Read this first
The short version, before the detail
Compulsory third party insurance in New South Wales is far more of a treatment system than most people expect. Behind the green slip on every registered vehicle sits a set of statutory benefits, and those benefits pay for medical care, physiotherapy, psychology and a share of lost income while you recover. Damages are a separate, much smaller and much later part of the picture. If you have just been hurt on a NSW road, the useful next move is a proper assessment and a claim, in that order, not a conversation about money.
Everything below is written by the clinic that runs these files. Where the page states a rule we give the section of the Motor Accident Injuries Act 2017or the paragraph of SIRA’s Motor Accident Guidelines it comes from, so you can check it yourself. We have kept dollar figures out entirely: the rates change, the rules do not.
Scope. This page describes the NSW CTP scheme, which covers motor accidents that happen in New South Wales. Queensland, Victoria and every other state and territory run their own motor injury schemes with different deadlines, different forms and different benefit periods, so nothing here should be read across a border. For the NSW workplace scheme, see our workers compensation NSW guide instead.
1. You are covered for treatment, whoever was at fault
This is the part that surprises people most, so it goes first. In New South Wales, statutory benefits for treatment and care are not a prize for winning an argument about who caused the crash. A driver who caused the collision is entitled to ambulance and hospital care, to treatment and care, and to weekly payments, capped at 52 weeks. Passengers, pedestrians, cyclists and motorcyclists sit inside the same scheme on the same footing.
Source: Motor Accident Injuries Act 2017 (NSW) ss 3.11 and 3.28 (checked September 2026).
We do not ask people how the crash happened before booking them in, and no form of ours will ever put that question to you. Fault is the insurer’s and, if it ever gets that far, a court’s question. Ours is what is injured, how badly, and what treatment will get you moving again. The practical effect of the rule is that hesitation is the only thing that reliably costs you: people who think they were to blame often wait weeks before seeing anyone, and those weeks come off the end of the entitlement, not off the front.
What the 52 weeks actually means
Two groups of people have their statutory benefits capped at 52 weeks. The first is anyone whose injuries are classified as threshold injuries. The second is anyone found to have been mostly at fault, which the Act defines as contributory negligence greater than 61%. For both groups, weekly payments stop at 52 weeks and funded treatment and care stops at 52 weeks.
Source: Motor Accident Injuries Act 2017 (NSW) ss 3.11(2) and 3.28(2) (checked September 2026).
Everyone else, meaning people whose injuries are not threshold injuries and who were not mostly at fault, is in a different position entirely. Weekly payments can run to 104 weeks, and treatment and care continues for as long as it remains reasonable and necessary, with no fixed end date written into the section. Where a damages claim is on foot, the weekly payment period can extend further again. That gap between a hard 52-week stop and open-ended funded treatment is the single biggest financial difference in the scheme, and section 6 of this page explains what decides which side of it you land on.
Source: Motor Accident Injuries Act 2017 (NSW) s 3.12(2) and s 3.24 (checked September 2026).
2. The clocks that decide everything
Motor accident claims are governed by dates far more than by argument. None of these are secret, but no one is paid to tell you about them in the week you need to hear it, so here they are in order.
28 days to report to police
The accident has to be reported to police within 28 days, and reporting it straight away is better. The event number the police give you is the first thing a CTP insurer asks for, and chasing it later is much harder than getting it now. This is not the same as the 24-hour rule people sometimes quote from other states, and it is worth saying plainly, because the belief that the claim is already dead is one of the commonest reasons injured people never call anyone.
Source: SIRA, guide for people injured in a motor vehicle accident (checked September 2026).
28 days to lodge if you want the back-pay
If a claim for statutory benefits is not made within 28 days of the accident, weekly payments are not payable for any period before the claim was actually made. Treatment is not affected by this rule. It is a quiet loss, it happens after the fact, and nobody sends a warning letter about it. If you have had time off work since the crash, this is the date to put in your phone.
Source: Motor Accident Injuries Act 2017 (NSW) s 6.13(2) (checked September 2026).
Three months to make the claim at all
The outer deadline for a statutory benefits claim is three months from the accident. Beyond that a late claim needs a full and satisfactory explanation for the delay, which shifts the burden onto you and slows everything down. Separately, a damages claim runs on a three-year limitation period, and the often-quoted 20-month figure is the earliest such a claim can usually be made rather than a deadline to beat.
Source: Motor Accident Injuries Act 2017 (NSW) ss 6.13 and 6.14 (checked September 2026).
Four weeks for the insurer to decide liability
Once the claim is in, four weeks is all the insurer gets to tell you whether liability for statutory benefits in that first 52-week block is accepted. Fail to notify you in the way the Act requires and acceptance is deemed to have happened anyway. There is a second decision point at nine months, which covers entitlements after the first 52 weeks, and that later one is where the threshold injury question is usually settled.
Source: Motor Accident Injuries Act 2017 (NSW) ss 6.19(1), 6.19(2) and 6.19(4) (checked September 2026).
Ten days for an answer on treatment
When a treatment request goes to the insurer, it must decide as soon as possible and no later than 10 days after receiving the request. An approved account is then payable within 20 days of the invoice. Those two numbers are the operating rhythm of a CTP file, and they are the ones we hold insurers to on your behalf.
Source: SIRA, Motor Accident Guidelines 4.106 (checked September 2026).
28 days on every certificate, and 28 days for the recovery plan
A Certificate of Fitness covers a maximum of 28 days, so weekly payments depend on a chain of them that never breaks. Alongside that, the insurer must complete a tailored recovery plan within 28 days of the claim being made and review it at least every 12 weeks, taking into account information from the people treating you. Both of those are recurring obligations rather than one-off events, which is exactly why they get dropped.
Sources: Motor Accident Injuries Act 2017 (NSW) s 3.15(3)(b); SIRA, Motor Accident Guidelines 4.92 and 4.93 (checked September 2026).
3. The Certificate of Fitness, and why who signs it matters
If you take one operational thing away from this page, take this. The Certificate of Fitness is the medical document that tells the insurer what your injury is and what work you can safely do. You have to supply certificates covering the whole period for which you claim weekly payments, together with a declaration about your employment and earnings. No current certificate means no current weekly payment, however clear the injury is.
Source: Motor Accident Injuries Act 2017 (NSW) s 3.15(1) (checked September 2026).
The first one is a doctor’s job
The first certificate on a claim must be given by your treating medical practitioner. That is the rule, and it is not negotiable, which is why the first appointment on a car accident file is with one of our doctors rather than anyone else. It is also the appointment where the diagnosis, examination findings and any imaging get written down for the first time, and those records go on to do a great deal of work later in the claim.
Source: SIRA, Motor Accident Guidelines 4.68 (checked September 2026).
Every one after that can come from your physio or psychologist
From the second certificate onwards the Guidelines widen the list of who may write one. A doctor still can, but so can the physiotherapist or the psychologist already treating you. This is the quiet structural advantage of being treated by a clinic that has all three. Your physio is already seeing you weekly and already knows what you can lift, reach and tolerate; asking them to certify the next 28 days is quicker, more accurate and far less likely to leave a gap than sending you back to a doctor’s waiting room for a form.
Source: SIRA, Motor Accident Guidelines 4.69 (checked September 2026).
What happens when the chain breaks
If a certificate lapses and is not remedied, the insurer can move to suspend weekly payments. Before it does, it has to warn you in writing, explain the consequence, give you not less than seven calendar days to fix it, and provide the Independent Review Office’s contact details. Seven days is not long if you are trying to get an appointment while injured, which is why we book the next certificate before the current one runs out rather than after. The full walkthrough of the form, the fields insurers query and the timing sits on our Certificate of Fitness page.
Sources: Motor Accident Injuries Act 2017 (NSW) s 3.15(7); SIRA, Motor Accident Guidelines 4.61 to 4.63 (checked September 2026).
4. What treatment CTP pays for
The Act entitles an injured person to the reasonable cost of treatment and care, and excludes cost that was not reasonable and necessary in the circumstances or did not relate to the injury. In practice the regulator applies five questions to every request: is the treatment directly related to the injuries from the crash; is it aimed at helping the person get back to their usual activities; is it appropriate for that type of injury; is it provided by an appropriately qualified health professional; and is it cost effective.
Sources: Motor Accident Injuries Act 2017 (NSW) s 3.24; SIRA, fees paid for motor crash health services (checked September 2026).
Read that list again and notice what it is really asking for. It is asking the treating clinician to explain the link between the crash and the symptom, to state the functional goal, and to justify the modality. A request that does those three things gets approved. A request that says “six sessions of physiotherapy” and stops there is the one that comes back with questions and burns a fortnight.
Early treatment before the claim exists
Being seen does not depend on a claim number already existing. Within the first 28 days after the accident, a CTP insurer has a discretion to pay for a single GP consultation and up to two allied health sessions, once it has been told about the crash and a claim or reference number exists. That window closes at 28 days and cannot be extended; after it, treatment runs on a lodged claim for statutory benefits. It is the front door of the scheme, and a great many people walk past it without knowing it is there.
Source: SIRA, Motor Accident Guidelines 4.78 and 4.79 (checked September 2026).
The treatment request and the 10-day answer
Once a claim exists, an initial allied health assessment is generally exempt from pre-approval, and everything beyond it goes to the insurer on a treatment request submitted after that first session. The insurer then has 10 days to decide. If it declines, it must give reasons, list all the information relevant to the decision including material that does not support the decision, provide copies, set out internal review rights and give you the Independent Review Office’s details. That obligation is worth knowing about, because a declined request with a proper reasons letter is a request you can answer with better evidence. The mechanics, including what a strong request looks like, are on our CTP treatment approvals page.
Source: SIRA, Motor Accident Guidelines 4.106 (checked September 2026).
How the people treating you are paid
Doctors bill the insurer at the Australian Medical Association rates applying when the service is given. For allied health, SIRA has not set maximum fees in the CTP scheme at all, so the rate has to be negotiated with the insurer before any treatment begins. That second point is why we put rates and approvals in writing first. If an insurer has denied liability or declined a request and treatment goes ahead anyway, the account falls back on the patient, and that is not a position we put anyone in.
Sources: SIRA, Motor Accident Guidelines 4.101 giving effect to Motor Accident Injuries Act 2017 (NSW) s 3.31(4); SIRA, allied health providers in the NSW CTP schemes (checked September 2026).
5. Weekly payments, and how the rate steps down
Weekly payments replace part of what the injury has stopped you earning. They are calculated from your pre-accident weekly earnings and reduced by whatever you can still earn, so going back on light duties does not switch them off. The rate is not flat; it steps down at fixed points written into the Act, and knowing where the steps are stops them feeling arbitrary when they arrive.
The first 13 weeks
The first entitlement period runs for 13 weeks from the day after the accident. During it, the weekly payment is 95% of the difference between your pre-accident weekly earnings and whatever you are still able to earn. The percentage applies to the shortfall, not to the whole wage. This is the most generous stretch of the schedule, and it exists to hold your household steady while the acute treatment happens.
Source: Motor Accident Injuries Act 2017 (NSW) s 3.6 (checked September 2026).
Weeks 14 to 78
The second entitlement period covers the 65 weeks that follow, which is weeks 14 through 78. Where there is a total loss of earning capacity the rate is 80%; where the loss is partial, meaning you are back doing something, the rate is 85%. It catches people out that partial loss is paid at a higher percentage than total loss, and it is deliberate: the scheme is built to make working what you can worthwhile.
Source: Motor Accident Injuries Act 2017 (NSW) s 3.7 (checked September 2026).
How long payments can run
After week 78 the entitlement narrows and is assessed on loss of earning capacity rather than actual earnings. The outer limit depends on the classification covered in the next section: 52 weeks for a threshold injury or where you were mostly at fault, and 104 weeks otherwise, extending further where a damages claim is pending. Two things you control sit underneath all of it, and both are on this page already: lodging inside 28 days, and never letting the certificate chain lapse.
Sources: Motor Accident Injuries Act 2017 (NSW) ss 3.8, 3.11 and 3.12 (checked September 2026).
6. Threshold and non-threshold injury, and what turns on it
Threshold injury is the classification that replaced the older term “minor injury”, and it is the hinge the whole scheme swings on. A threshold injury is a soft tissue injury, or a psychological or psychiatric injury that is not a recognised psychiatric illness. Soft tissue means injury to the connecting and supporting tissue: muscles, tendons, ligaments, menisci, cartilage, fascia, fat, blood vessels and synovial membranes.
Source: Motor Accident Injuries Act 2017 (NSW) s 1.6 (checked September 2026).
The exclusions do the real work
The definition then carves things out, and the carve-outs are what decide most files. An injury to a nerve is not a soft tissue injury. Neither is a complete or partial rupture of a tendon, ligament, meniscus or cartilage. So the difference between a threshold injury and a non-threshold injury is often the difference between a strain and a partial tear. Those are examination and imaging findings. They are recorded, or not recorded, in the first weeks after the crash by whoever is treating you.
One qualification is worth knowing, because it catches people out and it is the single most common misreading of the rule. The nerve carve-out is not a blanket. The Regulation returns an injury to a spinal nerve root to the threshold category where it manifests in neurological signs other than radiculopathy. Pins and needles or numbness in an arm or leg is therefore not by itself the answer. Radiculopathy is the finding that carries weight, and radiculopathy is a specific clinical picture rather than a description of pain.
Source: Motor Accident Injuries Act 2017 (NSW) s 1.6(2); SIRA, Providing allied health services in the NSW CTP schemes — FAQs (checked September 2026).
The same logic runs through psychological injury. A recognised psychiatric illness is not a threshold injury, while acute stress disorder and adjustment disorder are treated as threshold under the Regulation. A careful diagnostic formulation early on is therefore not paperwork; it is the thing that determines whether psychology sessions are funded for a year, or for however long the treatment continues to be reasonable and necessary.
Source: SIRA, allied health providers in the NSW CTP schemes (checked September 2026).
The nine-month decision point
Nine months from the claim is the deadline for the insurer to say whether it accepts liability for benefits beyond that first 52 weeks. That is when the threshold question is normally answered, and by then the clinical record either supports a non-threshold classification or it does not. Disputes about whether treatment and care is reasonable and necessary are the most common type of internal review in the scheme, and roughly a quarter of them are decided in the customer’s favour, which tells you both that the evidence matters and that pushing back is not futile.
Sources: Motor Accident Injuries Act 2017 (NSW) s 6.19(2); SIRA, 2017 CTP Scheme Performance Report to 30 June 2025 (checked September 2026).
7. Common injuries after a crash, and where to go next
Four presentations account for most of what walks through the door after a motor accident. Each has its own page with the clinical detail, the recovery pattern and how the treatment is funded under CTP.
Whiplash and neck strain
The classic rear-end injury, and the one most often waved away at the roadside because it feels manageable on the day. Whiplash-associated disorder ranges from stiffness that settles in a fortnight to persistent pain with headache, reduced rotation and disturbed sleep. Because a straightforward soft tissue strain and a partial ligament tear are on opposite sides of the threshold definition, examination detail matters here more than almost anywhere else. Read more on whiplash treatment in NSW.
Concussion and head injury
You do not need to have lost consciousness, and you do not need to have hit your head on anything. Fogginess, headache, nausea, light sensitivity and a short fuse in the days after a crash all warrant assessment. Concussion is also the injury most likely to be missed on the night, because the neck pain gets all the attention in the emergency department. Our page on concussion after a car accident covers assessment and graded return to activity.
Back and neck injury
Lumbar and thoracic pain after a crash covers a wide range, from muscular guarding through to disc injury with radicular symptoms. The presence or absence of nerve involvement is a clinical finding with direct consequences for how long treatment is funded, so it is examined for and documented rather than assumed. See back and neck injury after a car accident.
Psychological injury
Not being able to get back behind the wheel is an injury, not a character flaw. Intrusive memories, avoidance of the road where it happened, broken sleep and a startle response to braking are all common and all treatable. The Guidelines ask insurers, wherever possible, to use providers with expertise in managing psychological injury where recovery is likely to be delayed by psychological factors, so asking for the right clinician is a reasonable request rather than a favour. More at psychological injury after a car accident.
Source: SIRA, Motor Accident Guidelines 4.105 (checked September 2026).
8. Pedestrians, cyclists, motorcyclists and rideshare drivers
“Car accident” is a poor description of who this scheme actually covers. If you were hit by a motor vehicle, or were on or in one, you are inside it. Three groups have enough of their own complications to warrant separate pages.
Hit while walking or riding a bicycle
Pedestrians and cyclists are claimants under CTP in exactly the same way a driver is, and the claim goes to the insurer of the vehicle involved. Where the vehicle left the scene and was never identified, or turned out to be unregistered, the claim is directed instead to the Nominal Defendant, a fund SIRA manages. The injuries in this group tend to be more severe than the vehicle damage suggests, and both the 28-day reporting window and the lodgement clock apply just the same. See pedestrian and cyclist injury claims.
Source: SIRA, Nominal Defendant (checked September 2026).
Motorcyclists
Riders come off worse and recover slower, and the injury mix is different: shoulder and clavicle, wrist and hand, knee, and significant skin trauma alongside the joint damage. Multi-site injuries need a treatment plan that sequences the work rather than running four separate referrals in parallel. Our page on motorcycle accident injuries in NSW goes through it.
Rideshare and delivery drivers
If you were logged in and working when the crash happened, the first question is which scheme covers you, and the honest answer is that it depends on your engagement rather than on the app you drive for. Getting that triage right in the first week saves months, because the two schemes have different forms, different deadlines and different certificates. Start at rideshare and delivery driver accidents.
9. Crashed while driving for work
A crash on work time sits across two schemes, and the overlap is genuinely awkward. CTP statutory benefits are not payable where workers compensation is payable for the same injury. But a CTP insurer cannot refuse benefits on that basis unless you have actually made a successful workers compensation claim, or have failed to comply with its request that you make one. The door does not close, in other words, simply because you were driving a work vehicle at the time.
Source: Motor Accident Injuries Act 2017 (NSW) s 3.35 (checked September 2026).
Journey claims are the common version of this. A crash on the ordinary trip between home and work is only a workers compensation matter where the employment and the accident have a real and substantial connection. Where they do not, the CTP scheme is the one that responds. Deliver goods, drive between sites, run a work errand at lunchtime, or travel to a client and the analysis changes again.
Source: SIRA, work break and journey claims (checked September 2026).
This matters to us more than to most clinics, because we treat patients under both schemes every week and the certificates are not interchangeable: workers compensation runs on a Certificate of Capacity, CTP on a Certificate of Fitness. Our doctors work out which claim, or which combination, applies at the first appointment and write the right document rather than the familiar one. The full comparison is at car accident at work in NSW.
10. How WorkCover Hub treats car accident injuries
We are a clinic. Our doctors assess you and write the first Certificate of Fitness. Our physiotherapists do the hands-on rehabilitation and, from the second certificate onwards, can write the certificate themselves. Our psychologists handle the part of a crash that does not show on a scan. All of it runs on one file, so the person writing your treatment request is the person who examined you, and the insurer is dealing with one coherent clinical story instead of three unconnected providers.
Practically, the first appointment does four things: it assesses and documents the injury properly, it produces the first certificate, it gets a treatment plan in front of the insurer, and it tells you which clocks are already running on your claim. You can nominate us as your treating practice for the recovery plan, and the Guidelines expressly allow a medical practice rather than a single named doctor to be nominated, which means your file keeps moving when any one clinician is on leave. If you have already told the insurer you would prefer to be treated here, it has to facilitate that referral where we are suitable, and give written reasons if it will not.
Source: SIRA, Motor Accident Guidelines 4.99 and 4.104 (checked September 2026).
On an accepted claim with approvals in place, we bill the CTP insurer directly and you do not see an account from us. We agree rates with the insurer before treatment begins, because the CTP scheme sets no maximum allied health fee and an unagreed rate is an unrecoverable one. Appointment availability varies by discipline and location, and new crash injuries are prioritised; our team will tell you honestly on the phone what the next opening looks like rather than promising a day we cannot hold.
When you are ready, book at book a car accident appointment, or read how the clinic runs a CTP file end to end on our car accident injury service page. If you would rather talk to the regulator first, SIRA runs CTP Assist on 1300 656 919, and it is a genuinely useful free service.
Frequently asked questions
Eight questions our reception team fields most often from people in the first weeks after a crash. None of them are about money, which is itself telling.
Before you go
Being hurt on the road is disorienting in a way that has nothing to do with the severity of the injury. There is a vehicle to deal with, an insurer you have never spoken to, a workplace waiting on an answer, and a body that is not doing what it did last week. The scheme underneath all of that is less hostile than it looks. It funds treatment before it asks who was to blame, it gives you a defined answer within four weeks, and it pays the people treating you directly.
If you remember two things, make them these. Get assessed early, because the record written in the first few weeks is the record that decides your classification months later. And lodge inside 28 days, because that is the one deadline whose cost is invisible until it has already been paid. Everything else on this page follows from those two.
Sources
Every rule stated on this page comes from one of the following primary sources. All were checked in September 2026. Rules change; where a date or percentage matters to a decision you are making, check the current version or call CTP Assist on 1300 656 919.
- Motor Accident Injuries Act 2017 (NSW), sections 1.6, 3.6, 3.7, 3.8, 3.11, 3.12, 3.15, 3.24, 3.28, 3.31, 3.35, 6.13, 6.14 and 6.19.
- Motor Accident Injuries Regulation 2017 (NSW), including the threshold injury provisions and the legal costs schedule.
- SIRA, Motor Accident Guidelines, paragraphs 4.61 to 4.63, 4.68, 4.69, 4.78, 4.79, 4.87, 4.92, 4.93, 4.99, 4.101, 4.104, 4.105 and 4.106.
- SIRA, guide for people injured in a motor vehicle accident; fees paid for motor crash health services; allied health providers in the NSW CTP schemes; Nominal Defendant; work break and journey claims.
- SIRA, 2017 CTP Scheme Performance Report to 30 June 2025.
This page is general information about the NSW CTP scheme, not advice about your individual claim. For advice about your own injury, speak to a treating clinician.