Compensation Claims and the National Injury Insurance Scheme

When a person suffers serious injuries and requires funding assistance for reasonable medical treatment, care and support, they may be eligible to become a member of the National Injury Insurance Scheme, Queensland (NIISQ).

In addition, if the accident is due to someone else’s fault, the injured person may also be entitled to make a claim for compensation for their loss and damage caused by the negligence.

WHAT IS NIISQ?

NIISQ funds necessary and reasonable treatment, care and support for people who have sustained an eligible serious personal injury in a motor vehicle accident in Queensland, on or after 1 July 2016.

NIISQ is a no-fault Scheme, meaning necessary and reasonable treatment, care and support can be funded regardless of who was at fault in the accident.

Please note that NIISQ & the National Disability Insurance Scheme (NDIS) are two separate schemes designed to provide funding and access to support for people with a disability.

ELIGIBILITY FOR NIISQ

The injured person must meet all eligibility criteria outlined in the National Injury Insurance Scheme (Queensland) Act 2016 (the NIISQ Act) and the National Injury Insurance Scheme (Queensland) Regulation 2016 (the Regulation).

To summarise, eligible participants must have suffered serious personal injuries as a result of a motor vehicle accident in Queensland, on or after 1 July 2016.

There are no age restrictions for eligibility and no requirement to be an Australian citizen, permanent resident or visa requirement.

Participants will remain supported throughout Australia, however eligibility may be suspended if a participant leaves Australia for more than three months.

There is also an initial two-year period as an interim participant, followed by reassessment, and then lifetime participation if eligible.

ELIGIBLE SERIOUS INJURIES & NIISQ FUNDING

Those with serious or catastrophic injuries are eligible to access NIISQ. Examples of “serious personal injury” include but are not limited to:

1. Permanent spinal cord injuries;
2. Quadriplegia, tetraplegia, etc.;
3. Traumatic brain injuries;
4. Limb amputations;
5. Severe burns;
6. Permanent blindness caused by trauma, etc.

For eligible serious injury claimants, NIISQ funds the costs of medical treatment, equipment, aids, rehabilitation costs, medication prostheses, dental treatment, attendant care and support, respite care, educational and vocational training, home and transport modifications, ambulance costs.

NIISQ APPLICATION – LIFETIME PARTICIPANT

To claim NIISQ support, you (or your support person) must lodge an application for “interim participation” for the NIISQ Agency to consider. The application must be lodged within 12 months, although there is some discretion for NIISQ to accept applications outside of this timeframe.

If the application is accepted, NIISQ will assume management and control of your reasonable medical treatment, rehabilitation, and care and support, and you will remain in the scheme for up to 2 years. During this time, NIISQ will liaise with you, your support person, lawyer, and each of your treatment providers to facilitate the provision of your treatment and support.

Within the 2-year period, NIISQ will re-assess you to determine whether you qualify as a “lifetime participant” with permanent access to NIISQ support for the rest of your life.

COMPENSATION CLAIMS – MOTOR VEHICLE ACCIDENTS ONLY

It is important to note that where a lifetime participant commences a claim for compensation under the Motor Accident Insurance Act 1994 (“MAIA”), they are required to decide to either: -

1. remain in the scheme to receive lifelong treatment and care benefits from NIISQ, with those items being excluded from your lump sum CTP claim; or
2. opt out of the NIISQ scheme to pursue lump sum compensation for treatment and care through your CTP claim instead.

Please note that this decision is only required if your claim is commenced under the MAIA. Part 3 of the NIISQ Act defines insurers as only those under the statutory insurance scheme under the Insurance Act, being the MAIA. Therefore, the NIISQ preservation notice is only required to be provided where a claim is commenced against CTP insurers.

OTHER COMPENSATION CLAIMS

Please note that this does not include claims made under the Personal Injuries Proceedings Act 2002 (“PIPA”) or the Workers Compensation and Rehabilitation Act 2003 (“WCRA”).

WorkCover, other Worker’s Compensation, and public liability insurers are not included and therefore, a preservation notice is not required. Therefore, they may continue to receive NIISQ benefits and recover damages from their compensation claims under PIPA and/or WCRA.

NOT A LIFETIME PARTICIPANT

If you do not qualify as a lifetime participant, then you will exit the NIISQ scheme and will be entitled to claim treatment and care costs as part of a lump sum claim from the CTP insurer (if available to you). You
will not have to refund any amounts paid by NIISQ for treatment and care from your CTP claim.

HOW WE CAN HELP

The Compensation Team at Wallace & Wallace Lawyers are experienced in all aspects of Compensation Law.

We are able to assist you to determine if you are eligible for NIISQ entitlements, and or if you are entitled to make a claim for compensation for the personal injuries, or both.

If you are dissatisfied with your current representation, our experts can also offer a second opinion.  

If you, or someone you know has been injured in a motor vehicle accident, at work, or due to someone else’s fault, or you want a second opinion, call us now on (07) 4963 2000 or contact us via our online contact form for practical legal advice on how you should proceed.