Claim management

How long will it take to process my claim?

As the circumstances of each claim are often different, it is difficult to provide an exact timeframe for the settlement of your claim. The timeframe will depend on the complexity of your injuries and the circumstances of the accident.

Providing your Approved Insurer with detailed and accurate information about the accident, your injuries and medical condition promptly will assist the Approved Insurer to process your claim as quickly and efficiently as possible.

Subject to eligibility being met, there are six key steps in processing a CTP claim:

  1. Submit an Injury Claim Form or Fatality Claim Form to the Approved Insurer of the vehicle you believe to be most ‘at fault’ in the accident as soon as possible. If you are unsure of who the ‘at fault’ Approved Insurer is, visit ezyreg or contact the Regulator.
  2. Once your claim form has been allocated, the Approved Insurer will issue a claim number and appoint a claims consultant to your case.
  3. The Approved Insurer claims consultant contacts parties involved in the accident.
  4. The Approved Insurer will investigate who was at fault in the accident based on, for example, Accident Reports, police reports and other investigations.
  5. The Approved Insurer collects medical information and monitors your treatment. The insurer may pay some accounts prior to final settlement being reached.
  6. Once your injury has stabilised, the Approved Insurer will proceed to finalise your claim. Before your claim can be settled it must also be determined if you qualify for any compensation so that the Approved Insurer can determine a final amount that is appropriate.

This needs to be confirmed by medical and other evidence about any loss sustained as a result of injuries caused by or arising out of the accident. An offer of settlement will be made either directly to you, or if you are legally represented, to your representative.

If you have questions or concerns about the offer of settlement, they can be discussed with your claims consultant, or if you are legally represented, with your representative. Once settlement has been agreed the appropriate documents will be sent to you for your signature.

Your Approved Insurer may be legally obligated to contact Medicare Australia and other statutory authorities such as Centrelink and advise them of the settlement to be paid. These organisations may require reimbursement of amounts paid to you as a result of the claim. These amounts may  be deducted from your settlement payment.

How does the CTP Approved Insurer make decisions about my claim?

To process your claim, the Approved Insurer must investigate liability (who is at fault in the accident and to what degree) and the amount of compensation to be paid.

In many cases, these investigations can be complex and can therefore take some time. Decisions about liability are based on legislation, court precedents and outcomes.

Your CTP Insurer may also refer to legislation such as the Motor Vehicles Act 1959 and the Civil Liability Act 1936.

In the CTP Insurance scheme, a person who is injured in a motor vehicle accident may be entitled to compensation for their injuries.

Under Section 76 of the Civil Liability Act, the designated Minister has established an accreditation scheme called the Motor Accident Injury Assessment Scheme (MAIAS) to accredit Health Professionals to undertake assessments (ISV Medical Assessments) to assist in determining an injured person’s entitlement to compensation for accidents which occur on or after 1 July 2013. The ISV table is available here.

The Motor Accident Injury Assessment Scheme accredits medical practitioners (general and specialist) to undertake ISV Medical Assessments, comprising of a whole person impairment assessment and allocation of an ISV.

For further information about the Accreditation Scheme visit MAIAS.

Need help with an existing claim?

If you have an existing CTP Insurance claim which was made prior to 30 June 2016, please phone Allianz SA CTP (The Motor Accident Commission’s claims manager) on 1300 618 389.

If you have an existing claim which was made after 1 July 2016 and would like information about its progress, please phone the Approved Insurer that is managing your claim, or visit ezyreg or the CTP Insurance Regulator if you are unsure which insurer is managing your claim.

Should you wish to make a complaint, in the first instance you should contact your Approved Insurer and ask for assistance via their Dispute Resolution process. The contact details for the Approved Insurers are located here.

If the issue cannot be resolved or you are not satisfied with the outcome, you can contact the CTP Regulator Enquiries Line on 1300 303 558  or email ctp@sa.gov.au.