For people injured from 1 December 2017, weekly income support payments are available for the first time. Medical expenses and care costs are also available while you recover.
Personal injury benefits can be weekly payments and/or medical expenses. These types of benefits can also be referred to as 'Statutory Benefits'.
Did you know? Weekly income payments are new. They were not part of the old scheme.
Weekly payments compensate you for income you have lost because of your injury.
Your weekly payments will be a percentage of your pre-accident income:
- for the first 13 weeks the percentage may be up to 95 percent
- between 14 and 26 weeks the percentage may be up to 80 percent.
After 26 weeks your weekly payments will end if:
- you were at fault or
- your injuries are assessed as 'minor'.
If you are still receiving payments after 26 weeks they may be 80 percent of your pre-accident income.
To continue to receive income payments after two years, the person must have ongoing work incapacity and have lodged a claim for damages.
Make your claim as soon as possible
You must lodge your claim within 28 days from the date of the accident so you can get back pay for loss of income from the date of the accident. If you lodge your claim after 28 days, you will not receive back pay for loss of income from the date of accident.
If you do not want to claim back pay from the date of the accident, you must still lodge a claim within three months of the accident to claim any benefits, including medical expenses.
Did you know? Insurers can approve some preliminary medical expenses before you make a formal application for personal injury benefits. These are a GP visit and two treatment sessions such as physio. Contact CTP Assist on 1300 656 919 or firstname.lastname@example.org for more information.
The insurer will pay for reasonable and necessary expenses related to the injury. This includes:
- medical and pharmaceutical expenses
- rehabilitation and treatment expenses (like physiotherapy)
- the cost of travelling to and from appointments
- in some cases the insurer choosing to pay for injury-related support services (like personal care and help around the home).
Who can apply?
Did you know? If the injury is a result of a work-related accident you should make a workers compensation claim, not a CTP claim. See claiming workers compensation for more information.
Anyone injured in a motor vehicle accident covered by the NSW CTP scheme can apply. This includes:
- drivers and passengers
- riders and pillion passengers
The injury can be physical or psychological.
You can only claim if your injuries happened because of a ‘verified’ accident. ‘Verified’ means that you or someone else has reported the accident to the police within 28 days of the accident. This is an important way of proving that the accident happened. Read more
How to apply
Did you know? We can find out for you which insurer you need to claim with. See who do I claim with?
Did you know? Family members or a legal representative can apply on the injured person’ behalf. Hospital case workers may also be able to help.
Did you know? If you don't have all the details yet, you can still contact the insurer about making a claim. They will record what details you do have and send you a claim form with the information you've provided pre-filled. You can fill in the rest when you've obtained the extra details.
1. Fill out the form: You need to complete the Application for personal injury benefits form and provide as much detail about the accident as possible (including the police event number, any photos, ambulance reports, vehicle towing details etc), details of your injuries and what medical treatment you've already received. To receive weekly income payments, complete the Certificate of Fitness from your GP and include evidence of your pre-accident income (eg payslips).
2. Attach documents: Anything that helps the insurers to assess the claim can be included. This can include proof of your accident (eg any photos, police/ambulance reports), proof of your medical expenses (eg receipts) and Certificate of Fitness, proof of how much you earn (eg payslips/income statements).
What happens next?
1. The insurer will contact you after you lodge a claim, acknowledging receipt and providing advice on the next steps in the process.
This will include a claim number and the contact details for the insurer.
2. If you need immediate medical treatment the insurer must explain what you should do next (including how to get reimbursement for the medical expenses so far).
See our pages in the Injury Advice Centre for information to help you recover from certain types of injuries.
3. The insurer will investigate your claim including reviewing the police report and other evidence such as medical reports you have given.
The insurer may ask you to see other medical specialists.
4. The insurer must tell you within four weeks of the claim being made if they're accepting or denying the claim (along with a full explanation of their reasons). This must include the consequences of the decision (eg effects on your entitlements and when it will take effect), a list and copies of the information used by the insurer in making the decisions (if not already given), how the decision can be reviewed, and where to go for further help.
5. The insurer will start making payments to you within 14 days if the insurer accepts your claim. You will also need to start a Recovery Plan.
What if I disagree with the insurer?
If your claim is accepted the insurer will work with you to develop a Recovery Plan. A Recovery Plan is designed to return you to full pre-accident activities as soon as possible. You must participate in this plan to receive weekly income payments and medical expenses. It is prepared in consultation with you, your doctor and any relevant treating practitioners.
You will need to give the insurer a Certificate of Fitness, which explains how you are recovering and if you are still eligible for benefits. Your doctor will give you the Certificate of Fitness to give to the insurer. The insurer will ask you for these while you are recovering; how often will depend on your injury.