so get advice. The work quick check is a sensible first step.
Insurers make decisions under the scheme rules, and a refusal usually points to one of them. Common grounds include a claim lodged late, an injury classed as threshold, a finding that you were mostly at fault, or a view that the crash falls under a different scheme. The decision letter should give reasons, and those reasons tell you what evidence might change the outcome.
Yes. You can generally ask for an internal review, then take the dispute to the Personal Injury Commission. The label generally covers soft tissue injuries and threshold psychological injuries; nerve damage, and a full or partial tear of a tendon, ligament, meniscus or cartilage, fall outside it. Evidence from your treating doctor or specialist is usually central to the outcome.
Once more than 3 months have passed since the accident, a claim can only be accepted in limited circumstances, usually with a full and satisfactory explanation for the delay. If the insurer rejected your explanation, you can generally ask for an internal review. Put your reasons in writing with supporting evidence, such as medical records, and speak to a lawyer straight away.
It's an independent tribunal that started on 1 March 2021 and decides disputes in the NSW CTP scheme. Its CTP work covers merit review, medical assessment, miscellaneous claims assessment and the assessment of damages claims. You can generally apply once an internal review hasn't resolved the dispute. It replaced the dispute bodies used before 2021, so older information you find online may be out of date.
CTP claim denied: suburbs near Marrickville South
Ready to talk it through?
Get a free, no-obligation claim check. It's the first step toward understanding where your claim stands and what help it needs.
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.