Central Coast · CTP claims

Point Clare: your CTP claim, step by step

Most people can lodge a CTP claim themselves. We'll check yours for free and flag anything that needs more help.

Starting a CTP claim from Point Clare 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: 2250

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  • Helping people in Point Clare & Point Frederick

Starting your claim from Point Clare

Treated at Gosford Hospital or Wyong Hospital? Take the discharge summary to your GP. It helps them complete an accurate Certificate of Fitness, which the insurer relies on to assess your claim. At roughly 49 km from the Sydney CBD, Point Clare 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
Central Coast
Postcode
2250
Nearest public hospital
Gosford Hospital
From the Sydney CBD
~49 km

Your first months: the CTP claim timeline

A CTP claim runs to a clock that starts on the day of the accident. Here are the main points on it. Some depend on your accident date, so check which rules apply to you.

  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

    Lodge your claim for statutory benefits within 28 days of the accident so weekly payments can generally be back-paid to the day after. You can lodge through Service NSW online or with the CTP insurer.

  3. Within 14 days of your explanation

    A late claim, explained

    For accidents from 1 April 2023, a claim made after 28 days but within 3 months may still be back-paid if you give a full and satisfactory explanation. If the insurer doesn't reject it within 14 days, it's treated as accepted.

  4. Within 3 months

    The last point to claim

    Three months after the accident is the practical cut-off. Later claims can only be accepted in limited circumstances, usually with a full and satisfactory explanation. If you're past it, speak to a lawyer straight away.

  5. Weeks 1–13, then 14+

    Weekly payment rates

    Weekly payments are up to 95% of your pre-accident earnings for the first 13 weeks. From week 14 they're up to 80% or 85%, depending on your earning capacity. An indexed maximum applies.

  6. 52 weeks

    The threshold and at-fault line

    At 52 weeks, people with a threshold injury, and people wholly or mostly at fault, generally stop receiving weekly payments and treatment and care. For accidents between 1 December 2017 and 31 March 2023, that limit was 26 weeks.

  7. 104 weeks

    Weekly payments generally end

    Two years in, weekly payments generally stop unless you've lodged a damages claim that's still pending. To keep them going past 2 years, that damages claim must be lodged within 2 years of the accident.

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

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.

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

When the 52-week limit applies

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

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.

  • Date, time and place of the crash
  • Your Certificate of Fitness
  • Recent payslips, tax returns or business records
  • Receipts for treatment, medication and travel
  • Names and numbers of any witnesses

Read next:Checklist: your first 30 days

Weekly payments and treatment

If the injury affects your work, weekly payments are generally based on your pre-accident earnings, and the percentage steps down after the first 13 weeks. The insurer relies on your earnings records to set the rate and on your Certificate of Fitness to know what work you can do. There's an indexed maximum, and payments generally stop after 104 weeks.

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.

Rules change

Benefit rules depend on your accident date and have changed over time. This is general information; check the current rules or ask CTP Assist.

Read next:CTP weekly paymentsCTP entitlements

Lodging alone, or with help?

Plenty of claims run from start to finish without legal help. A few need it early. If you recognise your situation below, you'll have a fair idea where you stand.

Often worth talking to a lawyer

  • You've been asked to sign a release or settlement
  • The insurer's reasons for a decision don't make sense to you
  • Another driver was at fault and your injury is more than threshold
  • The insurer says you were mostly at fault

You may not need one

  • The insurer has accepted your claim
  • You need help understanding a question on the form
  • Your injury is healing well within the first months

If your claim is stuck because the paperwork from your treating team is thin, doctors and allied health familiar with CTP claims can help with a clear Certificate of Fitness, records and treatment plans.

Not quite your situation?

  • If you're not sure a CTP claim is even the right claim, for example because only your car was damaged, start with the car accident claim page. Car accident claim in Point Clare
  • If your main question is whether to bring in a lawyer, the CTP lawyer page for Point Clare explains when legal help is worth it. CTP lawyer in Point Clare
  • If a decision has already gone against you, the claim denied page explains internal review and what comes after it. CTP claim denied in Point Clare
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The Certificate of Fitness

Ask your GP for a Certificate of Fitness at your first visit after the crash, and keep getting updated ones while you're off work or on reduced hours. Gaps between certificates can cause gaps in payments. If your doctor isn't familiar with CTP forms, a practitioner who knows the scheme can make the process easier.

Read next:The Certificate of Fitness

Your case manager and what to expect

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.

  • Send updated certificates before the old one runs out
  • Keep copies of everything you send
  • Note the date on any decision letter

Read next:Dealing with your insurer and case manager

Signs your claim needs more than a form

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.

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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