Intent of Scheme
The National Injury Insurance Scheme (“NIIS”) is a no-fault scheme that provides lifetime treatment, care and support to those who sustain serious personal injuries in a motor vehicle or work related incident in Queensland on or after 1 July 2016.
Queensland workers’ compensation insurers have engaged the National Injury Insurance Agency Queensland (“NIISQ Agency”) to manage eligible individuals’ treatment, care and support on their behalf.
Who is eligible?
In order to be eligible for the scheme, individuals must have suffered a serious personal injury in a motor vehicle or workplace incident. Serious permanent injury is defined to include permanent spinal cord injuries, traumatic brain injuries, multiple or high level limb amputations, permanent injuries to the brachial plexus, severe burns and permanent legal blindness.
Individuals who are eligible for the scheme may receive a wide range of treatment, care and support services including (but not limited to) medical/pharmaceutical treatment, dental treatment, rehabilitation, home/transport modifications and attendant care.
The need for lifetime support for catastrophically injured individuals
Approximately half of all individuals who sustain serious personal injury in a motor vehicle incident are not eligible to seek compensation from a CTP insurer. This is because the Queensland motor vehicle claims process is fault based. This means that there is no cover for individuals who are considered at fault for an incident or alternatively are involved in an incident where there was no negligent party. For example, an individual who swerved to avoid collision with an animal or suffered an unexpected medical complication while driving would not be entitled to make a claim for compensation against a CTP insurer for injuries suffered as a result.
The intention of the NIIS is to ensure that all individuals who are catastrophically injured in a motor vehicle or workplace incident will be entitled to a lifetime of care and support, regardless of whether they are able to prove that another party was responsible for their injuries.
In contrast to the Queensland motor vehicle scheme, workers’ compensation schemes operate on a no-fault coverage ensuring that all individuals will receive some form of compensation if they are injured in a workplace incident. However, lifetime care and support is not always available in every jurisdiction and the extent of available entitlements can depend upon the jurisdiction in which the incident occurred.
Some of the workers’ compensation schemes fall slightly short of the minimum benchmarks targeted by the NIIS, such as restrictions on attendant care and allowing workers to substitute their existing and future rights in exchange for a lump sum payment by the insurer. Workers who are catastrophically injured as a result of a workplace incident require particularly high and sustained levels of care and support across their lifetime. The low prevalence of catastrophic workplace injuries means that workers’ compensation schemes are generally not adequately equipped to provide sufficient support.
However, the changes required to the existing workers’ compensation scheme are relatively minor compared to those required for the motor incident insurance scheme.
Article prepared by Anna Lambrianides. Anna is a Lawyer in Quinn & Scattini Lawyers’ Compensation Claims Team.
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