If you’ve made a CTP claim you’ve probably been told you don’t need a solicitor. In fact, a solicitor can’t charge for their time to help you complete your initial application for personal injury benefits (statutory benefits), and if they do help you, it can only be as a free service.
However, getting a solicitor to help you with your CTP claim can dramatically increase the benefits you receive. And what you’re probably not being told is that there are many situations where you can get your solicitor’s fees paid by the insurer.
This article explains when you should use a solicitor, what it will cost, when you can get the insurer to pay for your solicitor and how you can get free legal support.
Lodging your initial claim.
The application form appears simple, but what you write and the evidence you provide can have a significant impact on the benefits you receive. In particular the documentation of your injuries and whether they’re classified as minor will determine if you’re entitled to a lump sum, and often results in your benefits being cut off after six months.
Also, although the application process may appear straightforward, many applicants have benefits denied by the insurer. For example, the insurer may deny your treatment expenses, or travel to and from your treatment provider. They may also dispute the injuries you’ve sustained or the severity of your injuries. If this happens, your wages and other benefits could be cut off at any time during this period, so you’ll be forced to dispute the insurer’s decision.
Although a solicitor can’t be paid to assist you with completing your application, it’s a good idea to have it reviewed by a solicitor prior to lodging with SIRA or the insurer. In fact, it’s ideal to have a solicitor on your side as soon as possible, so that they’ll be familiar with your case and can offer you legal assistance as your claim progresses. See the section at the bottom of this article on how to get free legal support throughout your claim.
If you’re disputing the insurer’s decision over your benefits, the first step is to ask the insurance company to undertake an Insurer Internal Review, or IIR. SIRA prevents your lawyer from being paid to assist you in raising an IIR, however you can get a lawyer to review your IIR application for free – see the section at the bottom of this article for more information.
If the insurer doesn’t accept your dispute, then the next step is to raise a dispute with the Dispute Resolution Service (DRS). There are two types of disputes – paid disputes and unpaid disputes.
A paid dispute is a dispute that a solicitor can charge for, and the fees are fixed and paid by the insurer. You won’t have to pay anything to have a solicitor assist you with a paid dispute.
If a solicitor helps you with an unpaid dispute, they must do it free of charge.
Here are the most common dispute types:
- Definition of minor injury – paid dispute
- Not receiving reimbursement of expenses – unpaid dispute
- Not approving appropriate treatment or travel expenses – paid dispute
- Not receiving correct weekly payment of lost wages – unpaid dispute
Disputes are divided into three categories – Medical Disputes, Merit Disputes and Miscellaneous Disputes. Your lawyer will earn generally $1,600 for each paid dispute to a maximum of $6,000 for each dispute category. But you don’t need to worry about these fees – they’re paid for by the insurer under the CTP scheme.
For some disputes you’ll need a medical report to provide supporting evidence – for example, if you’re disputing the definition of your injury as “minor”.
The cost of the medical report will also be covered by the insurer up to a set amount. For most reports the insurer will reimburse you up to $1,600. If you don’t have a lawyer, you’ll be required to pay for these medical reports up front and then you’ll be reimbursed after the DRS determination, whether you’re successful or not. However, if you do have a lawyer, most good law firms will cover these expenses for you.
If your dispute has gone to the DRS, then the doctor completing the report must be approved by SIRA – click here to see the approved doctor list. If your doctor isn’t SIRA approved, then their report can’t be used at the DRS determination.
Lump sum claims.
If you’re applying for common law damages (lump sum) compensation, there’s a schedule of fixed fees a solicitor can be paid to assist you for claims up to $75,000, and these fees are paid by the insurer.
If your settlement amount is greater than $75,000, then the solicitor can “contract out” of the fixed fees (i.e.) they can charge an amount set by them, with your agreement. This agreement is known as a “costs agreement”, and only applies to the amount they charge for your claim over the $75,000 threshold. The fixed fees still apply to the work they do for the first $75,000 of your claim, and are still paid by the insurer.
When contracting out, solicitors will generally either charge by the hour, or for set fees according to each service they provide. They can’t charge a percentage of your claim amount, however they can “cap” their fees at a percentage of the amount they successfully claim over and above $75,000.
No Win, No Fee.
Many personal injury lawyers will work on a no win no fee basis, so their fees will come out of your settlement – you shouldn’t have to pay anything up front.
So, when should I use a solicitor?
- If you disagree with the insurer, you should contact a solicitor before you lodge your dispute.
- If you’re claiming lump sum benefits, you should contact a solicitor before you lodge your claim.
What if I want help with my initial application for personal injury benefits?
Solicitors can’t charge to help you apply, so we’ve introduced a free claim check service. You just register your details with this service, and you’ll get a free claim review with a lawyer to determine what benefits you’re entitled to, and you’ll get support throughout your claim. Then if a paid dispute arises or if you’re entitled to a lump sum, a dedicated solicitor will be assigned to your case, to make sure you get your full entitlements.
Our free claim check service.
By registering with this service you’ll get:
- A free one-on-one claim review with a lawyer
- Free legal assistance when you raise an IRR
- Free legal assistance with unpaid disputes
- A dedicated solicitor to help with paid disputes and lump sum applications, with all fees paid by the insurer (no cost to you)
- If your lump sum exceeds $75k, your dedicated solicitor will offer to work for you on a no win no fee basis, and only be paid after you receive your lump sum.
Click “start now” at the bottom of this article to register for your free claim check now.
…the insurer has legal, medical and financial experts on their side supporting their decisions – so it’s not exactly an even playing field.