Upper North Shore & Hornsby · CTP claims

Starting a CTP claim after a crash near Arcadia

Most people can lodge a CTP claim themselves. We'll check yours for free and flag anything that needs more help.

A CTP claim is how you access weekly payments and treatment after a NSW motor accident. For many people in Arcadia, it's a form, a medical certificate and some follow-up with the insurer. For others, it becomes the start of a dispute. This page walks through the steps and deadlines, and our free claim check tells you whether your situation needs a lawyer, a doctor or just a clear plan.

Postcode: 2159

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Lodging a claim when you live in Arcadia

Whether Hornsby Ku-ring-gai Hospital or Royal North Shore Hospital treated you, start a folder now: discharge summary, scans, receipts. The claim runs more smoothly when everything the insurer asks for is already in one place. At roughly 31 km from the Sydney CBD, Arcadia is no further from the CTP system than anywhere else. The Service NSW claim form is online, insurers work by phone and email, and our claim check is by phone and online.

Region
Upper North Shore & Hornsby
Postcode
2159
Public hospital in the region
Hornsby Ku-ring-gai Hospital
Distance to Hornsby
~10 km

Your first months: the CTP claim timeline

These are the dates that shape most statutory benefits claims in NSW. Missing an early one can cost weeks of payments, so it helps to know them before you need them.

  1. Day 0

    The accident

    Get medical help first. Then report the crash to police and note the event number, which the claim form asks for. The other vehicle's registration helps identify the right insurer later.

  2. Within 28 days

    Lodge your claim

    The 28-day mark is the one to aim for: claims received by then generally have weekly payments back-paid to the day after the accident. Lodging sooner also means the evidence is fresh.

  3. Within 14 days of your explanation

    A late claim, explained

    For accidents from 1 April 2023, a claim made after 28 days but within 3 months may still be back-paid if you give a full and satisfactory explanation. If the insurer doesn't reject it within 14 days, it's treated as accepted.

  4. Within 3 months

    The last point to claim

    Three months after the accident is the practical cut-off. Later claims can only be accepted in limited circumstances, usually with a full and satisfactory explanation. If you're past it, speak to a lawyer straight away.

  5. Weeks 1–13, then 14+

    Weekly payment rates

    For the first 13 weeks, payments are up to 95% of what you earned before the accident. After week 13 the rate becomes up to 80% or 85%; your earning capacity decides which. A legislated maximum applies.

  6. 52 weeks

    The threshold and at-fault line

    At 52 weeks, people with a threshold injury, and people wholly or mostly at fault, generally stop receiving weekly payments and treatment and care. For accidents between 1 December 2017 and 31 March 2023, that limit was 26 weeks.

  7. 104 weeks

    Weekly payments generally end

    Two years in, weekly payments generally stop unless you've lodged a damages claim that's still pending. To keep them going past 2 years, that damages claim must be lodged within 2 years of the accident.

General information, not legal advice. Dates depend on your accident date and circumstances. Rules change, so check the current rules.

Lodging the claim: where and how

You can lodge a claim for statutory benefits online through Service NSW, or directly with the relevant CTP insurer. If you're not sure which insurer that is, CTP Assist (1300 656 919) can help you identify it. The form asks about the accident, your injuries, your work and the treatment you've had so far, so have those details close by.

Not sure which insurer?

CTP Assist, run by SIRA, can help you work out which CTP insurer to claim against. Call 1300 656 919, 8:30am to 5pm weekdays.

Read next:CTP formsThe personal injury claim form

Documents to gather before you start

Think of the claim as three bundles of evidence: what happened, what it did to your body, and what it's costing you. The first is police and vehicle details. The second is hospital records and your Certificate of Fitness. The third is proof of earnings and receipts. Lodge on time even if one bundle isn't complete yet.

  • Police event number
  • Date, time and place of the crash
  • Your Certificate of Fitness
  • Hospital discharge summary, if you were admitted
  • Receipts for treatment, medication and travel

Read next:Checklist: your first 30 days

The 52-week limit and who it applies to

Plan around the 52-week mark if it applies to you. Keep your Certificates of Fitness current, keep treatment going as your doctor recommends, and ask the insurer in writing what will happen to payments and treatment when the period ends. If you think the threshold decision itself is wrong, you can ask for an internal review, generally within 28 days of receiving it.

Read next:Threshold vs non-threshold injury

Why the Certificate of Fitness matters

Ask your GP for a Certificate of Fitness at your first visit after the crash, and keep getting updated ones while you're off work or on reduced hours. Gaps between certificates can cause gaps in payments. If your doctor isn't familiar with CTP forms, a practitioner who knows the scheme can make the process easier.

Read next:The Certificate of Fitness

Is this a claim you can run yourself?

Lodging a CTP claim is something most people do without any legal help. A few situations change that. Here's a quick guide to which is which.

Often worth talking to a lawyer

  • Weekly payments stopped earlier than you expected
  • The insurer has refused to accept the claim
  • Someone died in the crash
  • Your injury has been classed as threshold and your doctor disagrees

You may not need one

  • Your weekly payments arrive on time and the amount looks correct
  • You're lodging within 28 days with the paperwork ready
  • You need help understanding a question on the form

If your claim is stuck because the paperwork from your treating team is thin, doctors and allied health familiar with CTP claims can help with a clear Certificate of Fitness, records and treatment plans.

Not quite your situation?

  • If you're still working out what kind of claim you have after the crash, the car accident claim page for Arcadia sorts that out first. Car accident claim in Arcadia
  • If you're weighing up whether your claim needs a lawyer at all, the CTP lawyer page covers when one helps and when it doesn't. CTP lawyer in Arcadia
  • If a decision has already gone against you, the claim denied page explains internal review and what comes after it. CTP claim denied in Arcadia
A clipboard of blank forms, folders and pens laid out on a wooden desk

Free claim check

Check your claim before the deadline

Call (02) 7238 7379 or start online. A free claim check helps you lodge on time and spot problems early.

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What the insurer pays for

Income support is the part of a CTP claim most people ask about first. The insurer can only pay the right amount if it knows what you earned before the accident and what you can earn now, so send your earnings records early and tell it about any return to work. A maximum weekly amount applies and is indexed every year, so check the current figure with the insurer rather than relying on an old one.

Keep in mind that treatment funding is a decision, not a given. Your treating team sends requests, and the insurer considers whether the treatment is reasonable and necessary. Keep receipts for anything you pay yourself. If a request is declined, you can ask for an internal review, generally within 28 days of receiving the decision.

Rules change

The scheme has changed more than once since 2017. What applies to you depends on your accident date, so check the current rules before relying on any detail.

Read next:CTP weekly paymentsCTP entitlements

Your case manager and what to expect

Insurers make decisions under the scheme rules, and your case manager is the person who passes them on. Most contact is routine: updated certificates, treatment approvals, payment questions. Reply promptly, keep copies of what you send, and ask for written reasons for any decision you don't understand. You can challenge decisions if you need to.

  • Reply to requests promptly
  • Note the date on any decision letter
  • Ask what a request is for if it's unclear

Read next:Dealing with your insurer and case manager

Signs your claim needs more than a form

If you lodged late, the stakes are higher: claims more than 3 months after the accident are accepted only in limited circumstances. The same goes if you've received a settlement offer or a letter you don't understand. In those situations, an independent lawyer's view is usually worth getting sooner rather than later.

Read next:What help do I need?

Frequently asked questions

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.

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