Making a Claim in the ACT
Who can claim?
A CTP motor accident notification form (MAN and MAMR) may be lodged by any person who has sustained personal injury as a result of a motor accident and who has not been charged with a serious driving offence.
The early payment up to $5,000 for medical expenses is designed to provide speedy access to treatment and rehabilitation to support a better health outcome.
A motor accident medical report (MAN and MAMR) should also be lodged.
A CTP notice of claim (NOC) form may be lodged by:
- person who has sustained personal injury as a result of a motor vehicle accident in the ACT for which they were not at fault. This may include a driver, motorcyclist (or cyclist), passenger or pedestrian, but not the driver of the vehicle at fault;
- or the estate of someone fatally injured as a result of a motor vehicle accident in the ACT for which the deceased person was not at fault.
If you are partly at fault you can still claim but your entitlement will be reduced by the extent of your contributory negligence.
If you have not already lodged a MANF and a MAMR, these forms should also be attached to the NOC form.
How long do I have to make a claim?
To claim early payment for medical expenses, the completed MAN and MAMR must be lodged with your own insurer within 30 working days after the motor accident. You will need to provide details of police attendance/notification of the accident.
Notice of claim (NOC), which gives notice of a claim and is a preliminary step to a possible court proceeding, must be given in writing to the CTP insurer of the at-fault vehicle within 9 months after the motor vehicle crash or from the time when injury symptoms first appear.
If the at-fault vehicle cannot be identified or is not insured for CTP, the notice of claim must be given to the Nominal Defendant within 3 months.
Failure to comply with time limits may prejudice your rights to pursue a claim.
If your claim is not settled within 3 years, from the date of the crash (or when your injuries become apparent), you must ensure that court proceedings have been issued on your behalf before the 3 years expire. If you were under 18 years of age at the time of the accident, then a 6-year time limit applies. Failure to comply with time limits may prejudice your rights to pursue a claim.
If you are making a claim in relation to an interstate accident, a different time limit may apply in some states.
How do I make a claim?
Step 1. Contact the relevant CTP insurer as soon as possible, because most motor accident victims will qualify for payment or reimbursement of the first $5,000 of their medical expenses (early payment) without first having to establish that someone else is responsible for the accident, so long as you notify the insurer within 30 working days of the date of the accident.
Step 2. You should obtain a copy of the MAN and MAMR form from the CTP insurer, the Nominal Defendant or from this website. Complete the MAN and MAMR form as fully as possible and either email, post or lodge the form in person with the CTP insurer or the Nominal Defendant.
If you need help to fill in the MAN and MAMR form, the CTP insurer can assist you.
Step 3. After you lodge the MAN and MAMR form, the CTP insurer will begin to evaluate your claim. The insurer may require you to be examined by a doctor of their choice and to complete the NOC to enable the insurer to investigate the crash and make an assessment of liability.
There is an obligation on all parties to share documents and information relevant to liability and the amount of damages. This includes copies of any reports about the accident, your medical condition and prospects for rehabilitation, and your cognitive, functional or vocational capacity. The insurer may also ask you to provide information such as the medical treatment or rehabilitation treatment you have sought or obtained for the injury, your medical history (where relevant), any other personal injury claims you have made, and information about your claim for past or future loss of income or in relation to gratuitous services.
Step 4. When you have recovered, or medical reports confirm the maximum degree of recovery has been reached, the insurer will contact you to finalise your claim. If you consider your claim has reached this stage, you should contact the insurer regarding settlement.
Who pays for the medical expenses?
If a MAN and MAMR is provided to the CTP insurer (or Nominal Defendant) within 30 working days of the motor accident, the insurer is obliged to pay the first $5,000 of your medical expenses incurred within 6 months of the accident (this does not constitute an admission of liability on the insurer's part). This is an early payment. In addition, the insurer may agree to pay for rehabilitation services without admitting liability.
Accounts paid by you are normally included in the final settlement. However, the insurer may consider interim reimbursement upon request. You should ask your treating practitioner about treatment costs you pay, in case there are gaps between the charge and reimbursement, which the insurer may not pay.
What am I entitled to claim?
You are entitled to make a claim for:
- Economic loss – this includes compensation for past and future loss of earning capacity and for past and future medical, treatment and care expenses.
- Non-economic loss (general damages) – this includes pain and suffering, loss of enjoyment of life and any loss of expectation of life experienced by you as a result of the injuries.
Can I claim for loss of earnings capacity?
Yes, although a CTP insurer has no legal liability to pay for loss of earnings capacity prior to settlement of the claim. The CTP insurer may consider pre-payment of the economic loss upon application.
What happens if a lawyer lodges a claim for me?
A lawyer can give you independent advice about whether you have a claim and about the amount of compensation you are likely to receive. The Law Society of the ACT can let you know their member firms and their areas of specialisation.
A lawyer must give the insurer written notice of your claim within 1 month of your first consultation with him or her. This applies in addition to the general 9 month time limit for notifying claims.
If you decide to lodge your claim through a lawyer, it is in your interest to ensure that the lawyer provides the forms you and your doctor have completed to the CTP insurer in time for you to seek early payment or reimbursement of the first $5,000 of your medical expenses if you qualify for payment. Your lawyer may obtain medical and other reports, collate details of your claim, negotiate with the insurer on your behalf and advise you about finalisation. A lawyer can bring court proceedings on your behalf should this be necessary.
Your lawyer may ask you to agree that all communication with the insurer concerning your claim should be made through your lawyer. However, if the CTP insurer admits liability, it becomes obliged to provide the cost of reasonably incurred medical expenses and reasonable and appropriate rehabilitation, among other things. You will need to ensure your lawyer provides you with timely notice of any of the insurer's requirements in this regard.
To assist you, the following contact details are provided:
ACT Insurance Authority
Phone (02) 6207 0184