How to lodge a NSW CTP claim (Motor Accident Injuries Act 2017) — a substantial procedural guide

Under the Motor Accident Injuries Act 2017, "lodging a claim" primarily refers to submitting an Application for Personal Injury Benefits. This starts your entitlement to statutory benefits, which include weekly payments for lost income and funding for medical treatment and care.

In more serious cases involving non-threshold injuries where you were not at fault, you may later lodge a separate Application for Damages under Common Law. However, the immediate priority for any injured person is the statutory benefits claim, which must be handled with precision to avoid early denials.

The first 28 days following a motor accident are the most critical for your claim. Actions taken (or missed) during this window will determine if your income support is backdated and how quickly statutory benefits begin after your claim is lodged.

The Application for Personal Injury Benefits is a comprehensive legal document. How you fill this out will be scrutinized by the insurer for years to come. It is highly recommended to have a specialized lawyer assist you with filling out the claim form to ensure all injuries are properly documented and you do not miss any entitlements. Contact us immediately for help with your application.

Section 6: Accident Description

Be factual and concise. Describe the direction of travel, the point of impact, and what the other driver did. Avoid admitting fault or using speculative language. This description is often compared against Police reports and witness statements later in the PIC.

Section 7: Your Injuries

List every part of your body that was affected. Insurers often use the "omission" of an injury in this early form to argue that subsequent symptoms (like radiating nerve pain or psychological distress) are unrelated to the accident.

The Certificate of Capacity

This is the "engine" of your claim. It must be completed by your GP and renewed regularly. If there is a gap in your certificates, the insurer will immediately stop your weekly payments. Ensure the "diagnosis" section is as specific as possible (e.g., "radiculopathy at L5/S1" rather than just "sore back").

If the at-fault vehicle stopped and you exchanged details, you can find their insurer via the Service NSW Free Registration Check. You only need the number plate.

Hit-and-Run or Uninsured Vehicles

If the vehicle is unidentified (e.g., a hit-and-run) or is found to be uninsured, you do not lose your right to claim. You can lodge your claim against the Nominal Defendant. Note that for unidentified vehicles, you must demonstrate that you have made "due inquiry and search" to find the vehicle (such as reporting to police and seeking witnesses).

Once your claim is lodged, the insurer is required to make several time-sensitive decisions:

• Early statutory benefits decision: The insurer should start paying reasonable and necessary treatment and weekly benefits once the claim requirements are met, while liability is being investigated.
• The 9-Month Liability Decision: The insurer typically has up to 9 months to make a final decision on liability, depending on the nature of the claim (Section 6.19). This decision will confirm whether the accident was your fault and the classification of your injury.

Strategic Tip: If the insurer sends you a letter classifying your injury as a "threshold injury" (minor injury), do not wait. You only have 28 days to request an Internal Review of that classification.

To maintain your claim, you must cooperate with the insurer’s "reasonable" requests. This includes attending Independent Medical Examinations (IMEs) arranged by the insurer.

IMEs are not there to treat you; they are there to provide an opinion to the insurer about your injury classification and capacity for work. It is essential to have your own treating specialists provide competing evidence to ensure a balanced view is presented if the matter goes to the Personal Injury Commission (PIC).

A statutory benefits claim is "lodged" once, but it is managed continuously. If your injuries are non-threshold, you will eventually reach "Maximum Medical Improvement" (MMI). At this stage, usually 12–18 months post-accident, you will lodge a WPI assessment request, which is the precursor to a common law damages settlement.