Parramatta & Cumberland · CTP claim denied

Starting a CTP dispute from Sydney Olympic Park

Internal review first, then the Personal Injury Commission. Check your options free, by phone or online.

Not every refused claim needs a lawyer. Some decisions are simple to challenge with better evidence, and some are right under the rules. What matters is acting within the deadline. If you're in Sydney Olympic Park and have received a decision you disagree with, our free claim check looks at what was decided, why, and what your realistic options are.

Postcode: 2127

  • Free claim check, no obligation
  • By phone & online, no office to visit
  • Helping people in Sydney Olympic Park & Liberty Grove

From decision letter to the Commission

Most CTP decisions follow the same review path. The deadlines are short, so it helps to know the order before you start. Complaints about how the insurer behaves are a separate track.

  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

    Expect a review decision in about 14 days in most cases, 21 days for some medical and miscellaneous matters, and up to 28 days where the insurer needs more information.

  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

    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.

Challenging a decision from Sydney Olympic Park

If Westmead Hospital or Auburn Hospital treated you, or your child was seen at The Children's Hospital at Westmead, include those records in any review. They help show what the injury actually involves. Sydney Olympic Park is about 5 km north-west 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. Coming under the City of Parramatta makes no difference to a CTP dispute. The same review steps and deadlines apply in Sydney Olympic Park as in any other part of NSW, because the scheme is statewide.

Region
Parramatta & Cumberland
Postcode
2127
Distance to Burwood
~5 km
Local government area
City of Parramatta

A refusal isn't the end of the road

Insurers make decisions under the scheme rules: whether to accept a claim, how much to pay, what treatment to fund, whether an injury is threshold. Most of them can be challenged. The first step is an internal review, which you generally need to request within 28 days of the decision reaching you. If that doesn't resolve it, the Personal Injury Commission can decide.

Read next:CTP claim denied?

Asking for an internal review

An internal review is a fresh look at the decision by the insurer. Ask in writing, generally within 28 days of receiving the decision. Say which decision you disagree with, why you think it's wrong and what outcome you want. Attach anything new: a report from your doctor, hospital records, payslips or witness details.

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 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

When the argument is about your injury

A threshold decision about a psychological injury can be disputed like any other. If the insurer has classified yours as threshold and your treating practitioner disagrees, their written opinion is the starting point for an internal review. If the review doesn't resolve it, the dispute can go on to medical assessment at the Personal Injury Commission, where the 28-day window for a certificate review applies.

Read next:Threshold injury disputesWhen the insurer says “threshold injury”

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Do you need a lawyer to challenge a decision?

Many people handle an internal review themselves. Disputes that reach the Personal Injury Commission, or that affect a damages claim, are where legal advice more often helps.

Often worth talking to a lawyer

  • A medical assessment certificate seems wrong
  • You've missed the review deadline
  • Your injury was classed as threshold and it affects a damages claim
  • You were driving for work and the insurer has refused on that basis

You may not need one

  • A treatment request was declined for lack of information you can supply
  • The decision was about a small, one-off expense
  • You agree with the decision once it's explained

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?

Common reasons a claim is refused or limited

Some decisions come up again and again. A claim may be refused because it was lodged late, or limited because the insurer says the injury is threshold or that you were mostly at fault. Weekly payments may stop, or a treatment request may be declined. Each raises its own evidence questions, and each can generally be reviewed.

  • The claim was lodged late
  • The injury was classed as a threshold injury
  • Weekly payments were stopped or reduced
  • A treatment request was declined

Read next:Claim denied? Quick check

When your issue is how you were treated

It helps to keep a dispute and a complaint apart. If the problem is the outcome, use internal review and then the Personal Injury Commission. If the problem is the way the insurer is handling your claim, the Independent Review Office can take a complaint. Sometimes both apply, and it's fine to use each path for a different part of the problem.

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

What a dispute might cost

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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