CTP Claim NSW - CTP Compensation Payouts | Law Partners

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Motor Vehicle, Injury and Rehabilitation
05 Mar 2020

CTP Claim Guide NSW - Know Your Rights.

What is a CTP claim?

A CTP claim is an insurance claim that you make to get compensation for being injured in a motor vehicle accident.

It’s compulsory for all vehicles in NSW to have CTP (Compulsory Third Party) insurance. If you’re injured in an accident involving a car or any other vehicle you can make a CTP claim for personal injury benefits to cover certain losses you’ve incurred. These losses can include past and future lost earnings, medical, treatment and care expenses and pain and suffering.

The CTP claim process in NSW is managed by SIRA (the State Insurance Regulatory Authority) but claims are assessed and processed by the CTP insurers.

The CTP claim NSW insurers are NRMA, QBE, GIO, Allianz, AAMI and CIC-Allianz.

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What does CTP insurance cover for you?

CTP insurance specifically covers personal injury and doesn’t cover property damage. A CTP claim covers personal injury to drivers, passengers, cyclists, motorcycle riders and pedestrians who are injured in motor vehicle accidents

Your CTP Claim

Am I entitled to make a CTP claim?

If you’ve been injured in an accident involving a motor vehicle, as a driver, passenger, cyclist, motorcycle rider or pedestrian, then you’re entitled to make a CTP insurance claim for certain losses you’ve incurred.

What if I’m the at fault driver?

Even if you’re the at-fault driver, or the driver mostly at fault, you can make a CTP claim in NSW, however personal injury benefits will be restricted to lost income, treatment and care expenses for a maximum of six months after the accident.

If you were at fault and the other driver was injured, then the other driver may claim personal injury benefits under your vehicle’s CTP insurance policy. You should provide the other driver with your CTP policy details.

What can you claim on CTP Insurance?

CTP insurance provides personal injury benefits under three categories, described in the following table:

CTP Claim CTP Compensation Payout Process
Medical and treatment expenses
  • Reimbursed to you after you submit receipts to the CTP insurer
  • CTP insurer will generally approve a number of sessions with your GP and other treatment providers
  • CTP insurer will generally write directly to your provider and notify them of the approval
  • CTP insurer will pay the GP or treatment provider directly – these expenses won’t form part of your regular payments
  • These CTP benefits are not capped
  • You should receive whatever treatment is necessary to make sure you recover from your injuries
Care expenses
  • Generally treated in the same way as medical and treatment expenses
  • Benefits are capped depending on the severity of your injuries
Income support payments
  • Weeks 1-13: 95% of pre-accident earnings
  • Weeks 14 – 26: 80-85% of pre-accident earnings
  • If the CTP insurer cuts off your benefits it will need to give you four weeks’ written notice

Can I claim a lump sum CTP payout?

If your injuries have been assessed as non-minor and you weren’t the driver at fault, you’re entitled to claim a lump sum. A lump sum claim is the only way to get support beyond 24 months after your accident, and these lump sum payments can be substantial. Minor and non-minor injuries are explained in the next section of this article.

Many injuries get worse over time, and psychological injuries can take some time to develop.  So if your injuries have been assessed as minor but you believe your condition has worsened or you’ve developed symptoms of psychological injuries, you should consider claiming a lump sum. For example, you may have suffered a minor whiplash injury, but the pain medication you’ve been taking has started to cause you digestive issues, which are regarded as non-minor.

Find out how much you can claim.

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CTP Compensation Payouts NSW

What is the average CTP payout in NSW?

In the 19 months to June 30, 2019, the average CTP payout amount in NSW for a car accident injury was $10,984. A total of $179.5 million was paid out in CTP compensation payouts and 16,342 CTP claims were submitted*.

It’s important to remember that CTP payout amounts depend on the extent of your injuries and your losses (such as lost income). To get an indication of your CTP payout amount you can use this CTP compensation calculator

*Average CTP payout NSW data according to SIRA Green Slip scheme quarterly insights, June 2019.

CTP compensation Payouts NSW- how much will I get?

CTP compensation payouts depend on whether your injuries are classified as minor or non-minor and your “whole person impairment” (WPI). WPI is a measurement of the severity of your injuries and the extent to which they permanently impair you on a scale of 0 – 100%.

  • A CTP compensation payout for a minor personal injury covers a soft-tissue or muscle injury, like a muscle strain or a sore back. The most common soft tissue injury after a crash is whiplash, which often results in neck pain.
  • A CTP payout for a minor psychological or psychiatric injury is a for a psychological or psychiatric injury that’s not a recognised psychiatric illness.
  • Non-minor CTP claims are for more serious injuries like fractures or injuries that affect your organs. They also include nerve injuries, injuries that require surgery, brain injuries and scarring.
  • Non-minor psychological or psychiatric injury claims cover diagnosed psychological or psychiatric illnesses such as depression or post-traumatic stress disorder (PTSD), as well as a range of others.

Read our detailed article on minor and non-minor injuries explained for more information.

The CTP Claim Process in NSW

How do I make a CTP claim?

  • When you make a CTP claim you must first notify the CTP insurer of the vehicle mostly at fault in your accident
  • Lodge an application for personal injury benefits.
  • You have 28 days after the date of the accident to lodge this application to get back-payment for any lost wages.
  • The final deadline for lodging your CTP claim is three months from the date of the accident.
  • Note that this application doesn’t cover any lump sum payments you might be entitled to – you need to apply for these separately.

For a more detailed explanation of the CTP claim process in NSW, please refer to this step-by-step guide to lodging your application

Or for more information on lump sum claims, read this article on what you need to know before you lodge a lump sum claim

What is the CTP claim time limit?

You must make your CTP claim within 28 days to be eligible for income loss from the date of the accident. The final CTP claim lodgment date is 3 months from the accident, although this can be extended in certain circumstances.

If your CTP injury claim is successful:

  • You should receive 95% of your pre-accident earnings for the first 14 weeks
  • Your payments will drop to 80-85% of your earnings after week 14
  • Income benefits will stop at 26 weeks if you were the driver mostly at fault or your injuries are minor
  • Treatment is available after 26 weeks even if your injuries are minor or you were at fault
  • Income support stops at 24 months – to receive support beyond that, you’ll need to submit a separate application for a lump sum

For more information on benefits and lump sums – see ctpclaimadvice.com.au

How long does the CTP claim process take in NSW?

Once you submit your CTP insurance claim it will be reviewed by the insurer, who must send you a letter within four weeks to tell you if they’re accepting or denying the claim.  Then the insurer will start making payments to you within 14 days if they accept the claim.

The CTP insurer’s letter will state the insurer’s decision on whether your injuries are considered “minor” or “non-minor”, who was at fault in the motor vehicle accident and what payments you’re entitled to.

However, it’s important to understand that CTP insurer’s decisions can be challenged. The first step is to request an “Insurer Internal Review”, then if you’re still not satisfied with the outcome you can escalate your dispute to the Dispute Resolution Service.

For more information, here’s a detailed article on checking and disputing insurers’ decisions

Who pays my CTP claim benefits?

When you make a successful CTP insurance claim, payments will be made to you by the CTP insurer of the car that was mostly at fault in the accident. For example, if you were stationary at traffic lights and you were hit from behind by another vehicle, then the CTP insurer for that vehicle will make your CTP compensation payments. In some accidents there might be more than one vehicle at fault – in that case, it’s the insurer of the vehicle that’s mostly at fault that will pay.

If you’re the driver mostly at fault in an accident, then anyone who was injured in the accident may be able to make a claim under your vehicle’s CTP policy. So it will be your insurer that pays the CTP insurance claim.

The CTP claim NSW insurers are NRMA, QBE, GIO, Allianz, AAMI and CIC-Allianz.

Find out how much you can claim.

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How long will I keep getting CTP benefits?

Category Entitlements
1. Minor injury
  • Income support and medical expenses for up to 6 months
2. Non-minor injury
  • Income support and medical expenses for up to 24 moths
  • A lump sum for future lost income
3. Non-minor injury over 10% WPI^
  • An additional lump sum for pain and suffering

Why are my CTP claim benefits being cut off?

If your benefits are being cut off by the CTP insurer, there could be a few reasons why:

  • The insurer has determined that you’re no longer entitled to receive benefits
  • Your injuries were assessed as minor, and you’ve reached the six-month limit for personal injury benefits
  • Your injuries were assessed as non-minor, and you’ve reached the 24-month limit for personal injury benefits
If your benefits have been cut off and you believe the decision is unfair or you haven’t fully recovered, there’s a dispute process available to you. You can call 13 15 15 to get free advice from a specialist CTP lawyer on how to lodge a dispute.

How can I get free legal help with my CTP claim?

For CTP claims in NSW, lawyers’ fees are regulated. Lawyers can’t charge to help you lodge your application for personal injury benefits. But if you’re disputing a CTP insurer’s decision, then for most disputes you can engage a lawyer at no cost to you.

There are two types of disputes – paid disputes and unpaid disputes.

  • A paid dispute is a dispute that a car accident lawyer can charge for, and the fees are fixed.
  • Your lawyer will earn generally $1,600 for each paid dispute to a maximum of $6,000 for each dispute category.
  • You won’t have to pay anything to have a lawyer assist you with a paid dispute – these fees are paid by the insurer.
  • If a lawyer helps you with an unpaid dispute, they must do it free of charge.
Law Partners is Australia’s largest specialist personal injury firm, with legal teams that specialise in CTP claims in NSW. We’re also the team behind ctpclaimadvice.com.au – Australia’s most comprehensive website on CTP claims, with step-by-step guides on how to claim your maximum CTP benefits, including any lump sums you’re entitled to.

Find out how much you can claim.

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