Upper North Shore & Hornsby · CTP claims

Starting a CTP claim after a crash near Mount Kuring-gai

The 28-day and 3-month deadlines, the Certificate of Fitness and weekly payments, explained plainly.

Starting a CTP claim from Mount Kuring-gai is mostly about getting the basics in on time. The claim form, the Certificate of Fitness and proof of income do most of the work. Things get harder when the insurer questions your injury, your fault or your delay. That's when an independent CTP lawyer may help, and our free claim check can tell you if you've reached that point.

Postcode: 2080

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Mount Kuring-gai: treatment, paperwork and your claim

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 25 km from the Sydney CBD, Mount Kuring-gai 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
2080
Nearest public hospital
Hornsby Ku-ring-gai Hospital
Distance to Hornsby
~7 km

How a CTP claim unfolds over time

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

    Lodged late, but inside 3 months, for an accident from 1 April 2023? Explain the delay fully. An explanation the insurer hasn't rejected within 14 days is treated as accepted, so back-pay can still apply.

  4. Within 3 months

    The last point to claim

    Claims can still be made up to 3 months after the accident, though weekly payments may then only start from the date of the claim. After 3 months, claims are accepted only in limited circumstances.

  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

    For accidents from 1 April 2023, statutory benefits for a threshold injury, or where you were wholly or mostly at fault, generally end 52 weeks after the accident. Children 16 and under keep treatment and care as long as needed.

  7. 104 weeks

    Weekly payments generally end

    At the 104-week mark, weekly payments generally end. They can run longer only while a common law damages claim is pending, and how much longer depends on the level of impairment.

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

Lodging your claim: the practical steps

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.

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

Threshold injuries and your benefit period

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

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.

Read next:The Certificate of Fitness

What statutory benefits cover

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.

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

Is this a claim you can run yourself?

Lodging is usually straightforward. What happens afterwards is where some claims need legal help. These lists show common signs either way; the claim check can give you a clearer answer.

Often worth talking to a lawyer

  • Your injury has been classed as threshold and your doctor disagrees
  • The insurer has refused to accept the claim
  • The insurer's reasons for a decision don't make sense to you
  • Weekly payments stopped earlier than you expected

You may not need one

  • Your weekly payments arrive on time and the amount looks correct
  • The insurer has accepted your claim
  • Your treatment requests are being approved

A claim runs on medical evidence. If you don't yet have a GP who'll complete a Certificate of Fitness, we can point you to doctors and allied health who know the CTP scheme.

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Your claim paperwork checklist

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
  • Registration numbers of the vehicles involved
  • Your employer's name and contact details
  • Names and numbers of any witnesses

Read next:Checklist: your first 30 days

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.

  • Send updated certificates before the old one runs out
  • Reply to requests promptly
  • Note the date on any decision letter

Read next:Dealing with your insurer and case manager

Help beyond lodging

Help comes in different forms. For treatment and medical evidence, doctors and allied health practitioners who know the CTP scheme are often the right first call. For disputes and damages, an independent CTP lawyer. For general questions, CTP Assist on 1300 656 919. Our free claim check helps you work out which of these you need.

Read next:What help do I need?

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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