A plain guide to CTP claims for Mona Vale

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.

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.

• Date, time and place of the crash
• Your Certificate of Fitness
• Recent payslips, tax returns or business records
• Your employer's name and contact details
• Receipts for treatment, medication and travel

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.

• Keep copies of everything you send
• Note the date on any decision letter
• Ask what a request is for if it's unclear

The Certificate of Fitness is where your medical story meets the insurer. It lists your injuries and says what work, if any, you can do. If a certificate misses an injury or overstates your capacity, weekly payments may not reflect your situation, so read each one before it goes to the insurer and raise anything wrong with your doctor.

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.

Many people lodge and manage a CTP claim on their own. It's worth getting help when the insurer refuses the claim, classifies your injury as threshold when your doctor disagrees, stops payments, or argues about fault. It's also worth asking a lawyer about damages if your injury is more than threshold and someone else was at fault.