What happens after you lodge a CTP claim

Lodging your CTP claim is the start of a process, not the end of one. Once your application reaches the insurer, a sequence of steps follows — most of them administrative, some of them medical — before you see any kind of decision.

Knowing roughly what to expect helps you respond to requests quickly and avoid the small delays that add up. Nothing here replaces the letter the insurer sends you — that letter is specific to your claim and should always take priority over general guidance.

Acknowledgement and a case manager

The insurer should acknowledge that your application has been received and assign a case manager. This person becomes your main point of contact for the life of the claim — the one who requests documents, explains decisions, and answers questions about where things stand.

Save their name and direct contact details somewhere you can find them. If you are dealing with a call centre queue every time you ring, ask to be transferred to your named case manager or request their direct line in writing.

The insurer starts gathering evidence

Behind the scenes, the insurer begins collecting what it needs to assess your claim: your Certificate of Fitness, any police report or event number, medical records, and — depending on your claim — payslips or employment details.

You may be asked to sign authority forms so the insurer can request records directly from hospitals, GPs, or employers. Signing these usually speeds things up, because the insurer is not waiting on you to chase paperwork from a third party.

Early treatment while the claim is being assessed

In many cases, a limited amount of treatment can be accessed early, before the insurer has finished assessing the full claim — the rules for this sit in the legislation and depend on your circumstances, so check the specifics with SIRA or your case manager rather than assuming.

This treatment is generally accessed through the CTP scheme, not paid by you directly. Keep attending appointments and keep your certificates current during this period — a gap in the medical record can complicate the assessment later.

What can slow things down

None of these are fatal to a claim, but each one adds time. The fastest way through this stage is simply responding to requests as they arrive and keeping your appointments booked.

• Missing or unsigned pages in the original application.
• Certificates that lapse before a new one is issued.
• Slow responses to requests for extra information or documents.
• Inconsistent details between your application, your certificates, and your treating notes.

How CTP Doctor fits in

Our role is medical, not administrative — we cannot lodge your application or chase your case manager for you. What we do is make sure your Certificate of Fitness and clinical notes are accurate, current, and consistent, so the insurer has what it needs to keep assessing your claim without unnecessary back-and-forth.

Appointments run by telehealth across NSW, or in person where appropriate — your doctor confirms which suits your injury, particularly for that first assessment.

If a decision does not go your way

Not every early decision is final. If treatment is declined or your claim is disputed, review pathways exist under the scheme. This page does not cover dispute strategy — for that, check SIRA's guidance or speak to a lawyer about your options.

What to expect from your own paperwork

Alongside the insurer's process, keep an eye on your own side of things. Save a copy of every form you sign, every certificate you are given, and every letter that arrives, whether by post, email, or through an online portal. It sounds basic, but a simple folder — physical or digital — saves real time later if a document goes missing or a date is queried.

If your circumstances change while the claim is progressing — a new symptom, a change in your work situation, a house move — let your case manager know. Claims move more smoothly when the insurer's file reflects your current situation rather than what was true when you first lodged.

A realistic sense of the early weeks

It is normal for the first few weeks after lodging to feel administrative rather than eventful: forms being processed, records being requested, a case manager getting across your file. That does not mean nothing is happening — it usually means the groundwork for later decisions is being put in place.

Staying engaged during this quieter period, by attending appointments and responding promptly to requests, tends to pay off once the claim moves into treatment approvals and, if relevant, weekly payments.