CTP Claim Denied or Cut Off — What You Can Do in NSW

A “denial” can mean different things: the insurer might dispute that the accident caused the injury, dispute that a treatment is reasonable, classify your injury as minor, or stop weekly payments after a certificate gap. Read the actual letter — the reason code matters for your next step.

Step 1: Understand the decision

Insurers usually must tell you why they decided what they decided and what review rights you have. Note any deadline — missing a review window can burn your options.

• Request the decision in writing if you only received a phone call.
• Ask for a copy of any independent medical report they relied on.
• Line up your Certificates of Fitness and treating reports chronologically.

Step 2: Internal review

Many disputes start with an internal review inside the insurer. You submit additional evidence — often stronger medical reasoning, updated certificates, or clarification of work capacity. This is where a clear clinical narrative from your treating team helps.

Step 3: Personal Injury Commission

If internal review does not fix the issue, statutory disputes often go to the Personal Injury Commission. PIC has its own forms, time limits, and processes. Lawyers routinely run PIC matters; self-represented people can struggle with procedure.

Step 4: Medical record clean-up

Weak certificates, inconsistent dates, or vague capacity comments sink claims. Our doctors can reassess, tighten diagnoses in line with clinical findings, and make sure certificates match your real restrictions — without stepping into legal strategy.