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 North Wollongong 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.
Wollongong & the Illawarra · CTP claim denied
North Wollongong: next steps for a refused CTP claim
Calm, clear steps for a refused claim, stopped payments or a threshold decision you disagree with.
Postcode: 2500
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- By phone & online, no office to visit
- Helping people in North Wollongong & Fairy Meadow
North Wollongong: reviews without the travel
Trucks on Mount Ousley Road and Picton Road mean some Illawarra crashes involve heavy vehicles and complex fault questions. If fault is in dispute, ask for an internal review within 28 days and get advice. At around 66 km from the Sydney CBD, living in North Wollongong 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. Coming under Wollongong City Council makes no difference to a CTP dispute. The same review steps and deadlines apply in North Wollongong as in any other part of NSW, because the scheme is statewide.
- Region
- Wollongong & the Illawarra
- Postcode
- 2500
- From the Sydney CBD
- ~66 km
- Local government area
- Wollongong City Council
A refusal isn't the end of the road
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?
Complaints versus disputes
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.
Making your internal review count
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.
Don't wait until the last days of the window to start. Specialist 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.
Read next:Insurer stopped my weekly payments
Free claim check
Get a clear view of your dispute
A free, no-obligation claim check by phone or online. We'll look at the decision and the deadline, and connect you with an independent lawyer if needed.
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
Medical and threshold disputes
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 decisions behind many disputes
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 injury was classed as a threshold injury
- 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
What a dispute might cost
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?
Your review path
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.
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.
When a dispute calls for 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
- Weekly payments were stopped and you can't work
- You've been found mostly at fault
- The whole claim has been refused
- Your injury was classed as threshold and it affects a damages claim
You may not need one
- You agree with the decision once it's explained
- A treatment request was declined for lack of information you can supply
- The decision was about a small, one-off expense
If your threshold dispute depends on whether there's nerve damage or a tear, the right assessment matters. Ask us about doctors and allied health experienced with CTP claims, from diagnosis to the Certificate of Fitness.
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 North Wollongong
- If the dispute turns on whether your injury is more than threshold, the injury compensation page explains what the medical evidence needs to show. Injury compensation lawyer in North Wollongong
- 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 North Wollongong
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.
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.
Generally yes. If your dispute went to medical assessment at the Personal Injury Commission and you think the certificate is wrong, you can seek a review, but it must generally be sought within 28 days of the certificate being issued. The grounds for a review are generally limited, so it's worth getting advice quickly about whether a review is likely to be accepted.
Not necessarily, but act now. Some decisions may still be open to challenge, and the rules can depend on the type of decision and your circumstances. Speak to a lawyer as soon as you can, and gather anything that explains the delay, such as a hospital stay or not receiving the letter. Don't assume the door is closed without checking.
First, check the letter for the reason. Payments may stop because the insurer says you can work, because your benefit period has ended, or for another reason under the scheme rules. If you disagree, ask for an internal review, generally within 28 days. Keep your Certificates of Fitness up to date in the meantime, and get advice if you can't work.
Only in part. SIRA's CTP Legal Advisory Service gives free advice on statutory benefits for accidents from 1 December 2017, but it doesn't cover matters already at internal review or the Personal Injury Commission, damages claims or older-scheme claims. It may help before you request a review. Once a dispute is under way, you'd generally need an independent lawyer.
CTP claim denied: suburbs near North Wollongong
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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.