Lifetime Care Scheme May Not Be The Complete Future Care Solution

Published 23 Aug 2012

NO FAULT SCHEME CHILDREN UNDER 16 YEARS

SUPPORT FOR CATASTROPHICALLY INJURED

MOTOR VEHICLE ACCIDENTS

In 2007 the Government implemented the Lifetime Care and Support Authority. The Authority was brought into existence to cover those people who were seriously injured in motor vehicle accidents regardless of whether the accident was their fault or not.

The Scheme was designed to help those eligible including those who had sustained traumatic brain injury, serious orthopaedic injury in particular, catastrophic spinal injury resulting in paraplegia or quadriplegia, severe brain damage or significant amputation.

The Lifetime Care Authority was brought into existence to ensure that medical and treatment expenses were paid for as was required, respite and attendant care services and domestic services were paid for and all aids and equipment, rehabilitation, transport and other expenses related to treatment and rehabilitation were paid for. Of course, the overwriting principal was that they were paid for provided they were considered reasonable and necessary.

The Scheme was considered and is still considered useful for those people who were at fault in a motor vehicle accident and who had no way of meeting the significant medical and treatment costs resulting from a catastrophic injury. It also covers those who were not at fault but who may also have a significant contributory negligence component due to alcohol or speed. Of course, for those individuals who were not at fault there is no bar at all in terms of being a participant in the Scheme and having all your medical, treatment and rehabilitation expenses paid for under the Scheme. The purposes of the scheme was to minimise the involvement of insurers. All insurers were required to pay into a fund to ensure the smooth operation of the Scheme.

Entry to the Scheme can be by way of nomination from a hospital from the Emergency Department from an insurer or from someone who has been catastrophically injured by applying to the Lifetime Care Authority.

Gerard Malouf & Partners have a significant number of catastrophically injured clients who have qualified under the Lifetime Care Authority and who receive ongoing benefits. Eligibility into the Lifetime Care Scheme does not prohibit an injured victim’s entitlement to claim past and future wage loss, non economic loss (general damages – pain and suffering) resulting from the injuries sustained in the accident. It is necessary to ensure that you receive professional legal advice in relation to entitlements even if you are already under the Lifetime Care Scheme. You need to ensure that your rights and future entitlements for the other heads of damages which include non economic loss and past and future economic loss are properly compensated for.

The Scheme currently has accident victims who have suffered quadriplegia or paraplegia, significant spinal injury, serious burns, brain damage and continues to pay for their medical and treatment expenses. Each person becomes a participate of the scheme for two years and at that stage consideration will be given as to whether they are permanently placed on the scheme or otherwise are therefore eligible to claim full compensation entitlements for all heads of damages.

Vrege (Reg) Kolokossian – Managing Partner at Gerard Malouf & Partners and also NSW Personal Injury Accredited Specialist solicitor says “The Scheme has significant limitations in terms of the allowances made for ongoing gratuitous care and the need for future paid care as the Lifetime Care Authority is the body who determines what is considered reasonable and necessary in terms of that level of paid care. Our experience has been that the level of paid care allowed by the Authority both in terms of past and future care is significantly underestimated by them and places all participants who have sustained catastrophic injury at a disadvantage.” Vrege also comments that “For a lot of the victims of catastrophic injuries it is up to the Lifetime Care Authority to determine what treatment they consider as being reasonable and necessary. This is not really satisfactory as it leaves those injured victims at the mercy of decisions made by the administrative staff within the Authority. The disadvantages for the injured victims are also that the funding of the Scheme will always be underestimated and therefore the level of future care required in my view will be less than satisfactory.”

It is for these reasons that it is essential that you ensure you obtain appropriate legal advice by personal injury accredited specialists such as Gerard Malouf & Partners who have over 25 years of experience in motor vehicle injury claims and who are New South Wales accredited personal injury specialist lawyers.