Caddens: your CTP claim, step by step

There are two main ways to lodge: the Service NSW online form, or the CTP insurer itself. Either way, you'll be asked for the accident date and place, the vehicles involved, your injuries, your employer and income, and the doctors treating you. Most people can complete it themselves in one go if they have the details to hand.

Some claims are capped at 52 weeks. For accidents on or after 1 April 2023, people whose injury is classed as a threshold injury can receive weekly payments and treatment and care for up to 52 weeks after the accident. The threshold label replaced the older term “minor injury” on that date. Whether an injury is threshold is a medical question in its own right; for running the claim, the point is the time limit it sets.

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.

• Log every call with the date and the name of the person
• Send updated certificates before the old one runs out
• Reply to requests promptly

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.

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
• Receipts for treatment, medication and travel
• Names and numbers of any witnesses

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.