How to lodge and run a CTP claim in Pambula

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.

Your case manager will ask for updated Certificates of Fitness, may request medical reports and may arrange an assessment with a doctor the insurer chooses. Attend any assessment you're asked to, and keep your own notes afterwards. If you think a decision is wrong, ask for an internal review rather than letting it sit.

• Keep copies of everything you send
• Reply to requests promptly
• Ask what a request is for if it's unclear

The claim goes more smoothly with a few things ready: the police event number, the other vehicle's registration, your Certificate of Fitness, payslips or tax records showing what you earned, and your employer's details. If you've paid for treatment or medication, keep the receipts too. Missing something shouldn't stop you lodging on time.

• Police event number
• Registration numbers of the vehicles involved
• Hospital discharge summary, if you were admitted
• Your employer's name and contact details
• Receipts for treatment, medication and travel

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.

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.

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.

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.

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.