For a small number of people each year, a road accident causes an injury that changes everything: a spinal cord injury, a severe brain injury, the loss of limbs, severe burns, permanent blindness. Queensland responded in 2016 with the National Injury Insurance Scheme (Queensland), NIISQ, which sits alongside the CTP scheme and covers the treatment, care and support these injuries need for life, whether or not anyone was at fault.

Key points

  • NIISQ provides lifetime treatment, care and support for serious injuries from motor accidents since 1 July 2016, regardless of fault.
  • A CTP claim against the at-fault insurer still covers lost income, general damages and other losses NIISQ does not.
  • A participant may elect to leave NIISQ for a lump sum from the insurer; the election is irreversible and needs advice.

Who NIISQ covers

NIISQ applies to people who suffer a serious personal injury in a motor vehicle accident in Queensland on or after 1 July 2016. The eligibility criteria are medical and specific: permanent spinal cord injury, moderate to severe traumatic brain injury, multiple or high-level amputations, severe burns, and permanent blindness, each defined by clinical thresholds. Fault is irrelevant. A driver who caused their own single-vehicle accident is covered on the same terms as a pedestrian who was hit.

What it provides

Necessary and reasonable treatment, care and support for the rest of the participant's life: hospital and medical treatment, rehabilitation, attendant care, aids and equipment, home and vehicle modifications, and educational and vocational support. It is provided as services and funding as the need arises, rather than as a lump sum, so it does not run out. Participants are accepted on an interim basis initially and become lifetime participants once the injury is confirmed as permanent.

How it fits with a CTP claim

NIISQ covers treatment, care and support. It does not cover the other losses a serious injury causes: lost income for the rest of a working life, the injury itself (general damages), and the loss of the life the person would have had. Where another driver was at fault, those losses remain claimable against the CTP insurer in the ordinary way.

There is, however, a choice to be made. A NIISQ participant with a CTP claim can either remain in NIISQ for lifetime care and claim the other heads of damage from the insurer, or elect to leave NIISQ and claim a lump sum for future care from the insurer as well. The election is significant and irreversible, and the Act sets conditions on when it can be made. For most people, lifetime care that cannot run out is the safer course; for some, particularly where the care needs are well defined and a lump sum offers flexibility, the alternative is right. It is a decision to make with legal and financial advice and with the family involved.

Timeframes

An application to NIISQ should be made as early as possible after the accident; the scheme can accept people while they are still in hospital and begin funding immediately. The CTP claim runs on its ordinary deadlines: notice within nine months, court within three years. For serious injuries the CTP claim will take longer than most, because the medical evidence about lifetime needs takes time to assemble, and it should not be settled early.

Dependants

Where an accident is fatal, the family of the deceased may claim against the CTP insurer for the loss of financial support and for funeral expenses, under the Civil Proceedings Act. NIISQ does not apply to fatal injuries.

Frequently asked questions

What injuries does NIISQ cover? Permanent spinal cord injury, moderate to severe traumatic brain injury, multiple or high-level amputations, severe burns and permanent blindness, each defined by clinical criteria.

Can I be in NIISQ and still make a CTP claim? Yes. NIISQ covers care; the CTP claim covers economic loss, general damages and other heads where another driver was at fault.

Does NIISQ cover accidents where I was at fault? Yes. Eligibility depends on the injury, not on fault.

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