What is the National Injury Insurance Scheme in Queensland

Gail Blaber

Head of Queensland CTP Claims | Brisbane

The National Injury Insurance Scheme (Queensland), or “NIISQ”, is a scheme which has operated since 1 July 2016 to assist people who have been catastrophically injured in a motor vehicle accident in Queensland.

NIISQ is a no fault scheme – meaning that you can participate in the scheme regardless of who was at fault for the accident. To be eligible to participate in the NIISQ, you must have sustained one of the following serious injuries:-

A permanent spinal cord injury;
A traumatic brain injury;
Multiple or high level limb amputations;
A permanent injury to the brachial plexus;
Severe burns;
Permanent blindness caused by trauma.

Once eligibility has been established, the NIISQ may fund necessary treatment, care and support, which includes:-

Rehabilitation;
Medical treatment;
Pharmaceutical treatment;
Dental treatment;
Prostheses;
Aids and appliances;
Respite care;
Educational and vocational training;
Home and transport modifications;
Attendant care and support;
Ambulance transportation.

Applications to participate in the NIISQ must be made within 12 months of the date of the accident. An application can be made by the injured person themselves, or by a hospital/person the injured person has authorised to make the application. In addition, CTP insurers can make applications to the NIISQ on an injured person’s behalf.

Once a participant has been accepted into the NIISQ, they will remain within the Scheme for two (2) years before being assessed for lifetime participation. If accepted as a Lifetime Participant, their treatment, care and support may be funded by the NIISQ for the rest of their life, unless they elect otherwise by “opting out” of the Scheme. There are strict timeframes that apply to preserving the right of lifetime participants to opt out of the NIISQ and pursue lump sum compensation.

The NIISQ operates alongside the CTP scheme and participants retain their rights to pursue common law damages claims from the CTP insurer of the at fault party. However, NIISQ will not provide compensation for loss of earnings, pain and suffering, and this remains the responsibility of the CTP insurer. In addition, there are various technical aspects to the interaction between the NIISQ and common law compensation which can sometimes be difficult to navigate, both when seeking rehabilitation support, and when negotiating settlement of a common law claim.

Without specialist advice from experienced personal injury lawyers, a NIISQ participant may not know what they may be entitled to, and additional treatment or support may significantly enhance their quality of life. If an injured person is unsatisfied with a decision made by the NIISQ about the treatment, care or support they are willing to fund, it may be possible to apply for a review of that decision.

In addition, if an injured person is a lifetime participant in NIISQ and has a common law CTP claim, the claimant will need to serve a preservation notice to preserve their right to pursue common law damages and the Scheme will need to be involved in any settlement negotiations. This is because the NIISQ is responsible for either funding their treatment, care and support for the injured person’s lifetime. If the injured person decides to “opt out” of the NIISQ upon settlement, they can accept their treatment, care and support damages as a lump sum. It is therefore essential that all aspects of future treatment, care and support needs are considered, and appropriate evidence is obtained, so that the injured person may make a fully informed decision on what would be best for their circumstances.

Given the complexities surrounding NIISQ participation, it is vital that seriously injured participants seek advice from an experienced personal injury lawyer.