Central Coast · CTP claims

CTP claims for people in The Entrance

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

Starting a CTP claim from The Entrance 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: 2261

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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

    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

    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

    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

    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

    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 the claim: where and how

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?

If more than one vehicle was involved, or you don't have the other driver's details, CTP Assist on 1300 656 919 can help identify the right insurer.

Read next:CTP formsThe personal injury claim form

Dealing with the insurer day to day

Once your claim is lodged, the insurer usually assigns a case manager. They're your main contact for payments, treatment requests and paperwork. Keep a simple log of each call: the date, who you spoke with and what was agreed. If something is promised by phone, ask for it by email so you have a record.

  • Ask for important decisions in writing
  • Send updated certificates before the old one runs out
  • Keep copies of everything you send

Read next:Dealing with your insurer and case manager

The Entrance: treatment, paperwork and your claim

If you normally commute to Sydney by train or the M1, an injury can stop work quickly. Tell the insurer your usual hours and earnings from the start, because weekly payments are based on what you earned before the accident. If Gosford 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. At roughly 65 km from the Sydney CBD, The Entrance 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
2261
Nearest public hospital
Gosford Hospital
From the Sydney CBD
~65 km
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Your doctor's part in the claim

In NSW CTP claims, your doctor fills in a Certificate of Fitness recording your injuries and your capacity for work. The first one generally goes in with your claim, and updated certificates follow as you recover. It's the document insurers rely on for weekly payments, so make sure it lists all your injuries, including any that appeared days later.

Read next:The Certificate of Fitness

What the insurer pays for

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.

Your CTP insurer covers treatment and care for accident injuries where it's reasonable and necessary, within whatever benefit period applies to you. That can include doctor visits, physiotherapy, medication and some travel for treatment. The insurer decides each request, and decisions can be reviewed, so ask before committing to large treatment costs.

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

Your claim paperwork checklist

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
  • Hospital discharge summary, if you were admitted
  • Your employer's name and contact details
  • Names and numbers of any witnesses

Read next:Checklist: your first 30 days

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

Help beyond lodging

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?

Lodging alone, or with help?

Lodging a CTP claim is something most people do without any legal help. A few situations change that. Here's a quick guide to which is which.

Often worth talking to a lawyer

  • The insurer has refused to accept the claim
  • Your claim went in more than 3 months after the accident
  • Someone died in the crash
  • Another driver was at fault and your injury is more than threshold

You may not need one

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

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 still working out what kind of claim you have after the crash, the car accident claim page for The Entrance sorts that out first. Car accident claim in The Entrance
  • If you're weighing up whether your claim needs a lawyer at all, the CTP lawyer page covers when one helps and when it doesn't. CTP lawyer in The Entrance
  • If a decision has already gone against you, the claim denied page explains internal review and what comes after it. CTP claim denied in The Entrance

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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