Understanding the CTP Claim Process and Requirements

Being involved in a motor vehicle is tremendously stressful, even if you are lucky enough to escape with minor injuries. In addition to the initial shock and physical discomfort, you may also face serious financial worries.

In Queensland, Compulsory Third Party (CTP) insurance protects injured parties by covering medical costs and offering compensation. 

Unfortunately, the CTP claims process can be daunting. Do you need a road map as you navigate the CTP claims process to seek compensation for personal injuries sustained in a motor vehicle accident? Start with this overview of the CTP claims process.

What Is a CTP Claim?

CTP insurance, regulated by the Motor Accident Insurance Commission (MAIC), is mandatory for all drivers in Queensland. It covers vehicle owners, anyone using the vehicle, and injured parties.

A CTP claim is made against the responsible party’s insurer. If the at-fault party cannot be identified or the vehicle was unregistered, victims can still make CTP claims, seeking compensation from the Nominal Defendant.

CTP covers:

• Medical expenses resulting from the accident
• The cost of rehabilitation programs
• Lost income (potentially on an indefinite basis)
• Care services
• Psychological services
• In the case of fatal road accidents, funeral costs and compensation for the victim’s lost income

The merit of each Queensland CTP claim is assessed individually.

Unfortunately, Queensland motorists cannot file CTP claims after being involved in a road accident where they were partly at fault or a motor vehicle accident in which nobody was at fault.

The need for a CTP claim may arise in numerous different situations, for example:

• A motorist hit you as a pedestrian, and you suffered injuries.
• You were driving more slowly than expected when another motorist hit you from behind — you may file a CTP claim even if you were partly at fault.
• You were injured in a hit-and-run accident, and the driver’s identity is unclear.
• You sustained injuries as a bus passenger.

The CTP Claim Process

Dealing with paperwork after a motor vehicle accident is always challenging, but Queensland’s CTP claims process is laid out clearly. Let’s look at the five steps you need to take to lodge a claim.

1. Step 1: Reporting the Accident

Promptly report the accident to the police to ensure a smooth CTP claims process. 

Anyone who is able is advised to contact the authorities while on the scene of the road accident. When this is not possible, claimants can complete a Report of Traffic Incident to Police form, available from the Motor Accident Insurance Commission website, and submit it to the police station at the earliest opportunity.

2. Step 2: Gathering Evidence

Gather the following evidence to support a successful CTP claim:

• At-fault vehicle’s registration number 
• Medical certificate documenting injuries
• Witness statements (where available)
• Police report
• Photographs (where available)
• Evidence of income loss resulting from the accident

Preserving evidence helps claimants make a strong case that results in faster CTP settlement.

3. Step 3: Notifying the Insurer

Queenslanders can identify motorists’ CTP insurers online or by contacting MAIC with the vehicle’s registration number.

Injured parties file CTP claims with the relevant insurer, via an online form or by mailing a copy of the Claim for non-fatal injury to the insurance company. Claimants must submit a claimant certificate, proof of identity, and a medical certificate alongside the claim form. When a lawyer represents a claimant, a law practice certificate should also be submitted.

4. Step 4: Assessment of the Claim

The at-fault party’s CTP insurer is obligated to confirm receipt of a (correctly filed) claim and respond regarding coverage of reasonable rehabilitation expenses within 14 days.

While the assessment of a CTP claim can take up to six months, the insurer has a legal duty to settle as quickly as possible. The insurance company will assess if the party you are filing against is liable and ensure the claim is not fraudulent.

Once the insurer accepts liability, they will evaluate medical and rehabilitation expenses to determine the coverage amount. Meanwhile, claimants must cooperate with the insurer’s investigation by providing relevant documentation.

5. Step 5: Settlement or Litigation

Once liability is accepted and the full extent of the injuries is clear, claimants (or their lawyers) and insurers begin negotiating. Settlement agreements are typically finalised out of court through back-and-forth negotiation and, in some cases, mediation.

Litigation may be a last-resort option when the insurer accepts liability but the parties cannot reach a mutually-agreeable settlement. This process requires filing a Notice of Claim and offering the insurer a final opportunity to settle. Court proceedings are then initiated.

CTP Claim Requirements

Understanding who may file a CTP claim, and under which circumstances, is critical. This section outlines important criteria to meet.

Time Limits for Filing a Claim

CTP claims must be filed:

• Within 12 weeks (three months) of the road accident if directed to the Nominal Defendant, namely in cases where the at-fault party remains unidentified.
• Within nine months of the motor vehicle accident in cases where the at-fault party was identified.
• Within nine months of the appearance of the first symptoms in cases where the injury was not immediately apparent. 
• Within one month of the first lawyer’s appointment, if a solicitor is managing the CTP claim.

Failing to file within the statutory timeframe can cause the claim to be rejected while lodging a claim promptly gives claimants access to the compensation they seek faster.

Required Documentation

CTP claimants must provide:

• An online claim for non-fatal injury, PDF claim form for non-fatal injury, or claim form for fatal injury
• Proof of identity
• Medical certificate
• Claimant certificate
• Law practice certificate, if represented by a lawyer

Supplying all required documents when lodging a CTP claim in Queensland is essential, as failure to do so will only prolong the process.

Eligibility Criteria

People lodging CTP claims in Queensland must meet the following requirements:

• The road traffic accident took place in Queensland.
• The claimant was injured in the accident or is filing on behalf of an immediate family member (including in the case of fatal accidents).
• The accident must entirely or partly have been caused by another motorist.

If the at-fault vehicle is registered outside Queensland, claimants may lodge CTP claims in the relevant jurisdiction.

Compensation Limits

The Queensland CTP program covers “unlimited liability”. Where a person becomes permanently disabled as a result of a car accident, lifelong compensation may be provided. Similarly, CTP insurance covers funeral expenses and a provider’s lost income following a fatal injury.

However, the maximum amount of compensation depends on the extent of the injuries, the cost of medical and rehabilitation expenses, and the amount of lost income.

Common Challenges and Pitfalls

Every step a claimant takes following a road accident can affect the claims process. Calling the police promptly is the first vital step injured parties can take. Beyond this initial stage, it is crucial to file within the time limit, to provide complete and accurate documentation, and to retain evidence. 

Engaging a solicitor can streamline the CTP claims process and increase claimants’ chances of a successful outcome.

Conclusion

Compulsory Third Party coverage protects all motorists and pedestrians involved in a motor vehicle accident in Queensland — whether at fault in an accident or the injured party. 

CTP insurance ensures that injured parties gain access to the compensation they need to recover from the accident and cover their lost income. Lodging a claim is challenging and complex but becomes more manageable once you fully understand the process. 

While injured parties can claim on their own behalf, working with a lawyer can impact the outcome and reduce stress. However, because the CTP settlement process requires back-and-forth negotiation with the insurer, it is crucial for claimants to understand the process in detail, even if they choose to engage a motor vehicle accident lawyer.