Upper North Shore & Hornsby · CTP claims

Your CTP claim from Pymble: forms, dates, payments

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

If you were hurt in a motor accident and live in Pymble, you can usually make a CTP claim without a lawyer. The claim goes to the CTP insurer, either online through Service NSW or directly, and timing matters: lodge within 28 days and weekly payments can generally be back-paid to the day after the accident. Our free claim check helps you get it right and tells you if anything about your claim needs legal help.

Postcode: 2073

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Pymble: treatment, paperwork and your claim

Crashes on the M1 north of Wahroonga or on Pennant Hills Road can involve vehicles from anywhere. The claim goes to the relevant vehicle's CTP insurer, and CTP Assist can help identify it if you're unsure. If Hornsby Ku-ring-gai Hospital admitted you, note the dates of your stay and when you were discharged. Days in hospital are days you couldn't work, and the insurer will want them on the claim form alongside your first Certificate of Fitness. Lodging a claim doesn't mean a trip to Macquarie Park, 4 km away. From Pymble, the claim form can be completed online, most insurer contact happens by phone and email, and our free claim check works the same way.

Region
Upper North Shore & Hornsby
Postcode
2073
Nearest public hospital
Hornsby Ku-ring-gai Hospital
Distance to Macquarie Park
~4 km

How a CTP claim unfolds over time

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

    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

    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

    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

    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

    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

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.

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

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

The 52-week limit and who it applies to

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

Working with the insurer and your case manager

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.

  • Log every call with the date and the name of the person
  • Keep copies of everything you send
  • Reply to requests promptly

Read next:Dealing with your insurer and case manager

Lodging alone, or with help?

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

  • The insurer has refused to accept the claim
  • Someone died in the crash
  • Your injury has been classed as threshold and your doctor disagrees
  • The insurer says you were mostly at fault

You may not need one

  • Your weekly payments arrive on time and the amount looks correct
  • You need help understanding a question on the form
  • The insurer has accepted your claim

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.

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 Pymble
  • If your main question is whether to bring in a lawyer, the CTP lawyer page for Pymble explains when legal help is worth it. CTP lawyer in Pymble
  • If the insurer has already refused your claim or cut off payments, the page on denied claims covers the review steps and deadlines. CTP claim denied in Pymble
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Documents to gather before you start

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
  • Registration numbers of the vehicles involved
  • Your Certificate of Fitness
  • Hospital discharge summary, if you were admitted
  • Receipts for treatment, medication and travel

Read next:Checklist: your first 30 days

Your doctor's part in the claim

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

Signs your claim needs more than a form

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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