When a CTP insurer refuses a claim or stops payments, the decision letter generally sets out its reasons. Those reasons are your starting point. For people in Parkesbourne, the next step is usually an internal review, then the Personal Injury Commission if needed. We can check your situation for free and, if your dispute calls for one, put you in touch with an independent CTP lawyer.
Goulburn & Southern Tablelands · CTP claim denied
Parkesbourne: next steps for a refused CTP claim
Internal review first, then the Personal Injury Commission. Check your options free, by phone or online.
Postcode: 2580
- Free claim check, no obligation
- By phone & online, no office to visit
- Helping people in Parkesbourne & Goulburn
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
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.
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
If your concern is how the insurer has treated you, such as delays or poor communication, that's a complaint, not a dispute. The Independent Review Office handles those complaints on 13 94 76.
General information, not legal advice. Timeframes are general, and some decisions follow different rules. Check your decision letter and get advice quickly.
Parkesbourne: reviews without the travel
If Goulburn Base Hospital treated you, or you were moved to Canberra Hospital, gather both sets of records. They can support a challenge to a threshold or treatment decision. Parkesbourne is about 16 km west of Goulburn, 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. Coming under Goulburn Mulwaree Council makes no difference to a CTP dispute. The same review steps and deadlines apply in Parkesbourne as in any other part of NSW, because the scheme is statewide.
- Region
- Goulburn & Southern Tablelands
- Postcode
- 2580
- Distance to Goulburn
- ~16 km
- Local government area
- Goulburn Mulwaree 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?
How to request a review
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
The Personal Injury Commission
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
Free claim check
Disagree with a decision? Start here
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.
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
- You were driving for work and the insurer has refused on that basis
- You've been found mostly at fault
- You've missed the review deadline
- A medical assessment certificate seems wrong
You may not need one
- You mainly want to complain about delays or communication
- The insurer asked for a document you can easily provide
- You agree with the decision once it's explained
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 Parkesbourne is the better fit. CTP lawyer in Parkesbourne
- When the real argument is how serious your injury is, the injury compensation page for Parkesbourne covers impairment and the threshold line. Injury compensation lawyer in Parkesbourne
- If you haven't had a decision yet and are still getting the claim in, start with the CTP claims page for Parkesbourne. CTP claims in Parkesbourne
When the argument is about your injury
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”
Complaints versus disputes
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.
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.
- You were found wholly or mostly at fault
- A treatment request was declined
- Your pre-accident earnings were set lower than you expected
- The insurer says the injury wasn't caused by the crash
Read next:Claim denied? Quick check
Paying for help with a review
In a dispute about statutory benefits, legal costs work differently from what many people expect. Costs are recoverable only where the Regulation or the Personal Injury Commission allows, the insurer pays whatever is recoverable, and in some disputes nothing can be recovered at all. So before you engage a lawyer for a review, ask how their fees would work for this particular dispute, and get the answer in writing.
Read next:What does a CTP lawyer cost?
Frequently asked questions
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.
Generally 28 days from receiving the decision. Ask in writing, say which decision you disagree with and why, and include any new evidence. Because the window is short, don't wait for every document before you lodge the request. If you're close to the deadline or past it, get advice quickly.
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.
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 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.
CTP claim denied: suburbs near Parkesbourne
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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.