In Queensland’s Compulsory Third Party (CTP) insurance claims process, the roles and responsibilities of claimants and CTP insurers are designed to promote the fair and efficient handling of claims. When parties follow their roles and responsibilities, this assists in ensuring a smoother claims process under the Queensland CTP scheme.
How CTP insurance works in Queensland
The CTP insurance scheme is underwritten by licensed insurers, meaning they take on the financial risk of claims and managing and paying them. In Queensland, CTP insurance claims operate under a common law system. This means claimants must prove that a motor vehicle was ‘at fault’ for the accident and for the injuries sustained to claim compensation for those injuries and losses. For more information, see Qld’s CTP scheme.
To start a claim, a person injured in a motor vehicle accident submits a Notice of Accident Claim Form to the CTP insurer of the vehicle that may have caused or contributed to the accident. The claims process includes collecting evidence, negotiating with the insurer, and either reaching an agreed settlement or going to court if needed. For more details, see What to do after an accident.
Claimants can choose to seek their own legal advice or legal representation at any stage of the claim. For more information on legal advice, see About legal advice.
Claims involving children (under 18 years) and litigation guardians
If a child under 18 is injured in a motor vehicle accident, they may be eligible for compensation under Queensland’s CTP insurance scheme. These claims require a litigation guardian (usually a parent or legal guardian) to act on their behalf. It is important to be aware that different timeframes apply for children compared to adult claims. For more information, see FAQs – Claims involving children (under 18 years).
MAIC’s role
The Motor Accident Insurance Commission (MAIC) regulates Queensland’s CTP insurance scheme. MAIC oversees the scheme by regulating the insurers, monitoring the claims management process and working to keep premiums fair and affordable. MAIC also supports research and education initiatives to help reduce road trauma and improve rehabilitation outcomes. For more information, see About MAIC and ND.
The claimant’s role
The claimant is responsible for:
- submitting a completed Notice of Accident Claim Form to the insurer, promptly and within the relevant timeframes
- being prepared to give specific information to the CTP insurer, including documents or records, if requested
- completing an Additional information form if requested by the insurer
- providing evidence to prove the claim, such as medical reports, witness statements, and proof of financial losses (e.g. payslips and tax returns)
- following medical advice, sharing recovery updates with the insurer, and attending medical examinations or other assessments if required
- informing the CTP insurer of any significant change that may affect the claim, such as a change in their medical condition or work situation
- taking all reasonable steps to recover from the sustained injuries, including undertaking recommended medical treatment, participating in recommended rehabilitation and returning to work as soon as able, or taking all reasonable steps to find work
- carefully considering and responding to settlement offers promptly (accepting, rejecting or making a counteroffer), and seeking legal advice if required, as settlements are final
- attending settlement conferences if required
- communicating openly and respectfully with the CTP insurer, even during disagreements
- being truthful in the claim, as providing false or misleading information is an offence under the Motor Accident Insurance Act 1994.
The CTP insurer’s role
The CTP insurer is responsible for:
- responding as the CTP insurer of the vehicle that may have caused the crash within 14 days of receiving the Notice of Accident Claim Form. They also advise if the claim form was lodged correctly and whether the CTP insurer will pay the costs of reasonable and appropriate treatment at that stage
- investigating the crash to decide who was at fault, using evidence including police reports and witness statements, and advising of a liability decision within six months from the date of receiving a correctly lodged claim form
- processing the claim, including reviewing the claimant’s medical reports and treatment needs
- assessing how the claimant’s injuries affect their life, work and daily activities
- funding ‘reasonable and appropriate’ rehabilitation services, such as physiotherapy or counselling
- attempting to settle the claim as soon as possible and paying compensation if the claim is successful. The amount of compensation will depend on how serious a claimant’s injuries are and how the injuries affect the claimant’s life. This may include money for things such as medical costs, lost income and pain and suffering. Each claim is different and will depend on the facts and circumstances of each case
- communicating openly and respectfully with the claimant, providing clear and timely updates, and answering their questions
- offering ways to resolve disputes if issues arise.
Claims process disagreements
Open and respectful communication is key. Disputes may arise about who was at fault for the motor vehicle accident, rehabilitation, the value of the claim, or settlement terms, but constructive communication can help resolve them effectively.
For more details on resolving disagreements, visit Resolving claims disagreements.