What happens after I complete a MVA claim form?
Motor Accidents
29 April 2026
min read
Key Takeaways
After submitting a motor vehicle accident claim, the insurer must notify you within 3 months via a Section 81 Notice if they accept liability. This notice determines whether they’ll cover your medical expenses and rehabilitation services.
• Insurers must decide on liability within 3 months of receiving your claim
• If accepted, the insurer pays all reasonable medical and rehabilitation costs
• If denied, you receive no medical coverage and should immediately consult a lawyer
This information is for accidents after 1 December 2017.
If your accident occurred after 1 December 2017, you will receive a letter from the CTP insurance company telling you that your claim has been received.
You will also receive a claim number that you must use when you contact the insurer about your claim. You should also give the claim number to your medical practitioners, who will send any bills directly to the insurer for payment.
The insurer will investigate the claim. Do not speak to an investigator without first consulting with your lawyer.
What happens after your claim has been received?
After your claim has been lodged and you’re given a claim number, the insurer will then investigate the claim.
As part of this investigation they will normally obtain a copy of the police accident report. You may also be required to speak to an investigator about your claim. If you are asked to speak to an investigator you should contact your Lawyer first to assist you in providing a statement to an investigator. Do not speak to an investigator without first consulting with your lawyer.
The insurer will then determine whether or not they will accept that you were wholly or predominantly at fault. The insurer must advise you before the end of the 52 weeks, usually around 9 months if they will accept liability beyond 52 weeks
You should speak to a lawyer about this decision.
If the insurer accepts your claim beyond 52 weeks
If fault is accepted the insurer will pay your reasonable and necessary medical, hospital, rehabilitation and travel expenses for life. The insurer will consider what medical treatment is reasonable and necessary and will pay your medical practitioners accordingly.
The maximum amount that an insurer has to pay for particular treatment is set out in the AMA list of medical services and fees. If your doctor charges over and above that set fee you may be responsible to cover the difference in cost.
To pay the medical practitioners, the insurer will require a copy of all accounts and/or receipts. You should ensure that you keep a copy of all of the original accounts and forward them to the insurer to request payment or reimbursement of expenses you have paid.
You will also continue to receive loss of income payments
If the insurer denies your claim beyond 52 weeks
If the insurer does not accept that their driver was at fault and/or that you have a threshold injury they will notify you writing and decline payments after 52 weeks. You should immediately contact your Lawyer to assist you in determining whether or not the insurer was correct in declining your claim.
The insurer will not pay for any medical treatment or loss of income beyond 52 weeks.
You will not need to refund any treatment paid for prior to this decision.
If the insurer makes no decision
On occasions the insurer will not make a decision within the required time frame. If this occurs you need to contact IRO NSW for assistance or a lawyer
The failure to decide your claim is however taken to be a denial of liability and you should again consult your lawyer if this occurs.
What is early rehabilitation?
If your claim is accepted by the insurer then they will engage in early rehabilitation to assist you with treatment after the motor vehicle accident. Rehabilitation aims to return the injured person to a level of function and quality of life comparable to their pre injury level. To do this they usually appoint a rehabilitation provider. A rehabilitation provider is a company appointed by the CTP insurer to provide rehabilitation services which include Occupational Therapist, Rehabilitation Counsellors, Psychologist and Exercise Psychologists.
The rehabilitation provider’s role is to assist you to develop a plan and goals to assist in your recovery and return to work.
The rehabilitation provider will assist the insurer in determining what treatment is reasonable and necessary.
What other benefits are paid by the insurer?
The only benefit that is paid upfront by the insurer are medical expenses and loss of income payments.
Occasionally if you are seriously injured an insurer will also pay for attendant care services. Attendant care services are services that provide assistance to people with everyday tasks and activities of daily living and can include personal assistance, nursing assistance, home maintenance and domestic services.
You may have a further claim available called a Common Law claim for damages, this is a claim for compensation as a one off lump sum. This may include:
- A lump sum for pain and suffering if you have an assessment of WPI greater than 10%
- Past and future loss of earning capacity
- Past and future loss of superannuation
This amount is determined once all evidence to prove your claim has been obtained by your lawyer.
The insurer is the approached to see if an agreement can be reached as to how much compensation you are entitled to receive as a result of the injury sustained. This is usually done by meeting with the insurer for an informal discussion known as an informal settlement conference (ISC).
If we cannot reach agreement then this we will be determine through the Personal Injury Commission.
It usually takes between 1 to 3 years for the date of an injury to finally resolve a claim, sometimes longer.
Should you have any questions please do not hesitate to contact us.
Disclaimer
The information contained on this article is of a general nature only and is not intended to be legal advice. The law may have changed since the information was published. There is no intention to create a lawyer-client relationship and you should always seek legal advice about your own personal circumstances.
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