Balmoral: your CTP claim, step by step

Lodging is mostly a matter of answering the form honestly and completely. Describe every injury you know about, even ones that seem small, and list each practitioner you've seen. If you're unsure of an answer, give the most accurate answer you can and say so, rather than leaving it blank. The insurer can ask follow-up questions, and it generally will, so a clear first account saves trouble later.

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.

• Ask for important decisions in writing
• Reply to requests promptly
• Ask what a request is for if it's unclear

Weekly payments replace part of your income while the injury keeps you off work or on reduced hours. The insurer sets your rate from what you earned before the accident, so give it the full picture from the start: every job you held and the hours you usually worked. A legislated maximum applies and is indexed each year, so the cap itself changes over time.

Treatment and care is the other half of statutory benefits. The insurer generally funds treatment for your injuries, such as GP care, physiotherapy or psychology, where it's reasonable and necessary and within your benefit period. Approval isn't automatic: your practitioner usually requests it, the insurer decides, and you can ask for a review if you disagree.

You don't need a perfect file to lodge. Start with the basics you have, then add documents as they arrive. Insurers generally ask for more information later, and it's better to lodge within 28 days with a gap in the paperwork than to wait for every page and lose back-pay.

• Registration numbers of the vehicles involved
• Your Certificate of Fitness
• Hospital discharge summary, if you were admitted
• Recent payslips, tax returns or business records
• Your employer's name and contact details

The 52-week limit isn't only about threshold injuries. For accidents from 1 April 2023, it generally applies too if you were wholly or mostly at fault, whatever your injury. For accidents between 1 December 2017 and 31 March 2023, both limits were 26 weeks instead. Children who were 16 or under at the time of the accident are an exception: they can receive treatment and care for as long as they need it, regardless of fault.

In NSW CTP claims, your doctor fills in a Certificate of Fitness recording your injuries and your capacity for work. The first one generally goes in with your claim, and updated certificates follow as you recover. It's the document insurers rely on for weekly payments, so make sure it lists all your injuries, including any that appeared days later.

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.