We handle the CTP insurer, the paperwork, the medical evidence and any disputes, so you can focus on recovering.
Who can claim
Every registered vehicle in NSW carries compulsory third party (CTP) insurance, often called a green slip. If you were injured in a motor accident in NSW as a driver, passenger, motorcyclist, cyclist or pedestrian, you can usually claim against it.
The same scheme covers crashes involving trucks, buses, taxis and rideshare vehicles, and delivery riders hit by a vehicle. If the vehicle at fault was uninsured, or drove off and cannot be identified, the claim may be made against the Nominal Defendant instead.
Statutory benefits are generally paid whether or not anyone was at fault, even if the accident was your own fault. If you were mostly at fault, they generally stop 52 weeks after the accident.
If you were driving or riding for work when you were hurt, the workers compensation scheme may cover you instead of CTP statutory benefits. We look at both schemes and tell you which applies.
Weekly payments and treatment
A CTP claim starts with statutory benefits, paid by the insurer while you recover.
- Weekly payments if you had been working in the period before the accident, or had work lined up, and your injuries stop you working or cut your hours. For the first 13 weeks they are generally 95% of your lost earnings. After that they are generally 80% if you cannot work at all, or 85% if you can do some work. All weekly payments are capped at a statutory maximum.
- Treatment and care, including medical and hospital treatment, physiotherapy, medication, rehabilitation, aids, paid care at home and travel to appointments, where it is reasonable and necessary and relates to your accident injuries.
If your injuries are not threshold injuries and you were not mostly at fault, weekly payments can continue for up to 104 weeks after the accident, and longer while a damages claim is pending.
Threshold and non-threshold injuries
The insurer will decide whether your injuries are threshold injuries (sometimes called minor injuries). Broadly, a threshold injury is a soft tissue injury, or a psychological or psychiatric injury that is not a recognised psychiatric illness. Injuries to nerves, and complete or partial ruptures of tendons, ligaments, menisci or cartilage, generally do not count as soft tissue injuries. The regulations can also treat particular injuries as threshold injuries, or exclude them.
The decision matters. If your only injuries are threshold injuries, statutory benefits generally stop 52 weeks after the accident and you cannot claim damages. If any of your injuries is not a threshold injury and you were not mostly at fault, benefits can continue beyond 52 weeks, and if someone else was at fault a damages claim may be open to you.
You can ask the insurer to review a threshold decision. If it does not change its mind, a medical assessor at the Personal Injury Commission can decide the question. The outcome often turns on the medical evidence, and we help you gather it.
Damages when another driver was at fault
If the accident was caused, wholly or partly, by the fault of another driver or vehicle owner, and your injuries are not threshold injuries, you may be able to claim damages as a lump sum. Damages can include:
- Past and future loss of earnings or earning capacity, including lost superannuation contributions
- Non-economic loss, such as pain and suffering, but only if your permanent impairment is assessed at more than 10%
Damages can be reduced if your own actions contributed, for example by not wearing a seat belt. Weekly payments you have already received are deducted from any damages. A damages claim can only be settled if you have a lawyer or the Personal Injury Commission approves the settlement.
Disputes with the insurer
The insurer makes many decisions on a CTP claim: whether to accept it, how much to pay each week, which treatment to fund and whether your injuries are threshold injuries. If you disagree with a decision, the first step is usually an internal review by the insurer. You generally have 28 days from receiving the decision to ask for one, and the insurer usually has 14 days to give you its answer.
If the review does not fix the problem, the dispute can go to the Personal Injury Commission, which is independent of the insurer. Merit reviewers decide disputes such as the amount of your weekly payments. Medical assessors decide whether an injury is a threshold injury, whether treatment is reasonable and necessary, and the degree of permanent impairment. Other disputes, such as whether you were mostly at fault for the accident, can also go to the Commission.
We prepare the review and the Commission application, gather the evidence and keep track of the deadlines.
Time limits and costs
The CTP scheme has strict time limits, so it pays to act early.
- To protect back-payment of weekly payments, a claim should be lodged within 28 days of the accident. If it is lodged later, weekly payments are generally not paid for the period before the claim.
- A claim for statutory benefits must generally be made within 3 months of the accident. Later claims are possible only in limited circumstances.
- A claim for damages must generally be made within 3 years of the accident.
Report the accident to the police, see a doctor as soon as you can and keep your receipts. Our guide to what to do after a car accident in NSW covers the first steps.
Legal costs in the CTP scheme are regulated. On a statutory benefits claim, the law limits what any lawyer can charge you, and some legal costs can be recovered from the insurer where the rules allow. The first consultation is free. We run eligible CTP damages claims on a No Win, No Fee* basis, which means you do not pay our professional fees unless your damages claim succeeds. Conditions apply and we explain them in writing before you commit to anything.
How we help
- We deal with the CTP insurer so you do not have to
- Your claim lodged early, with every deadline tracked
- Threshold decisions and treatment refusals reviewed, and challenged where the evidence supports it
- Medical evidence arranged to support your claim
- Damages claims prepared and negotiated
- No Win, No Fee* on eligible CTP damages claims