No-fault Accident Compensation Schemes

If you suffer a catastrophic injury in Queensland, your life will change forever. So it’s good to know there is a no-fault accident compensation scheme that can provide funding for the services and support you need – perhaps even for the rest of your life.

Find out more about the criteria for making a claim under these No-fault Accident Compensation Schemes and contact us if you believe you have a claim.

 National Injury Insurance Scheme Queensland

In 2011, the National Injury Insurance Scheme Queensland (NIISQ) was proposed to provide funding for people who have suffered catastrophic injuries caused by various types of accidents. Unfortunately, the scheme is still only partially implemented and only in Queensland. 

The National Injury Insurance Scheme Queensland (NIISQ) provides funding for people who need ongoing support and treatment for serious injury after a motor vehicle accident specifically.

Under this no-fault scheme, you can get help no matter who caused your injury.

Motorists fund the NIISQ through a levy they pay as part of their Compulsory Third Party insurance.

Funding can pay for ongoing treatment, care and support such as:

• rehabilitation
• medical and pharmaceutical treatment
• dental treatment
• prostheses
• aids and appliances
• respite care
• education and training
• home and transport modifications
• attendant care
• ambulance.

Items and services not covered under the NIISQ include:

• wages/economic loss, and pain and suffering (though you could make a claim under the other driver’s CTP insurance if they were at fault)
• rent, utilities, holidays, and personal or household items 
• child minding 
• services provided by unregistered providers
• services for someone other than the participant
• transport costs, other than for treatment and rehabilitation.

Eligibility for NIISQ funding

You may be eligible for funding if you’ve suffered a serious personal injury due to a motor vehicle accident in Queensland since 1 July 2016. A ‘serious’ injury is defined by law as a:

• permanent spinal cord injury
• traumatic brain injury
• multiple or high-level limb amputation
• permanent injury to the brachial plexus
• severe burn
• permanent blindness caused by trauma.

There are no age restrictions on funding, and you don’t need to be an Australian citizen or permanent resident. However, your eligibility might be suspended if you leave Australia for more than 3 months. 

If you’re from another Australian state or territory, and you suffer a serious personal injury due to a motor vehicle accident in Queensland, you may be able to access these no-fault accident compensation schemes and NIISQ funding if you meet the eligibility requirements.

Applying for NIISQ funding

If you or a loved one is seriously injured in a motor vehicle accident in Queensland, you can apply to NIISQ by completing an application form and providing a medical certificate.

In your application, you need to provide details about the car accident and the extent of your injuries. Provide as much evidence as you can, including witness statements, police reports, medical reports, photos and video, and any other supporting documentation that will help. 

Your personal injury lawyer can help you gather this information, as you may be too unwell to do this yourself. We work on your behalf to ensure a smooth process.

The NIISQ Agency will assess your application and, if you’re accepted, they will assess your needs and arrange funding with relevant support and service providers.

If NIISQ rejects your claim

If the NIISQ denies your application, this isn’t necessarily the end. There are other avenues we can help you explore to get you the funding you need.

You have the right to request of review of NIISQ’s decision about your eligibility. This involves requesting an internal review, conducted by NIISQ itself. However there are strict timeframes – you must request this review within 28 days.

If you don’t get the response you need and we believe you could still be eligible for NIIS funding, we can help you apply for an external review through either the Medical Assessment Tribunal or the Queensland Civil and Administrative Tribunal.

Serious injury due to work-related accidents

If your serious personal injury was caused by a work accident rather than a motor vehicle accident, you might be eligible for lifetime treatment, care and support under workers compensation legislation.

Workers compensation is also a no-fault accident compensation scheme that provides support until you’re well enough to return to work. However, if it becomes clear that your injury is permanent and you can’t work, you will be considered to have suffered permanent impairment.

At this point, WorkCover will send you for a medical assessment to determine your percentage of permanent impairment and offer you a lump sum amount of compensation.

As the NIISQ doesn’t cover workplace accidents, your workers compensation insurer will make determinations about your injury and the accident. 

However, Queensland insurers have engaged the NIISQ Agency to manage eligible workers’ treatment, care and support. The agency works with WorkCover Queensland and other workers compensation insurers to: 

• facilitate partnerships between injured workers and medical professionals
• ensure social workers and/or hospital staff are aware of the scheme and refer eligible workers early
• support workers through a referral to the NIISQ Agency
• identify and/or coordinate suitable return-to-work opportunities.

What about public liability and medical negligence claims?

If you have suffered a serious injury due to medical negligence, or an accident out in the community, you can’t apply for funding under the NIISQ at this point.

However, there are other options open to you. For example, you might be eligible to make a claim under the National Disability Insurance Scheme (NDIS).

If the accident occurred in a shop or on public transport – and due to someone else’s negligence – you may make a claim against the at-fault party’s public liability insurance. Or if your injury was caused by the negligence of a medical professionals, you may make a claim against their medical malpractice insurance. 

However, these are not no-fault claims – you need to be able to prove your injury was caused by negligence.

If your injury meets the criteria for a public liability or medical malpractice claim, we can help you collect the evidence you need and negotiate with insurers on your behalf. Get in touch with Main Lawyers to discuss your situation with us. 

Car accidents in other states or territories

The NIISQ applies only to motor vehicle accidents in Queensland, so you can’t claim NIISQ funding if your accident occurred in another state or territory. However, other Australian states and territories have a scheme that’s equivalent to the NIIS.

Making a CTP claim

If you’re injured in a motor vehicle accident due to another driver’s negligence (even partial), you may be eligible to make a CTP claim. This is a claim against the Compulsory Third Party insurer of the at-fault vehicle.

Even if you’re an NIISQ participant, you can make a CTP claim. Any settlement you receive won’t include the treatment, care and support component that’s funded by NIISQ. And you won’t have to repay any funding paid by NIISQ, as the settlement amount will exclude these.

Make sure you get legal advice from a lawyer experienced in car accident claims to get all the information you need.

Opting out to claim a lump sum

If you’re receiving funding from the NIISQ and want to claim a lump sum for your treatment, care and support, you need to meet some criteria. To opt out, you must:

• be a lifetime NIISQ participant
• have a valid CTP claim
• have less than 50% contributory negligence (i.e. be less than 50% at fault for the accident)
• not have been excluded from getting a lump sum by a court.

If you take this option, you’ll stop receiving funding through the NIISQ.

To do this, you need to send a ‘preservation notice’ to the CTP insurer and the NIISQ stating that you intend to claim a lump sum for damages for future treatment, care and support.