{"id":"qld:act-2016-034","name":"National Injury Insurance Scheme (Queensland) Act 2016","slug":"national-injury-insurance-scheme-queensland-act-2016","collection":"act","jurisdiction":"qld","status":"in_force","isInForce":true,"actNumber":"34 of 2016","makingDate":null,"administeringDepartment":null,"currentVersion":{"id":174723,"registerId":"qld-qld:act-2016-034-current","compilationNumber":null,"startDate":"2026-04-05","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"ch.1-pt.1","sectionType":"part","heading":"Introduction","content":"# Introduction","sortOrder":0},{"sectionNumber":"sec.1","sectionType":"section","heading":"Short title","content":"### sec.1 Short title\n\nThis Act may be cited as the National Injury Insurance Scheme (Queensland) Act 2016 .","sortOrder":1},{"sectionNumber":"sec.2","sectionType":"section","heading":"Commencement","content":"### sec.2 Commencement\n\nThe following provisions commence on a day to be fixed by proclamation—\nchapter 4 , part 2 ;\nchapter 10 , part 1 and part 2 , division 2 , subdivision 3 .\nThe remaining provisions of this Act commence on 1 July 2016.\n(sec.2-ssec.1) The following provisions commence on a day to be fixed by proclamation— chapter 4 , part 2 ; chapter 10 , part 1 and part 2 , division 2 , subdivision 3 .\n(sec.2-ssec.2) The remaining provisions of this Act commence on 1 July 2016.\n- (a) chapter 4 , part 2 ;\n- (b) chapter 10 , part 1 and part 2 , division 2 , subdivision 3 .","sortOrder":2},{"sectionNumber":"ch.1-pt.2","sectionType":"part","heading":"Purpose and application","content":"# Purpose and application","sortOrder":3},{"sectionNumber":"sec.3","sectionType":"section","heading":"Purpose of Act and achieving purpose","content":"### sec.3 Purpose of Act and achieving purpose\n\nThe purpose of this Act is to ensure that persons who suffer particular serious personal injuries as a result of a motor accident in Queensland receive necessary and reasonable treatment, care and support, regardless of fault.\nThe purpose is achieved by establishing—\na national injury insurance scheme, Queensland for—\nassessing the treatment, care and support needed by participants in the scheme; and\nmaking payments for the treatment, care and support of participants; and\na National Injury Insurance Agency, Queensland to administer the scheme; and\na national injury insurance scheme fund, Queensland.\n(sec.3-ssec.1) The purpose of this Act is to ensure that persons who suffer particular serious personal injuries as a result of a motor accident in Queensland receive necessary and reasonable treatment, care and support, regardless of fault.\n(sec.3-ssec.2) The purpose is achieved by establishing— a national injury insurance scheme, Queensland for— assessing the treatment, care and support needed by participants in the scheme; and making payments for the treatment, care and support of participants; and a National Injury Insurance Agency, Queensland to administer the scheme; and a national injury insurance scheme fund, Queensland.\n- (a) a national injury insurance scheme, Queensland for— (i) assessing the treatment, care and support needed by participants in the scheme; and (ii) making payments for the treatment, care and support of participants; and\n- (i) assessing the treatment, care and support needed by participants in the scheme; and\n- (ii) making payments for the treatment, care and support of participants; and\n- (b) a National Injury Insurance Agency, Queensland to administer the scheme; and\n- (c) a national injury insurance scheme fund, Queensland.\n- (i) assessing the treatment, care and support needed by participants in the scheme; and\n- (ii) making payments for the treatment, care and support of participants; and","sortOrder":4},{"sectionNumber":"sec.4","sectionType":"section","heading":"Application of Act","content":"### sec.4 Application of Act\n\nThis Act applies in relation to a serious personal injury caused by, through or in connection with a prescribed vehicle, if—\nthe injury is a result of—\nthe driving of the prescribed vehicle; or\na collision, or action taken to avoid a collision, with the prescribed vehicle; or\nthe prescribed vehicle running out of control; or\na defect in the prescribed vehicle causing loss of control of the vehicle while the vehicle is being driven; and\nthe incident (the motor accident ) resulting in the injury happens in Queensland on or after 1 July 2016.\nHowever, this Act does not apply in relation to a serious personal injury caused by, through or in connection with an uninsured motor vehicle, other than a prescribed vehicle stated in subsection (3) (a) , unless the motor accident resulting in the injury happens on a road or public place.\nAlso, this Act does not apply in relation to a serious personal injury caused by, through or in connection with—\nany of the following prescribed vehicles unless the motor accident resulting in the injury happens on a road—\na tractor, backhoe, bulldozer, end-loader, forklift, industrial crane or hoist, or other mobile machinery;\nan agricultural machine;\na motor vehicle adapted to run on rail or tram tracks;\nan amphibious vehicle;\na motor vehicle prescribed by regulation; or\na prescribed vehicle that, at the particular time of the motor accident resulting in the injury, is being used for the actual doing of an act or making of a threat that is an act of terrorism.\nIn this section—\nact of terrorism see the Insurance Act , section 4B .\nagricultural machine means a machine with its own automotive power that is—\nbuilt to perform agricultural tasks; and\nbeing used for agricultural purposes.\ntractors and harvesters being used for agricultural purposes\nmobile machinery see the Insurance Act , section 4 .\npublic place see the Transport Operations (Road Use Management) Act 1995 , schedule 4 .\nroad see the Transport Operations (Road Use Management) Act 1995 , schedule 4 .\nuninsured motor vehicle means a prescribed vehicle—\nfor which a CTP insurance policy is not in force; and\nof which a self-insurer is not the registered owner; and\nthat is not a trailer.\n(sec.4-ssec.1) This Act applies in relation to a serious personal injury caused by, through or in connection with a prescribed vehicle, if— the injury is a result of— the driving of the prescribed vehicle; or a collision, or action taken to avoid a collision, with the prescribed vehicle; or the prescribed vehicle running out of control; or a defect in the prescribed vehicle causing loss of control of the vehicle while the vehicle is being driven; and the incident (the motor accident ) resulting in the injury happens in Queensland on or after 1 July 2016.\n(sec.4-ssec.2) However, this Act does not apply in relation to a serious personal injury caused by, through or in connection with an uninsured motor vehicle, other than a prescribed vehicle stated in subsection (3) (a) , unless the motor accident resulting in the injury happens on a road or public place.\n(sec.4-ssec.3) Also, this Act does not apply in relation to a serious personal injury caused by, through or in connection with— any of the following prescribed vehicles unless the motor accident resulting in the injury happens on a road— a tractor, backhoe, bulldozer, end-loader, forklift, industrial crane or hoist, or other mobile machinery; an agricultural machine; a motor vehicle adapted to run on rail or tram tracks; an amphibious vehicle; a motor vehicle prescribed by regulation; or a prescribed vehicle that, at the particular time of the motor accident resulting in the injury, is being used for the actual doing of an act or making of a threat that is an act of terrorism.\n(sec.4-ssec.4) In this section— act of terrorism see the Insurance Act , section 4B . agricultural machine means a machine with its own automotive power that is— built to perform agricultural tasks; and being used for agricultural purposes. tractors and harvesters being used for agricultural purposes mobile machinery see the Insurance Act , section 4 . public place see the Transport Operations (Road Use Management) Act 1995 , schedule 4 . road see the Transport Operations (Road Use Management) Act 1995 , schedule 4 . uninsured motor vehicle means a prescribed vehicle— for which a CTP insurance policy is not in force; and of which a self-insurer is not the registered owner; and that is not a trailer.\n- (a) the injury is a result of— (i) the driving of the prescribed vehicle; or (ii) a collision, or action taken to avoid a collision, with the prescribed vehicle; or (iii) the prescribed vehicle running out of control; or (iv) a defect in the prescribed vehicle causing loss of control of the vehicle while the vehicle is being driven; and\n- (i) the driving of the prescribed vehicle; or\n- (ii) a collision, or action taken to avoid a collision, with the prescribed vehicle; or\n- (iii) the prescribed vehicle running out of control; or\n- (iv) a defect in the prescribed vehicle causing loss of control of the vehicle while the vehicle is being driven; and\n- (b) the incident (the motor accident ) resulting in the injury happens in Queensland on or after 1 July 2016.\n- (i) the driving of the prescribed vehicle; or\n- (ii) a collision, or action taken to avoid a collision, with the prescribed vehicle; or\n- (iii) the prescribed vehicle running out of control; or\n- (iv) a defect in the prescribed vehicle causing loss of control of the vehicle while the vehicle is being driven; and\n- (a) any of the following prescribed vehicles unless the motor accident resulting in the injury happens on a road— (i) a tractor, backhoe, bulldozer, end-loader, forklift, industrial crane or hoist, or other mobile machinery; (ii) an agricultural machine; (iii) a motor vehicle adapted to run on rail or tram tracks; (iv) an amphibious vehicle; (v) a motor vehicle prescribed by regulation; or\n- (i) a tractor, backhoe, bulldozer, end-loader, forklift, industrial crane or hoist, or other mobile machinery;\n- (ii) an agricultural machine;\n- (iii) a motor vehicle adapted to run on rail or tram tracks;\n- (iv) an amphibious vehicle;\n- (v) a motor vehicle prescribed by regulation; or\n- (b) a prescribed vehicle that, at the particular time of the motor accident resulting in the injury, is being used for the actual doing of an act or making of a threat that is an act of terrorism.\n- (i) a tractor, backhoe, bulldozer, end-loader, forklift, industrial crane or hoist, or other mobile machinery;\n- (ii) an agricultural machine;\n- (iii) a motor vehicle adapted to run on rail or tram tracks;\n- (iv) an amphibious vehicle;\n- (v) a motor vehicle prescribed by regulation; or\n- (a) built to perform agricultural tasks; and\n- (b) being used for agricultural purposes.\n- (a) for which a CTP insurance policy is not in force; and\n- (b) of which a self-insurer is not the registered owner; and\n- (c) that is not a trailer.","sortOrder":5},{"sectionNumber":"sec.5","sectionType":"section","heading":"Act binds all persons","content":"### sec.5 Act binds all persons\n\nThis Act binds all persons, including the State, and, to the extent the legislative power of the Parliament permits, the Commonwealth and the other States.\nHowever, the State, the Commonwealth or another State can not be prosecuted for an offence against this Act.\n(sec.5-ssec.1) This Act binds all persons, including the State, and, to the extent the legislative power of the Parliament permits, the Commonwealth and the other States.\n(sec.5-ssec.2) However, the State, the Commonwealth or another State can not be prosecuted for an offence against this Act.","sortOrder":6},{"sectionNumber":"ch.1-pt.3","sectionType":"part","heading":"Interpretation","content":"# Interpretation","sortOrder":7},{"sectionNumber":"sec.6","sectionType":"section","heading":"Definitions","content":"### sec.6 Definitions\n\nThe dictionary in schedule 1 defines particular words used in this Act.","sortOrder":8},{"sectionNumber":"sec.7","sectionType":"section","heading":"Meaning of prescribed vehicle","content":"### sec.7 Meaning of prescribed vehicle\n\nA prescribed vehicle is—\na motor vehicle or a trailer for which a CTP insurance policy is in force; or\na trailer to which a CTP insurance policy extends; or\na motor vehicle of which a self-insurer is the registered owner; or\na trailer for which a self-insurer would be the insurer under the Insurance Act or a corresponding law if the trailer were involved in an incident in Queensland resulting in personal injury; or\na motor vehicle or a trailer to which a nominal defendant scheme would apply if the motor vehicle or trailer were involved in an incident in Queensland resulting in personal injury.\n- (a) a motor vehicle or a trailer for which a CTP insurance policy is in force; or\n- (b) a trailer to which a CTP insurance policy extends; or\n- (c) a motor vehicle of which a self-insurer is the registered owner; or\n- (d) a trailer for which a self-insurer would be the insurer under the Insurance Act or a corresponding law if the trailer were involved in an incident in Queensland resulting in personal injury; or\n- (e) a motor vehicle or a trailer to which a nominal defendant scheme would apply if the motor vehicle or trailer were involved in an incident in Queensland resulting in personal injury.","sortOrder":9},{"sectionNumber":"sec.8","sectionType":"section","heading":"Meaning of treatment, care and support needs","content":"### sec.8 Meaning of treatment, care and support needs\n\nThe treatment, care and support needs of a person are the person’s needs for, or relating to, 1 or more of the following—\nmedical or pharmaceutical treatment;\ndental treatment;\nrehabilitation;\nambulance transportation;\nrespite care;\nattendant care and support services;\naids and appliances, other than ordinary personal or household items;\nan air conditioner, a laptop, linen, a mobile phone, a personal computer or a washing machine\nprosthesis;\neducation or vocational training;\nhome or transport modification.\n- (a) medical or pharmaceutical treatment;\n- (b) dental treatment;\n- (c) rehabilitation;\n- (d) ambulance transportation;\n- (e) respite care;\n- (f) attendant care and support services;\n- (g) aids and appliances, other than ordinary personal or household items; Examples of ordinary personal or household items— an air conditioner, a laptop, linen, a mobile phone, a personal computer or a washing machine\n- (h) prosthesis;\n- (i) education or vocational training;\n- (j) home or transport modification.","sortOrder":10},{"sectionNumber":"sec.9","sectionType":"section","heading":"Meaning of excluded treatment, care and support","content":"### sec.9 Meaning of excluded treatment, care and support\n\nExcluded treatment, care and support is treatment, care and support that—\nis provided without charge; or\nif the participant is a child—ordinarily falls within the ordinary costs of raising a child; or\nmust be provided by a registered provider but is provided by a person who, at the time of provision, is not a registered provider; or\nis provided as part of a medical trial or on another experimental basis; or\nis provided as part of a public sector health service, as defined in the Hospital and Health Boards Act 2011 , schedule 2 ; or\nis provided by State emergency services, including the Queensland Ambulance Service, Queensland Fire and Rescue or Rural Fire Service Queensland; or\nis prescribed by regulation.\nFor subsection (1) (c) , the following treatment, care and support must be provided by a registered provider—\nattendant care and support services that are personal assistance services or services to assist a person to participate in the community;\nany other treatment, care or support prescribed by regulation.\nHowever, subsection (2) (a) does not apply if the treatment, care and support is being provided to a person at a hospital (whether as an inpatient or an outpatient) as part of the services provided by the hospital.\ns 9 amd 2024 No. 22 s 92 sch 1\n(sec.9-ssec.1) Excluded treatment, care and support is treatment, care and support that— is provided without charge; or if the participant is a child—ordinarily falls within the ordinary costs of raising a child; or must be provided by a registered provider but is provided by a person who, at the time of provision, is not a registered provider; or is provided as part of a medical trial or on another experimental basis; or is provided as part of a public sector health service, as defined in the Hospital and Health Boards Act 2011 , schedule 2 ; or is provided by State emergency services, including the Queensland Ambulance Service, Queensland Fire and Rescue or Rural Fire Service Queensland; or is prescribed by regulation.\n(sec.9-ssec.2) For subsection (1) (c) , the following treatment, care and support must be provided by a registered provider— attendant care and support services that are personal assistance services or services to assist a person to participate in the community; any other treatment, care or support prescribed by regulation.\n(sec.9-ssec.3) However, subsection (2) (a) does not apply if the treatment, care and support is being provided to a person at a hospital (whether as an inpatient or an outpatient) as part of the services provided by the hospital.\n- (a) is provided without charge; or\n- (b) if the participant is a child—ordinarily falls within the ordinary costs of raising a child; or\n- (c) must be provided by a registered provider but is provided by a person who, at the time of provision, is not a registered provider; or\n- (d) is provided as part of a medical trial or on another experimental basis; or\n- (e) is provided as part of a public sector health service, as defined in the Hospital and Health Boards Act 2011 , schedule 2 ; or\n- (f) is provided by State emergency services, including the Queensland Ambulance Service, Queensland Fire and Rescue or Rural Fire Service Queensland; or\n- (g) is prescribed by regulation.\n- (a) attendant care and support services that are personal assistance services or services to assist a person to participate in the community;\n- (b) any other treatment, care or support prescribed by regulation.","sortOrder":11},{"sectionNumber":"sec.10","sectionType":"section","heading":"When a claim is finalised","content":"### sec.10 When a claim is finalised\n\nFor this Act, a claim against an insurer is finalised if—\nthe claim has been settled by agreement and, if the agreement must, under another Act, be sanctioned by a court or the public trustee, the sanction has been given; or\nfinal judgment has been given by a court on an action for damages in relation to the claim and, if an award of damages under the final judgment must, under another Act, be sanctioned by a court or the public trustee, the sanction has been given.\n- (a) the claim has been settled by agreement and, if the agreement must, under another Act, be sanctioned by a court or the public trustee, the sanction has been given; or\n- (b) final judgment has been given by a court on an action for damages in relation to the claim and, if an award of damages under the final judgment must, under another Act, be sanctioned by a court or the public trustee, the sanction has been given.","sortOrder":12},{"sectionNumber":"sec.11","sectionType":"section","heading":"References in Act to particular terms","content":"### sec.11 References in Act to particular terms\n\nIn a provision of this Act about an application, a reference to—\nthe applicant is a reference to the person who made the application; and\nthe injured person is a reference to the injured person the subject of the application; and\nthe serious personal injury is a reference to the serious personal injury the subject of the application.\nIn a provision of this Act about a participant in the scheme, a reference to—\nthe participant’s injury is a reference to the serious personal injury in relation to which the participant is accepted into the scheme; and\nthe motor accident is a reference to the motor accident that resulted in the participant’s injury.\nIn a provision of this Act about a service request or a payment request, a reference to the participant is a reference to the participant the subject of the request.\nIn a provision of this Act about the giving of a notice or other document to or by a participant or an injured person, a reference to the participant or injured person includes a reference to—\nif the participant or injured person is a child—the child’s parent or guardian; or\notherwise—a person acting for the participant or injured person.\nIn a provision of this Act about the giving of a notice or other document to or by an insurer against whom a claim has been made, a reference to the insurer is a reference to the claim manager under the Insurance Act , section 38 , if 2 or more insurers may be liable on the claim.\n(sec.11-ssec.1) In a provision of this Act about an application, a reference to— the applicant is a reference to the person who made the application; and the injured person is a reference to the injured person the subject of the application; and the serious personal injury is a reference to the serious personal injury the subject of the application.\n(sec.11-ssec.2) In a provision of this Act about a participant in the scheme, a reference to— the participant’s injury is a reference to the serious personal injury in relation to which the participant is accepted into the scheme; and the motor accident is a reference to the motor accident that resulted in the participant’s injury.\n(sec.11-ssec.3) In a provision of this Act about a service request or a payment request, a reference to the participant is a reference to the participant the subject of the request.\n(sec.11-ssec.4) In a provision of this Act about the giving of a notice or other document to or by a participant or an injured person, a reference to the participant or injured person includes a reference to— if the participant or injured person is a child—the child’s parent or guardian; or otherwise—a person acting for the participant or injured person.\n(sec.11-ssec.5) In a provision of this Act about the giving of a notice or other document to or by an insurer against whom a claim has been made, a reference to the insurer is a reference to the claim manager under the Insurance Act , section 38 , if 2 or more insurers may be liable on the claim.\n- (a) the applicant is a reference to the person who made the application; and\n- (b) the injured person is a reference to the injured person the subject of the application; and\n- (c) the serious personal injury is a reference to the serious personal injury the subject of the application.\n- (a) the participant’s injury is a reference to the serious personal injury in relation to which the participant is accepted into the scheme; and\n- (b) the motor accident is a reference to the motor accident that resulted in the participant’s injury.\n- (a) if the participant or injured person is a child—the child’s parent or guardian; or\n- (b) otherwise—a person acting for the participant or injured person.","sortOrder":13},{"sectionNumber":"ch.2-pt.1","sectionType":"part","heading":"Preliminary","content":"# Preliminary","sortOrder":14},{"sectionNumber":"sec.12","sectionType":"section","heading":"Persons eligible to participate in scheme","content":"### sec.12 Persons eligible to participate in scheme\n\nA person is eligible to participate in the scheme in relation to a serious personal injury suffered by the person if—\nthis Act applies in relation to the injury; and\nthe injury meets the criteria (the eligibility criteria ) for the injury prescribed by regulation.\nHowever, a person is not eligible to participate in the scheme in relation to a serious personal injury if—\nthe person has been awarded damages, under a final judgment of a court or a binding settlement, in relation to the person’s treatment, care and support needs as a result of the injury; and\nthe damages were paid other than by way of a payment by the agency under section 44 (3) (a) .\nAlso, a person is not eligible to participate in the scheme in relation to a serious personal injury if—\nbefore the motor accident resulting in the serious personal injury, the person suffered from another injury or condition; and\nthe serious personal injury does not permanently increase the extent of any disability experienced by the person before the motor accident.\n(sec.12-ssec.1) A person is eligible to participate in the scheme in relation to a serious personal injury suffered by the person if— this Act applies in relation to the injury; and the injury meets the criteria (the eligibility criteria ) for the injury prescribed by regulation.\n(sec.12-ssec.2) However, a person is not eligible to participate in the scheme in relation to a serious personal injury if— the person has been awarded damages, under a final judgment of a court or a binding settlement, in relation to the person’s treatment, care and support needs as a result of the injury; and the damages were paid other than by way of a payment by the agency under section 44 (3) (a) .\n(sec.12-ssec.3) Also, a person is not eligible to participate in the scheme in relation to a serious personal injury if— before the motor accident resulting in the serious personal injury, the person suffered from another injury or condition; and the serious personal injury does not permanently increase the extent of any disability experienced by the person before the motor accident.\n- (a) this Act applies in relation to the injury; and\n- (b) the injury meets the criteria (the eligibility criteria ) for the injury prescribed by regulation.\n- (a) the person has been awarded damages, under a final judgment of a court or a binding settlement, in relation to the person’s treatment, care and support needs as a result of the injury; and\n- (b) the damages were paid other than by way of a payment by the agency under section 44 (3) (a) .\n- (a) before the motor accident resulting in the serious personal injury, the person suffered from another injury or condition; and\n- (b) the serious personal injury does not permanently increase the extent of any disability experienced by the person before the motor accident.","sortOrder":15},{"sectionNumber":"sec.13","sectionType":"section","heading":"Persons may buy into scheme in particular circumstances","content":"### sec.13 Persons may buy into scheme in particular circumstances\n\nThis section applies to a person who—\nsuffers a serious personal injury prescribed by regulation; and\nis not eligible under section 12 to participate in the scheme in relation to the injury.\nThe agency may decide to accept the person as a participant in the scheme in relation to the injury for a period agreed between the person and the agency.\nIf the person is accepted as a participant under subsection (2) , the person must pay to the agency a contribution, calculated in the way prescribed by regulation, towards the person’s treatment, care and support needs as a result of the injury.\nIf the contribution is not paid within 28 days after the person is accepted as a participant, the person—\nstops being a participant; and\nis taken to have never been a participant.\nThe following provisions do not apply to the person—\npart 4 , division 4 ;\npart 5 ;\nsection 52 .\nA regulation may make provision about accepting persons as participants in the scheme under this section, including by prescribing any of the following matters—\nthe circumstances in which an application (a buy-in application ) may be made to the agency for approval to participate in the scheme under this section;\nthe requirements for making a buy-in application;\nthe matters the agency must consider in deciding a buy-in application;\nthe period for deciding a buy-in application;\nwhen and how the agency must give notice of a decision on a buy-in application, including whether the notice must be an information notice;\nhow a contribution must be dealt with if the person stops being a participant.\n(sec.13-ssec.1) This section applies to a person who— suffers a serious personal injury prescribed by regulation; and is not eligible under section 12 to participate in the scheme in relation to the injury.\n(sec.13-ssec.2) The agency may decide to accept the person as a participant in the scheme in relation to the injury for a period agreed between the person and the agency.\n(sec.13-ssec.3) If the person is accepted as a participant under subsection (2) , the person must pay to the agency a contribution, calculated in the way prescribed by regulation, towards the person’s treatment, care and support needs as a result of the injury.\n(sec.13-ssec.4) If the contribution is not paid within 28 days after the person is accepted as a participant, the person— stops being a participant; and is taken to have never been a participant.\n(sec.13-ssec.5) The following provisions do not apply to the person— part 4 , division 4 ; part 5 ; section 52 .\n(sec.13-ssec.6) A regulation may make provision about accepting persons as participants in the scheme under this section, including by prescribing any of the following matters— the circumstances in which an application (a buy-in application ) may be made to the agency for approval to participate in the scheme under this section; the requirements for making a buy-in application; the matters the agency must consider in deciding a buy-in application; the period for deciding a buy-in application; when and how the agency must give notice of a decision on a buy-in application, including whether the notice must be an information notice; how a contribution must be dealt with if the person stops being a participant.\n- (a) suffers a serious personal injury prescribed by regulation; and\n- (b) is not eligible under section 12 to participate in the scheme in relation to the injury.\n- (a) stops being a participant; and\n- (b) is taken to have never been a participant.\n- (a) part 4 , division 4 ;\n- (b) part 5 ;\n- (c) section 52 .\n- (a) the circumstances in which an application (a buy-in application ) may be made to the agency for approval to participate in the scheme under this section;\n- (b) the requirements for making a buy-in application;\n- (c) the matters the agency must consider in deciding a buy-in application;\n- (d) the period for deciding a buy-in application;\n- (e) when and how the agency must give notice of a decision on a buy-in application, including whether the notice must be an information notice;\n- (f) how a contribution must be dealt with if the person stops being a participant.","sortOrder":16},{"sectionNumber":"sec.14","sectionType":"section","heading":"Participants in scheme","content":"### sec.14 Participants in scheme\n\nA person is a participant in the scheme if the agency accepts the person as a participant in the scheme under—\nsection 13 ; or\nsection 22 .\nA participant is a lifetime participant if the agency accepts the person as a participant for the rest of the person’s life under—\nsection 22 (3) ; or\nsection 46 (4) .\nA participant is an interim participant if the agency accepts the person, under section 22 (1) (a) , as a participant in the scheme for the participation period.\nA participant is a buy-in participant if the agency accepts the person, under section 13 , as a participant in the scheme.\nA person’s participation in the scheme starts the day the person is accepted into the scheme.\nA person’s participation in the scheme ends—\nif the person dies; or\nif the person stops being a participant under this chapter; or\nfor a buy-in participant—at the end of the period mentioned in section 13 (2) ; or\nin the circumstances prescribed by regulation.\n(sec.14-ssec.1) A person is a participant in the scheme if the agency accepts the person as a participant in the scheme under— section 13 ; or section 22 .\n(sec.14-ssec.2) A participant is a lifetime participant if the agency accepts the person as a participant for the rest of the person’s life under— section 22 (3) ; or section 46 (4) .\n(sec.14-ssec.3) A participant is an interim participant if the agency accepts the person, under section 22 (1) (a) , as a participant in the scheme for the participation period.\n(sec.14-ssec.4) A participant is a buy-in participant if the agency accepts the person, under section 13 , as a participant in the scheme.\n(sec.14-ssec.5) A person’s participation in the scheme starts the day the person is accepted into the scheme.\n(sec.14-ssec.6) A person’s participation in the scheme ends— if the person dies; or if the person stops being a participant under this chapter; or for a buy-in participant—at the end of the period mentioned in section 13 (2) ; or in the circumstances prescribed by regulation.\n- (a) section 13 ; or\n- (b) section 22 .\n- (a) section 22 (3) ; or\n- (b) section 46 (4) .\n- (a) if the person dies; or\n- (b) if the person stops being a participant under this chapter; or\n- (c) for a buy-in participant—at the end of the period mentioned in section 13 (2) ; or\n- (d) in the circumstances prescribed by regulation.","sortOrder":17},{"sectionNumber":"sec.15","sectionType":"section","heading":"Necessary and reasonable treatment, care and support needs","content":"### sec.15 Necessary and reasonable treatment, care and support needs\n\nFor this chapter, the agency must consider the following matters in deciding whether a person’s treatment, care and support needs as a result of a serious personal injury are necessary and reasonable in the circumstances—\nwhether the treatment, care and support needs are excluded treatment, care and support;\nany other matter prescribed by regulation.\n- (a) whether the treatment, care and support needs are excluded treatment, care and support;\n- (b) any other matter prescribed by regulation.","sortOrder":18},{"sectionNumber":"ch.2-pt.2","sectionType":"part","heading":"Application to participate in scheme","content":"# Application to participate in scheme","sortOrder":19},{"sectionNumber":"ch.2-pt.2-div.1","sectionType":"division","heading":"Making application","content":"## Making application","sortOrder":20},{"sectionNumber":"sec.16","sectionType":"section","heading":"Application for approval","content":"### sec.16 Application for approval\n\nA person may apply to the agency for approval to participate in the scheme in relation to a serious personal injury suffered by the person as a result of a motor accident.\nIf the application is made within 1 year after the motor accident happened (the application period ), the agency must accept the application.\nIf the application is made after the application period, the agency must decide whether or not to accept the application.\nIn making a decision under subsection (3) , the agency must consider whether it would be fair and reasonable in the circumstances to accept the application, having regard to—\nwhether the person is likely to be eligible to participate in the scheme; and\nwhether a claim has been made, or can be made, for the serious personal injury; and\nthe nature and severity of the person’s injury.\nIf the agency decides not to accept an application, the agency must give the applicant an information notice for the decision.\n(sec.16-ssec.1) A person may apply to the agency for approval to participate in the scheme in relation to a serious personal injury suffered by the person as a result of a motor accident.\n(sec.16-ssec.2) If the application is made within 1 year after the motor accident happened (the application period ), the agency must accept the application.\n(sec.16-ssec.3) If the application is made after the application period, the agency must decide whether or not to accept the application.\n(sec.16-ssec.4) In making a decision under subsection (3) , the agency must consider whether it would be fair and reasonable in the circumstances to accept the application, having regard to— whether the person is likely to be eligible to participate in the scheme; and whether a claim has been made, or can be made, for the serious personal injury; and the nature and severity of the person’s injury.\n(sec.16-ssec.5) If the agency decides not to accept an application, the agency must give the applicant an information notice for the decision.\n- (a) whether the person is likely to be eligible to participate in the scheme; and\n- (b) whether a claim has been made, or can be made, for the serious personal injury; and\n- (c) the nature and severity of the person’s injury.","sortOrder":21},{"sectionNumber":"sec.17","sectionType":"section","heading":"When application may not be made","content":"### sec.17 When application may not be made\n\nAn application may not be made in relation to an injured person’s serious personal injury if—\nanother person has made an application in relation to the injury and the application has not been decided; or\nthe injured person is an interim participant in relation to the injury.\nSubsection (3) applies if—\nan application has been made in relation to an injured person’s serious personal injury and the application has been refused; or\nan injured person was an interim participant in relation to a serious personal injury and the injured person’s participation in the scheme has ended.\nA person may not make an application in relation to the serious personal injury unless—\nthe person gives the agency medical information, not previously considered by the agency, about the injured person’s injury or condition; or\nthe person gives the agency medical information showing that the injured person’s condition as a result of the injury has deteriorated since the earlier application was made or the injured person’s participation ended.\nIf an injured person, or a person acting for an injured person, has received a payment under section 44 (3) (a) in relation to the injured person’s serious personal injury—\nan application in relation to the injury—\nmay be made only in the circumstances prescribed by regulation; and\nmay not be made for a period, of at least 5 years after the payment is received, prescribed by regulation; and\nsection 16 (2) and (3) do not apply to the making of the application.\n(sec.17-ssec.1) An application may not be made in relation to an injured person’s serious personal injury if— another person has made an application in relation to the injury and the application has not been decided; or the injured person is an interim participant in relation to the injury.\n(sec.17-ssec.2) Subsection (3) applies if— an application has been made in relation to an injured person’s serious personal injury and the application has been refused; or an injured person was an interim participant in relation to a serious personal injury and the injured person’s participation in the scheme has ended.\n(sec.17-ssec.3) A person may not make an application in relation to the serious personal injury unless— the person gives the agency medical information, not previously considered by the agency, about the injured person’s injury or condition; or the person gives the agency medical information showing that the injured person’s condition as a result of the injury has deteriorated since the earlier application was made or the injured person’s participation ended.\n(sec.17-ssec.4) If an injured person, or a person acting for an injured person, has received a payment under section 44 (3) (a) in relation to the injured person’s serious personal injury— an application in relation to the injury— may be made only in the circumstances prescribed by regulation; and may not be made for a period, of at least 5 years after the payment is received, prescribed by regulation; and section 16 (2) and (3) do not apply to the making of the application.\n- (a) another person has made an application in relation to the injury and the application has not been decided; or\n- (b) the injured person is an interim participant in relation to the injury.\n- (a) an application has been made in relation to an injured person’s serious personal injury and the application has been refused; or\n- (b) an injured person was an interim participant in relation to a serious personal injury and the injured person’s participation in the scheme has ended.\n- (a) the person gives the agency medical information, not previously considered by the agency, about the injured person’s injury or condition; or\n- (b) the person gives the agency medical information showing that the injured person’s condition as a result of the injury has deteriorated since the earlier application was made or the injured person’s participation ended.\n- (a) an application in relation to the injury— (i) may be made only in the circumstances prescribed by regulation; and (ii) may not be made for a period, of at least 5 years after the payment is received, prescribed by regulation; and\n- (i) may be made only in the circumstances prescribed by regulation; and\n- (ii) may not be made for a period, of at least 5 years after the payment is received, prescribed by regulation; and\n- (b) section 16 (2) and (3) do not apply to the making of the application.\n- (i) may be made only in the circumstances prescribed by regulation; and\n- (ii) may not be made for a period, of at least 5 years after the payment is received, prescribed by regulation; and","sortOrder":22},{"sectionNumber":"sec.18","sectionType":"section","heading":"When person other than injured person may make application","content":"### sec.18 When person other than injured person may make application\n\nAn application may be made for an injured person—\nby an insurer against whom a claim has been made, if the claim—\nrelates to the injured person’s serious personal injury; and\nhas not been finalised; or\nif the injured person is a child—by the child’s parent or guardian; or\nby another person who is acting for the injured person.\nIf an insurer makes an application for an injured person, the insurer must give the person a copy of the application.\n(sec.18-ssec.1) An application may be made for an injured person— by an insurer against whom a claim has been made, if the claim— relates to the injured person’s serious personal injury; and has not been finalised; or if the injured person is a child—by the child’s parent or guardian; or by another person who is acting for the injured person.\n(sec.18-ssec.2) If an insurer makes an application for an injured person, the insurer must give the person a copy of the application.\n- (a) by an insurer against whom a claim has been made, if the claim— (i) relates to the injured person’s serious personal injury; and (ii) has not been finalised; or\n- (i) relates to the injured person’s serious personal injury; and\n- (ii) has not been finalised; or\n- (b) if the injured person is a child—by the child’s parent or guardian; or\n- (c) by another person who is acting for the injured person.\n- (i) relates to the injured person’s serious personal injury; and\n- (ii) has not been finalised; or","sortOrder":23},{"sectionNumber":"sec.19","sectionType":"section","heading":"Requirements for application","content":"### sec.19 Requirements for application\n\nAn application must—\nbe in the approved form; and\ninclude or be accompanied by the information prescribed by regulation.\nSubsections (3) and (4) apply if an application is made by a person other than an insurer.\nThe application must state that the applicant permits the agency to exchange information about the injured person with an entity prescribed by regulation for the purpose of the agency performing its functions under this Act, including, in particular—\ndeciding whether or not the person is eligible to participate in the scheme; and\nif it is decided that the person is eligible to participate in the scheme—\ndeciding whether the person is to be a lifetime participant or an interim participant; and\nassessing the treatment, care and support needed by the person; and\nreviewing the person’s participation in the scheme.\nIf the injured person, or a person acting for the injured person, has made, or intends to make, a claim against an insurer for the serious personal injury, the application must also state—\nthat the person has made, or intends to make, the claim; and\nif the claim has been made—\nthe day the claim was made; and\nthe status of the claim; and\nthe insurer against whom the claim was, or is intended to be, made.\n(sec.19-ssec.1) An application must— be in the approved form; and include or be accompanied by the information prescribed by regulation.\n(sec.19-ssec.2) Subsections (3) and (4) apply if an application is made by a person other than an insurer.\n(sec.19-ssec.3) The application must state that the applicant permits the agency to exchange information about the injured person with an entity prescribed by regulation for the purpose of the agency performing its functions under this Act, including, in particular— deciding whether or not the person is eligible to participate in the scheme; and if it is decided that the person is eligible to participate in the scheme— deciding whether the person is to be a lifetime participant or an interim participant; and assessing the treatment, care and support needed by the person; and reviewing the person’s participation in the scheme.\n(sec.19-ssec.4) If the injured person, or a person acting for the injured person, has made, or intends to make, a claim against an insurer for the serious personal injury, the application must also state— that the person has made, or intends to make, the claim; and if the claim has been made— the day the claim was made; and the status of the claim; and the insurer against whom the claim was, or is intended to be, made.\n- (a) be in the approved form; and\n- (b) include or be accompanied by the information prescribed by regulation.\n- (a) deciding whether or not the person is eligible to participate in the scheme; and\n- (b) if it is decided that the person is eligible to participate in the scheme— (i) deciding whether the person is to be a lifetime participant or an interim participant; and (ii) assessing the treatment, care and support needed by the person; and (iii) reviewing the person’s participation in the scheme.\n- (i) deciding whether the person is to be a lifetime participant or an interim participant; and\n- (ii) assessing the treatment, care and support needed by the person; and\n- (iii) reviewing the person’s participation in the scheme.\n- (i) deciding whether the person is to be a lifetime participant or an interim participant; and\n- (ii) assessing the treatment, care and support needed by the person; and\n- (iii) reviewing the person’s participation in the scheme.\n- (a) that the person has made, or intends to make, the claim; and\n- (b) if the claim has been made— (i) the day the claim was made; and (ii) the status of the claim; and\n- (i) the day the claim was made; and\n- (ii) the status of the claim; and\n- (c) the insurer against whom the claim was, or is intended to be, made.\n- (i) the day the claim was made; and\n- (ii) the status of the claim; and","sortOrder":24},{"sectionNumber":"sec.20","sectionType":"section","heading":"Notifying insurer about application","content":"### sec.20 Notifying insurer about application\n\nThis section applies if an application—\nis made by a person other than an insurer; and\nstates that—\na claim has been made against an insurer for the serious personal injury; and\nthe claim has not been finalised.\nThe agency must give notice of the application to the insurer.\nThe notice must—\nstate the name of the injured person; and\nstate the day the application was made; and\ninclude a brief description of the serious personal injury; and\nstate the day the motor accident resulting in the injury happened.\n(sec.20-ssec.1) This section applies if an application— is made by a person other than an insurer; and states that— a claim has been made against an insurer for the serious personal injury; and the claim has not been finalised.\n(sec.20-ssec.2) The agency must give notice of the application to the insurer.\n(sec.20-ssec.3) The notice must— state the name of the injured person; and state the day the application was made; and include a brief description of the serious personal injury; and state the day the motor accident resulting in the injury happened.\n- (a) is made by a person other than an insurer; and\n- (b) states that— (i) a claim has been made against an insurer for the serious personal injury; and (ii) the claim has not been finalised.\n- (i) a claim has been made against an insurer for the serious personal injury; and\n- (ii) the claim has not been finalised.\n- (i) a claim has been made against an insurer for the serious personal injury; and\n- (ii) the claim has not been finalised.\n- (a) state the name of the injured person; and\n- (b) state the day the application was made; and\n- (c) include a brief description of the serious personal injury; and\n- (d) state the day the motor accident resulting in the injury happened.","sortOrder":25},{"sectionNumber":"sec.21","sectionType":"section","heading":"Information request","content":"### sec.21 Information request\n\nThe agency may, by notice (an information request ), ask any of the following persons to give further information needed to decide an application—\nthe applicant;\nif the applicant is not the injured person—the injured person.\nThe information request must be made within 28 days after the application is received.\n(sec.21-ssec.1) The agency may, by notice (an information request ), ask any of the following persons to give further information needed to decide an application— the applicant; if the applicant is not the injured person—the injured person.\n(sec.21-ssec.2) The information request must be made within 28 days after the application is received.\n- (a) the applicant;\n- (b) if the applicant is not the injured person—the injured person.","sortOrder":26},{"sectionNumber":"ch.2-pt.2-div.2","sectionType":"division","heading":"Deciding application","content":"## Deciding application","sortOrder":27},{"sectionNumber":"sec.22","sectionType":"section","heading":"Deciding application","content":"### sec.22 Deciding application\n\nAfter receiving an application, the agency must—\nif the injured person is eligible to participate in the scheme in relation to the serious personal injury—accept the person as a participant in the scheme in relation to the injury for the participation period; or\notherwise—refuse the application.\nSubsection (3) applies if the agency is satisfied that the serious personal injury is likely to continue to meet the eligibility criteria for the injury after the participation period ends.\nThe agency may, instead of accepting the injured person as a participant for the participation period, accept the injured person as a participant in the scheme for the rest of the person’s life.\nSubsections (5) and (6) apply if—\nthe injured person, or a person acting for the injured person, has received a payment from the agency under section 44 (3) (a) in relation to the serious personal injury; and\nthe agency is not satisfied that the injured person is suffering severe financial hardship.\nDespite subsection (1) (a) , the agency may refuse the application.\nIf the agency decides to accept the injured person as a participant in the scheme, the acceptance may be subject to conditions.\nA decision under this section must be made within the decision-making period.\nHowever, the agency may, by notice given to the applicant and without the applicant’s agreement, extend the decision-making period by not more than 28 days.\nA notice given under subsection (8) must state the reason for the extension.\n(sec.22-ssec.1) After receiving an application, the agency must— if the injured person is eligible to participate in the scheme in relation to the serious personal injury—accept the person as a participant in the scheme in relation to the injury for the participation period; or otherwise—refuse the application.\n(sec.22-ssec.2) Subsection (3) applies if the agency is satisfied that the serious personal injury is likely to continue to meet the eligibility criteria for the injury after the participation period ends.\n(sec.22-ssec.3) The agency may, instead of accepting the injured person as a participant for the participation period, accept the injured person as a participant in the scheme for the rest of the person’s life.\n(sec.22-ssec.4) Subsections (5) and (6) apply if— the injured person, or a person acting for the injured person, has received a payment from the agency under section 44 (3) (a) in relation to the serious personal injury; and the agency is not satisfied that the injured person is suffering severe financial hardship.\n(sec.22-ssec.5) Despite subsection (1) (a) , the agency may refuse the application.\n(sec.22-ssec.6) If the agency decides to accept the injured person as a participant in the scheme, the acceptance may be subject to conditions.\n(sec.22-ssec.7) A decision under this section must be made within the decision-making period.\n(sec.22-ssec.8) However, the agency may, by notice given to the applicant and without the applicant’s agreement, extend the decision-making period by not more than 28 days.\n(sec.22-ssec.9) A notice given under subsection (8) must state the reason for the extension.\n- (a) if the injured person is eligible to participate in the scheme in relation to the serious personal injury—accept the person as a participant in the scheme in relation to the injury for the participation period; or\n- (b) otherwise—refuse the application.\n- (a) the injured person, or a person acting for the injured person, has received a payment from the agency under section 44 (3) (a) in relation to the serious personal injury; and\n- (b) the agency is not satisfied that the injured person is suffering severe financial hardship.","sortOrder":28},{"sectionNumber":"sec.23","sectionType":"section","heading":"Notice of decision","content":"### sec.23 Notice of decision\n\nThe agency must give notice of a decision on an application to—\nthe applicant; and\nif the applicant is not the injured person—the injured person; and\nif a claim, other than a finalised claim, has been made against an insurer for the serious personal injury and the insurer is not the applicant—the insurer.\nIf the agency refuses the application, or accepts the injured person on conditions, the notice must be an information notice.\n(sec.23-ssec.1) The agency must give notice of a decision on an application to— the applicant; and if the applicant is not the injured person—the injured person; and if a claim, other than a finalised claim, has been made against an insurer for the serious personal injury and the insurer is not the applicant—the insurer.\n(sec.23-ssec.2) If the agency refuses the application, or accepts the injured person on conditions, the notice must be an information notice.\n- (a) the applicant; and\n- (b) if the applicant is not the injured person—the injured person; and\n- (c) if a claim, other than a finalised claim, has been made against an insurer for the serious personal injury and the insurer is not the applicant—the insurer.","sortOrder":29},{"sectionNumber":"sec.24","sectionType":"section","heading":"Failure to decide application","content":"### sec.24 Failure to decide application\n\nIf the agency fails to decide an application within the decision-making period, the failure is taken to be a decision by the agency to refuse the application.\nIf the application is taken to be refused under this section, each person mentioned in section 23 (1) is entitled to be given an information notice by the agency for the decision.\nIn this section—\ndecision-making period includes an extension of the decision-making period under section 22 (8) .\n(sec.24-ssec.1) If the agency fails to decide an application within the decision-making period, the failure is taken to be a decision by the agency to refuse the application.\n(sec.24-ssec.2) If the application is taken to be refused under this section, each person mentioned in section 23 (1) is entitled to be given an information notice by the agency for the decision.\n(sec.24-ssec.3) In this section— decision-making period includes an extension of the decision-making period under section 22 (8) .","sortOrder":30},{"sectionNumber":"ch.2-pt.3","sectionType":"part","heading":"Assessing needs","content":"# Assessing needs","sortOrder":31},{"sectionNumber":"ch.2-pt.3-div.1","sectionType":"division","heading":"Preparing support plans","content":"## Preparing support plans","sortOrder":32},{"sectionNumber":"sec.25","sectionType":"section","heading":"Assessment of participant’s needs for treatment, care and support","content":"### sec.25 Assessment of participant’s needs for treatment, care and support\n\nFor each participant in the scheme, the agency—\nmust assess the participant’s treatment, care and support needs as a result of the participant’s injury; and\nmay assess any other treatment, care or support needed by the participant, including treatment, care or support that is, or may be, provided or funded other than under the scheme.\nIn carrying out the assessment, the agency must, to the extent practicable, consult with the participant about the following matters—\nthe treatment, care and support the participant considers necessary and reasonable as a result of the participant’s injury;\nthe participant’s abilities and limitations;\nthe participant’s individual goals.\nThe agency may also consult with any other person the agency considers appropriate.\nThe assessment must be carried out in the way, and at the intervals, prescribed by regulation.\nHowever, subsection (4) does not prevent the agency from carrying out—\nan extra assessment at any time the agency considers appropriate; or\nan assessment of the treatment, care and support needed by a participant for a particular period only.\n(sec.25-ssec.1) For each participant in the scheme, the agency— must assess the participant’s treatment, care and support needs as a result of the participant’s injury; and may assess any other treatment, care or support needed by the participant, including treatment, care or support that is, or may be, provided or funded other than under the scheme.\n(sec.25-ssec.2) In carrying out the assessment, the agency must, to the extent practicable, consult with the participant about the following matters— the treatment, care and support the participant considers necessary and reasonable as a result of the participant’s injury; the participant’s abilities and limitations; the participant’s individual goals.\n(sec.25-ssec.3) The agency may also consult with any other person the agency considers appropriate.\n(sec.25-ssec.4) The assessment must be carried out in the way, and at the intervals, prescribed by regulation.\n(sec.25-ssec.5) However, subsection (4) does not prevent the agency from carrying out— an extra assessment at any time the agency considers appropriate; or an assessment of the treatment, care and support needed by a participant for a particular period only.\n- (a) must assess the participant’s treatment, care and support needs as a result of the participant’s injury; and\n- (b) may assess any other treatment, care or support needed by the participant, including treatment, care or support that is, or may be, provided or funded other than under the scheme.\n- (a) the treatment, care and support the participant considers necessary and reasonable as a result of the participant’s injury;\n- (b) the participant’s abilities and limitations;\n- (c) the participant’s individual goals.\n- (a) an extra assessment at any time the agency considers appropriate; or\n- (b) an assessment of the treatment, care and support needed by a participant for a particular period only.","sortOrder":33},{"sectionNumber":"sec.26","sectionType":"section","heading":"Making support plan","content":"### sec.26 Making support plan\n\nAfter carrying out the first assessment of a participant under section 25 , the agency must make a plan (a support plan ) that states—\nthe name of the participant; and\nthe outcomes of the assessment under section 25 (1) ; and\nthe matters stated in section 25 (2) , if known by the agency; and\nany treatment, care and support needs the agency considers are necessary and reasonable in the circumstances as a result of the participant’s injury; and\nany other treatment, care or support the agency considers should be funded, in whole or part, under the scheme, having regard to the following matters—\nwhether the treatment, care or support is needed by the participant as a result of the participant’s injury or another personal injury resulting from the motor accident;\nwhether it would be fair and reasonable in the circumstances to fund, in whole or part, the treatment, care or support;\nwhether providing the treatment, care or support will, or is likely to, reduce the participant’s treatment, care and support needs;\nwhether funding all or part of the treatment, care or support is more practical or cost-effective than funding the participant’s treatment, care and support needs, without compromising the level of treatment, care or support received by the participant under the scheme;\nwhether the treatment, care or support is excluded treatment, care and support;\nwhere the treatment, care or support is to be provided, including, for example, whether the treatment, care or support is to be provided outside Australia; and\nany other matter prescribed by regulation.\nAfter making the support plan, the agency must give the participant a copy of the plan.\nA support plan made for a participant must be consistent with an existing decision on a service request relating to the participant.\nHowever, subsection (3) applies only to the extent the support plan relates to the period covered by the existing decision.\n(sec.26-ssec.1) After carrying out the first assessment of a participant under section 25 , the agency must make a plan (a support plan ) that states— the name of the participant; and the outcomes of the assessment under section 25 (1) ; and the matters stated in section 25 (2) , if known by the agency; and any treatment, care and support needs the agency considers are necessary and reasonable in the circumstances as a result of the participant’s injury; and any other treatment, care or support the agency considers should be funded, in whole or part, under the scheme, having regard to the following matters— whether the treatment, care or support is needed by the participant as a result of the participant’s injury or another personal injury resulting from the motor accident; whether it would be fair and reasonable in the circumstances to fund, in whole or part, the treatment, care or support; whether providing the treatment, care or support will, or is likely to, reduce the participant’s treatment, care and support needs; whether funding all or part of the treatment, care or support is more practical or cost-effective than funding the participant’s treatment, care and support needs, without compromising the level of treatment, care or support received by the participant under the scheme; whether the treatment, care or support is excluded treatment, care and support; where the treatment, care or support is to be provided, including, for example, whether the treatment, care or support is to be provided outside Australia; and any other matter prescribed by regulation.\n(sec.26-ssec.2) After making the support plan, the agency must give the participant a copy of the plan.\n(sec.26-ssec.3) A support plan made for a participant must be consistent with an existing decision on a service request relating to the participant.\n(sec.26-ssec.4) However, subsection (3) applies only to the extent the support plan relates to the period covered by the existing decision.\n- (a) the name of the participant; and\n- (b) the outcomes of the assessment under section 25 (1) ; and\n- (c) the matters stated in section 25 (2) , if known by the agency; and\n- (d) any treatment, care and support needs the agency considers are necessary and reasonable in the circumstances as a result of the participant’s injury; and\n- (e) any other treatment, care or support the agency considers should be funded, in whole or part, under the scheme, having regard to the following matters— (i) whether the treatment, care or support is needed by the participant as a result of the participant’s injury or another personal injury resulting from the motor accident; (ii) whether it would be fair and reasonable in the circumstances to fund, in whole or part, the treatment, care or support; (iii) whether providing the treatment, care or support will, or is likely to, reduce the participant’s treatment, care and support needs; (iv) whether funding all or part of the treatment, care or support is more practical or cost-effective than funding the participant’s treatment, care and support needs, without compromising the level of treatment, care or support received by the participant under the scheme; (v) whether the treatment, care or support is excluded treatment, care and support; (vi) where the treatment, care or support is to be provided, including, for example, whether the treatment, care or support is to be provided outside Australia; and\n- (i) whether the treatment, care or support is needed by the participant as a result of the participant’s injury or another personal injury resulting from the motor accident;\n- (ii) whether it would be fair and reasonable in the circumstances to fund, in whole or part, the treatment, care or support;\n- (iii) whether providing the treatment, care or support will, or is likely to, reduce the participant’s treatment, care and support needs;\n- (iv) whether funding all or part of the treatment, care or support is more practical or cost-effective than funding the participant’s treatment, care and support needs, without compromising the level of treatment, care or support received by the participant under the scheme;\n- (v) whether the treatment, care or support is excluded treatment, care and support;\n- (vi) where the treatment, care or support is to be provided, including, for example, whether the treatment, care or support is to be provided outside Australia; and\n- (f) any other matter prescribed by regulation.\n- (i) whether the treatment, care or support is needed by the participant as a result of the participant’s injury or another personal injury resulting from the motor accident;\n- (ii) whether it would be fair and reasonable in the circumstances to fund, in whole or part, the treatment, care or support;\n- (iii) whether providing the treatment, care or support will, or is likely to, reduce the participant’s treatment, care and support needs;\n- (iv) whether funding all or part of the treatment, care or support is more practical or cost-effective than funding the participant’s treatment, care and support needs, without compromising the level of treatment, care or support received by the participant under the scheme;\n- (v) whether the treatment, care or support is excluded treatment, care and support;\n- (vi) where the treatment, care or support is to be provided, including, for example, whether the treatment, care or support is to be provided outside Australia; and","sortOrder":34},{"sectionNumber":"sec.27","sectionType":"section","heading":"Amending support plan","content":"### sec.27 Amending support plan\n\nAfter carrying out a further assessment of a participant under section 25 , the agency may amend the participant’s support plan to reflect the outcomes of the assessment.\nSee also sections 31 (5) and 51 .\nWithout limiting subsection (1) , the agency may amend the support plan to include—\nany treatment, care and support needs the agency considers are necessary and reasonable in the circumstances as a result of the participant’s injury; or\nany other treatment, care or support the agency considers should be funded, in whole or part, under the scheme, having regard to the matters stated in section 26 (1) (e) .\nAn amendment to a participant’s support plan must be consistent with an existing decision on a service request relating to the participant.\nHowever, subsection (3) applies only to the extent the amendment relates to the period covered by the existing decision.\n(sec.27-ssec.1) After carrying out a further assessment of a participant under section 25 , the agency may amend the participant’s support plan to reflect the outcomes of the assessment. See also sections 31 (5) and 51 .\n(sec.27-ssec.2) Without limiting subsection (1) , the agency may amend the support plan to include— any treatment, care and support needs the agency considers are necessary and reasonable in the circumstances as a result of the participant’s injury; or any other treatment, care or support the agency considers should be funded, in whole or part, under the scheme, having regard to the matters stated in section 26 (1) (e) .\n(sec.27-ssec.3) An amendment to a participant’s support plan must be consistent with an existing decision on a service request relating to the participant.\n(sec.27-ssec.4) However, subsection (3) applies only to the extent the amendment relates to the period covered by the existing decision.\n- (a) any treatment, care and support needs the agency considers are necessary and reasonable in the circumstances as a result of the participant’s injury; or\n- (b) any other treatment, care or support the agency considers should be funded, in whole or part, under the scheme, having regard to the matters stated in section 26 (1) (e) .","sortOrder":35},{"sectionNumber":"ch.2-pt.3-div.2","sectionType":"division","heading":"Service requests","content":"## Service requests","sortOrder":36},{"sectionNumber":"sec.28","sectionType":"section","heading":"Making service request","content":"### sec.28 Making service request\n\nA person may, by notice (a service request ), ask the agency to fund particular treatment, care or support (the requested service ) to be provided to a participant in a particular period.\nA service request may be made before or after a support plan is made for the participant.\nIf a service request is made by a person who is not the participant, the person making the request must give a copy of the request to the participant.\n(sec.28-ssec.1) A person may, by notice (a service request ), ask the agency to fund particular treatment, care or support (the requested service ) to be provided to a participant in a particular period.\n(sec.28-ssec.2) A service request may be made before or after a support plan is made for the participant.\n(sec.28-ssec.3) If a service request is made by a person who is not the participant, the person making the request must give a copy of the request to the participant.","sortOrder":37},{"sectionNumber":"sec.29","sectionType":"section","heading":"Information request","content":"### sec.29 Information request\n\nThe agency may, by notice (an information request ), ask any of the following persons for further information needed to decide a service request—\nthe person who made the request;\nif the person who made the request is not the participant—the participant.\nThe information request must be made within 28 days after the service request is received.\n(sec.29-ssec.1) The agency may, by notice (an information request ), ask any of the following persons for further information needed to decide a service request— the person who made the request; if the person who made the request is not the participant—the participant.\n(sec.29-ssec.2) The information request must be made within 28 days after the service request is received.\n- (a) the person who made the request;\n- (b) if the person who made the request is not the participant—the participant.","sortOrder":38},{"sectionNumber":"sec.30","sectionType":"section","heading":"Assessing service request","content":"### sec.30 Assessing service request\n\nIn assessing a service request, the agency must consider the following matters—\nwhether or not the requested service relates to the participant’s treatment, care and support needs as a result of the participant’s injury;\nif the requested service relates to the participant’s treatment, care and support needs as a result of the participant’s injury—whether or not the needs are necessary and reasonable in the circumstances;\nif the requested service does not relate to the participant’s treatment, care and support needs as a result of the participant’s injury, or it relates to treatment, care and support needs that are not necessary and reasonable in the circumstances—whether or not the agency considers the requested service should be funded, in whole or part, under the scheme, having regard to the matters stated in section 26 (1) (e) .\n- (a) whether or not the requested service relates to the participant’s treatment, care and support needs as a result of the participant’s injury;\n- (b) if the requested service relates to the participant’s treatment, care and support needs as a result of the participant’s injury—whether or not the needs are necessary and reasonable in the circumstances;\n- (c) if the requested service does not relate to the participant’s treatment, care and support needs as a result of the participant’s injury, or it relates to treatment, care and support needs that are not necessary and reasonable in the circumstances—whether or not the agency considers the requested service should be funded, in whole or part, under the scheme, having regard to the matters stated in section 26 (1) (e) .","sortOrder":39},{"sectionNumber":"sec.31","sectionType":"section","heading":"Deciding service request","content":"### sec.31 Deciding service request\n\nAfter assessing a service request, the agency must—\ndecide to—\napprove the request with or without conditions; or\nrefuse the request; and\ngive notice of the decision to—\nthe person who made the request; and\nif the person who made the request is not the participant—the participant.\nA decision under subsection (1) must be made within the decision-making period.\nIf the agency decides to approve the request with conditions, or refuse the request, the notice given to the participant must be an information notice.\nSubsections (5) and (6) apply if a support plan has been made for the participant.\nIf the agency decides to approve the request, with or without conditions, the agency must amend the support plan to reflect the approval.\nIf the agency decides to refuse the request, a copy of the information notice for the decision must be attached to the support plan.\n(sec.31-ssec.1) After assessing a service request, the agency must— decide to— approve the request with or without conditions; or refuse the request; and give notice of the decision to— the person who made the request; and if the person who made the request is not the participant—the participant.\n(sec.31-ssec.2) A decision under subsection (1) must be made within the decision-making period.\n(sec.31-ssec.3) If the agency decides to approve the request with conditions, or refuse the request, the notice given to the participant must be an information notice.\n(sec.31-ssec.4) Subsections (5) and (6) apply if a support plan has been made for the participant.\n(sec.31-ssec.5) If the agency decides to approve the request, with or without conditions, the agency must amend the support plan to reflect the approval.\n(sec.31-ssec.6) If the agency decides to refuse the request, a copy of the information notice for the decision must be attached to the support plan.\n- (a) decide to— (i) approve the request with or without conditions; or (ii) refuse the request; and\n- (i) approve the request with or without conditions; or\n- (ii) refuse the request; and\n- (b) give notice of the decision to— (i) the person who made the request; and (ii) if the person who made the request is not the participant—the participant.\n- (i) the person who made the request; and\n- (ii) if the person who made the request is not the participant—the participant.\n- (i) approve the request with or without conditions; or\n- (ii) refuse the request; and\n- (i) the person who made the request; and\n- (ii) if the person who made the request is not the participant—the participant.","sortOrder":40},{"sectionNumber":"sec.32","sectionType":"section","heading":"Failure to decide service request","content":"### sec.32 Failure to decide service request\n\nIf the agency fails to decide a service request within the decision-making period, the failure is taken to be a decision by the agency to refuse the request.\nIf the request is taken to be refused under this section, the participant is entitled to be given an information notice by the agency for the decision.\n(sec.32-ssec.1) If the agency fails to decide a service request within the decision-making period, the failure is taken to be a decision by the agency to refuse the request.\n(sec.32-ssec.2) If the request is taken to be refused under this section, the participant is entitled to be given an information notice by the agency for the decision.","sortOrder":41},{"sectionNumber":"ch.2-pt.4","sectionType":"part","heading":"Payments","content":"# Payments","sortOrder":42},{"sectionNumber":"ch.2-pt.4-div.1","sectionType":"division","heading":"Preliminary","content":"## Preliminary","sortOrder":43},{"sectionNumber":"sec.33","sectionType":"section","heading":"About this part","content":"### sec.33 About this part\n\nThis part sets out the 3 ways that payments may be made in relation to the treatment, care and support of participants in the scheme.\nSee also section 94 .\nDivision 2 provides for payments to be made under funding agreements to cover particular treatment, care and support expenses incurred in particular periods.\nDivision 3 provides for payment requests to be made for treatment, care and support expenses as the expenses are incurred.\nDivision 4 provides for the agency to contribute towards an insurer’s liability for treatment, care and support damages on a claim in particular circumstances.\n(sec.33-ssec.1) This part sets out the 3 ways that payments may be made in relation to the treatment, care and support of participants in the scheme. See also section 94 .\n(sec.33-ssec.2) Division 2 provides for payments to be made under funding agreements to cover particular treatment, care and support expenses incurred in particular periods.\n(sec.33-ssec.3) Division 3 provides for payment requests to be made for treatment, care and support expenses as the expenses are incurred.\n(sec.33-ssec.4) Division 4 provides for the agency to contribute towards an insurer’s liability for treatment, care and support damages on a claim in particular circumstances.","sortOrder":44},{"sectionNumber":"ch.2-pt.4-div.2","sectionType":"division","heading":"Funding agreements","content":"## Funding agreements","sortOrder":45},{"sectionNumber":"sec.34","sectionType":"section","heading":"Funding agreement","content":"### sec.34 Funding agreement\n\nThe agency may enter into an agreement (a funding agreement ) with a person that provides for the agency to pay to the person an amount to cover particular expenses to be incurred by the person, in a stated period, for the treatment, care or support of a participant.\nHowever, a funding agreement may not be entered into in the circumstances, or for the treatment, care or support, prescribed by regulation.\nA funding agreement must include the terms prescribed by regulation.\n(sec.34-ssec.1) The agency may enter into an agreement (a funding agreement ) with a person that provides for the agency to pay to the person an amount to cover particular expenses to be incurred by the person, in a stated period, for the treatment, care or support of a participant.\n(sec.34-ssec.2) However, a funding agreement may not be entered into in the circumstances, or for the treatment, care or support, prescribed by regulation.\n(sec.34-ssec.3) A funding agreement must include the terms prescribed by regulation.","sortOrder":46},{"sectionNumber":"ch.2-pt.4-div.3","sectionType":"division","heading":"Payment requests","content":"## Payment requests","sortOrder":47},{"sectionNumber":"sec.35","sectionType":"section","heading":"Request for payment","content":"### sec.35 Request for payment\n\nA person who incurs an expense for the treatment, care or support of a participant may, by notice (a payment request ), ask the agency to pay all or part of the amount of the expense (the requested amount ).\nHowever, a payment request may not be made for the expense if—\nthe person has entered into a funding agreement with the agency for the treatment, care or support; and\nthe expense was incurred in the period covered by the funding agreement.\nA payment request must be made within 6 months after the expense is incurred.\nHowever, the agency may accept a later payment request if the agency considers it is fair and reasonable in the circumstances to accept the request.\n(sec.35-ssec.1) A person who incurs an expense for the treatment, care or support of a participant may, by notice (a payment request ), ask the agency to pay all or part of the amount of the expense (the requested amount ).\n(sec.35-ssec.2) However, a payment request may not be made for the expense if— the person has entered into a funding agreement with the agency for the treatment, care or support; and the expense was incurred in the period covered by the funding agreement.\n(sec.35-ssec.3) A payment request must be made within 6 months after the expense is incurred.\n(sec.35-ssec.4) However, the agency may accept a later payment request if the agency considers it is fair and reasonable in the circumstances to accept the request.\n- (a) the person has entered into a funding agreement with the agency for the treatment, care or support; and\n- (b) the expense was incurred in the period covered by the funding agreement.","sortOrder":48},{"sectionNumber":"sec.36","sectionType":"section","heading":"Information request","content":"### sec.36 Information request\n\nThe agency may, by notice (an information request ), ask any of the following persons for information needed to decide a payment request—\nthe person who made the payment request;\nif the person who made the payment request is not the participant—the participant.\nThe information request must—\nbe made within 28 days after the payment request is received; and\nstate that, if the requested information is not given to the agency by a stated day (the due day ), the payment request will lapse.\nThe due day must be at least 10 days after the information request is given.\nThe payment request lapses if the requested information is not given to the agency—\nby the due day; or\nby a later day agreed between the agency and the person to whom the information request was given.\nIf the information request is made to a person, other than the person who made the payment request, the agency must give a copy of the information request to the person who made the payment request.\n(sec.36-ssec.1) The agency may, by notice (an information request ), ask any of the following persons for information needed to decide a payment request— the person who made the payment request; if the person who made the payment request is not the participant—the participant.\n(sec.36-ssec.2) The information request must— be made within 28 days after the payment request is received; and state that, if the requested information is not given to the agency by a stated day (the due day ), the payment request will lapse.\n(sec.36-ssec.3) The due day must be at least 10 days after the information request is given.\n(sec.36-ssec.4) The payment request lapses if the requested information is not given to the agency— by the due day; or by a later day agreed between the agency and the person to whom the information request was given.\n(sec.36-ssec.5) If the information request is made to a person, other than the person who made the payment request, the agency must give a copy of the information request to the person who made the payment request.\n- (a) the person who made the payment request;\n- (b) if the person who made the payment request is not the participant—the participant.\n- (a) be made within 28 days after the payment request is received; and\n- (b) state that, if the requested information is not given to the agency by a stated day (the due day ), the payment request will lapse.\n- (a) by the due day; or\n- (b) by a later day agreed between the agency and the person to whom the information request was given.","sortOrder":49},{"sectionNumber":"sec.37","sectionType":"section","heading":"Deciding payment request","content":"### sec.37 Deciding payment request\n\nThe agency must, within the decision-making period, decide to—\napprove the payment request; or\nrefuse the payment request.\nThe agency must approve the payment request if—\nthe expense is incurred in the period the participant is a participant in the scheme; and\nthe treatment, care or support that the request relates to is an approved service for the participant.\nTo remove any doubt, it is declared that the agency may approve the payment request even though the treatment, care or support is not an approved service.\nIf the agency approves the payment request, the agency must pay the requested amount to the person who made the request within 28 days after making the decision.\nHowever, the agency is not liable to pay a part of the requested amount that exceeds—\nif the requested amount relates to treatment, care or support provided within Australia—an amount prescribed by regulation for the treatment, care or support; or\nif the requested amount relates to treatment, care or support provided outside Australia—the average cost of providing the treatment, care or support in Queensland.\nIn this section—\napproved service does not include excluded treatment, care and support, unless—\nif a support plan has been made for the participant—the excluded treatment, care and support is specifically stated in the support plan to be—\na treatment, care and support need that the agency considers is necessary and reasonable in the circumstances as a result of the participant’s injury; or\ntreatment, care or support the agency considers should be funded, in whole or part, under the scheme; or\nif a support plan has not been made for the participant—the excluded treatment, care and support is specifically approved under a service request approval relating to the participant.\n(sec.37-ssec.1) The agency must, within the decision-making period, decide to— approve the payment request; or refuse the payment request.\n(sec.37-ssec.2) The agency must approve the payment request if— the expense is incurred in the period the participant is a participant in the scheme; and the treatment, care or support that the request relates to is an approved service for the participant.\n(sec.37-ssec.3) To remove any doubt, it is declared that the agency may approve the payment request even though the treatment, care or support is not an approved service.\n(sec.37-ssec.4) If the agency approves the payment request, the agency must pay the requested amount to the person who made the request within 28 days after making the decision.\n(sec.37-ssec.5) However, the agency is not liable to pay a part of the requested amount that exceeds— if the requested amount relates to treatment, care or support provided within Australia—an amount prescribed by regulation for the treatment, care or support; or if the requested amount relates to treatment, care or support provided outside Australia—the average cost of providing the treatment, care or support in Queensland.\n(sec.37-ssec.6) In this section— approved service does not include excluded treatment, care and support, unless— if a support plan has been made for the participant—the excluded treatment, care and support is specifically stated in the support plan to be— a treatment, care and support need that the agency considers is necessary and reasonable in the circumstances as a result of the participant’s injury; or treatment, care or support the agency considers should be funded, in whole or part, under the scheme; or if a support plan has not been made for the participant—the excluded treatment, care and support is specifically approved under a service request approval relating to the participant.\n- (a) approve the payment request; or\n- (b) refuse the payment request.\n- (a) the expense is incurred in the period the participant is a participant in the scheme; and\n- (b) the treatment, care or support that the request relates to is an approved service for the participant.\n- (a) if the requested amount relates to treatment, care or support provided within Australia—an amount prescribed by regulation for the treatment, care or support; or\n- (b) if the requested amount relates to treatment, care or support provided outside Australia—the average cost of providing the treatment, care or support in Queensland.\n- (a) if a support plan has been made for the participant—the excluded treatment, care and support is specifically stated in the support plan to be— (i) a treatment, care and support need that the agency considers is necessary and reasonable in the circumstances as a result of the participant’s injury; or (ii) treatment, care or support the agency considers should be funded, in whole or part, under the scheme; or\n- (i) a treatment, care and support need that the agency considers is necessary and reasonable in the circumstances as a result of the participant’s injury; or\n- (ii) treatment, care or support the agency considers should be funded, in whole or part, under the scheme; or\n- (b) if a support plan has not been made for the participant—the excluded treatment, care and support is specifically approved under a service request approval relating to the participant.\n- (i) a treatment, care and support need that the agency considers is necessary and reasonable in the circumstances as a result of the participant’s injury; or\n- (ii) treatment, care or support the agency considers should be funded, in whole or part, under the scheme; or","sortOrder":50},{"sectionNumber":"sec.38","sectionType":"section","heading":"Notice of decision","content":"### sec.38 Notice of decision\n\nIf the payment request is refused, the agency must give notice of the decision to—\nthe person who made the payment request; and\nif the person who made the payment request is not the participant—the participant.\nThe notice given to the participant must be an information notice.\n(sec.38-ssec.1) If the payment request is refused, the agency must give notice of the decision to— the person who made the payment request; and if the person who made the payment request is not the participant—the participant.\n(sec.38-ssec.2) The notice given to the participant must be an information notice.\n- (a) the person who made the payment request; and\n- (b) if the person who made the payment request is not the participant—the participant.","sortOrder":51},{"sectionNumber":"sec.39","sectionType":"section","heading":"Failure to decide payment request","content":"### sec.39 Failure to decide payment request\n\nIf the agency fails to decide a payment request within the decision-making period, the failure is taken to be a decision by the agency to refuse the request.\nIf the request is taken to be refused under this section, the participant is entitled to be given an information notice by the agency for the decision.\n(sec.39-ssec.1) If the agency fails to decide a payment request within the decision-making period, the failure is taken to be a decision by the agency to refuse the request.\n(sec.39-ssec.2) If the request is taken to be refused under this section, the participant is entitled to be given an information notice by the agency for the decision.","sortOrder":52},{"sectionNumber":"ch.2-pt.4-div.4","sectionType":"division","heading":"Contribution by agency","content":"## Contribution by agency","sortOrder":53},{"sectionNumber":"sec.40","sectionType":"section","heading":"Application of division","content":"### sec.40 Application of division\n\nThis division applies in relation to a lifetime participant if a claim has been made against an insurer for the participant’s injury.","sortOrder":54},{"sectionNumber":"sec.41","sectionType":"section","heading":"Notice about right to treatment, care and support damages","content":"### sec.41 Notice about right to treatment, care and support damages\n\nThe participant must give a notice to the agency and the insurer stating whether or not the participant wants to preserve any right the participant may have to be awarded treatment, care and support damages under a final judgment of a court or a binding settlement.\nA notice given under subsection (1) stating that the participant wants to preserve any right the participant may have to be awarded treatment, care and support damages is a preservation notice .\nThe participant must give a notice under subsection (1) —\nif the claim is made after the participant is accepted as a lifetime participant—within 14 days after the participant is given, or is entitled to be given, a notice under the Insurance Act , section 39 (1) or (2) ; or\nif the claim is made before the participant is accepted as a lifetime participant—within 14 days after the participant is given notice of the participant’s acceptance into the scheme as a lifetime participant.\nHowever, a notice may be given after the period stated in subsection (3) , but before a final judgment is given, or a settlement is made, in relation to the claim, if—\nthe insurer and the agency agree to the notice being given; and\nfor a claim that is the subject of a proceeding before a court—the court orders that the notice may be given.\nIf the agency considers the participant is a person under a legal disability, the agency must apply to the court for an order sanctioning a notice given under subsection (1) .\nSubsections (7) and (8) apply if the court considers the participant is a person under a legal disability.\nThe court—\nmust decide whether or not to sanction the notice; and\nmay order that the participant, or a person acting for the participant, give a new notice under subsection (1) ; and\nmay make any other order the court considers appropriate.\nIf the participant is an adult, the court may exercise all the powers of QCAT under the Guardianship and Administration Act 2000 , chapter 3 .\nIf the court exercises a power mentioned in subsection (8) , the Guardianship and Administration Act 2000 , section 245 (3) to (6) applies in relation to the exercise of the power as if the court were acting under section 245 (2) of that Act.\nThis section is subject to section 43 .\nIn this section—\ncourt means—\nif a proceeding in relation to the claim has been brought in the District Court or the Supreme Court—the court hearing the proceeding; or\notherwise—the District Court or the Supreme Court.\n(sec.41-ssec.1) The participant must give a notice to the agency and the insurer stating whether or not the participant wants to preserve any right the participant may have to be awarded treatment, care and support damages under a final judgment of a court or a binding settlement.\n(sec.41-ssec.2) A notice given under subsection (1) stating that the participant wants to preserve any right the participant may have to be awarded treatment, care and support damages is a preservation notice .\n(sec.41-ssec.3) The participant must give a notice under subsection (1) — if the claim is made after the participant is accepted as a lifetime participant—within 14 days after the participant is given, or is entitled to be given, a notice under the Insurance Act , section 39 (1) or (2) ; or if the claim is made before the participant is accepted as a lifetime participant—within 14 days after the participant is given notice of the participant’s acceptance into the scheme as a lifetime participant.\n(sec.41-ssec.4) However, a notice may be given after the period stated in subsection (3) , but before a final judgment is given, or a settlement is made, in relation to the claim, if— the insurer and the agency agree to the notice being given; and for a claim that is the subject of a proceeding before a court—the court orders that the notice may be given.\n(sec.41-ssec.5) If the agency considers the participant is a person under a legal disability, the agency must apply to the court for an order sanctioning a notice given under subsection (1) .\n(sec.41-ssec.6) Subsections (7) and (8) apply if the court considers the participant is a person under a legal disability.\n(sec.41-ssec.7) The court— must decide whether or not to sanction the notice; and may order that the participant, or a person acting for the participant, give a new notice under subsection (1) ; and may make any other order the court considers appropriate.\n(sec.41-ssec.8) If the participant is an adult, the court may exercise all the powers of QCAT under the Guardianship and Administration Act 2000 , chapter 3 .\n(sec.41-ssec.9) If the court exercises a power mentioned in subsection (8) , the Guardianship and Administration Act 2000 , section 245 (3) to (6) applies in relation to the exercise of the power as if the court were acting under section 245 (2) of that Act.\n(sec.41-ssec.10) This section is subject to section 43 .\n(sec.41-ssec.11) In this section— court means— if a proceeding in relation to the claim has been brought in the District Court or the Supreme Court—the court hearing the proceeding; or otherwise—the District Court or the Supreme Court.\n- (a) if the claim is made after the participant is accepted as a lifetime participant—within 14 days after the participant is given, or is entitled to be given, a notice under the Insurance Act , section 39 (1) or (2) ; or\n- (b) if the claim is made before the participant is accepted as a lifetime participant—within 14 days after the participant is given notice of the participant’s acceptance into the scheme as a lifetime participant.\n- (a) the insurer and the agency agree to the notice being given; and\n- (b) for a claim that is the subject of a proceeding before a court—the court orders that the notice may be given.\n- (a) must decide whether or not to sanction the notice; and\n- (b) may order that the participant, or a person acting for the participant, give a new notice under subsection (1) ; and\n- (c) may make any other order the court considers appropriate.\n- (a) if a proceeding in relation to the claim has been brought in the District Court or the Supreme Court—the court hearing the proceeding; or\n- (b) otherwise—the District Court or the Supreme Court.","sortOrder":55},{"sectionNumber":"sec.42","sectionType":"section","heading":"Liability of agency to contribute towards damages","content":"### sec.42 Liability of agency to contribute towards damages\n\nIf the participant gives a preservation notice, the agency is liable to contribute towards the insurer’s liability, if any, on the claim for treatment, care and support damages.\nFor the awarding of damages in relation to a participant’s treatment, care and support needs, see the Civil Liability Act 2003 , chapter 3 , part 2A .\nFor the role of the agency in relation to a claim that the agency is liable to contribute towards, see the Insurance Act , part 4 , division 8 .\nHowever, the agency stops being liable to contribute if—\na court decides, or the parties to the claim agree by way of settlement, that—\nthe participant is guilty of contributory negligence in relation to the claim; and\nthe damages that the participant would otherwise be entitled to in the absence of contributory negligence are to be reduced, because of the contributory negligence, by 50% or more; or\na court decides, under section 41 (7) , not to sanction the preservation notice; or\na court makes an order, under section 43 , preventing the participant from being awarded treatment, care and support damages; or\nfor a participant other than a participant whose preservation notice has been sanctioned by a court—the participant, by notice to the agency and the insurer, withdraws the preservation notice.\nIn this section—\nparty , to the claim, includes the agency.\n(sec.42-ssec.1) If the participant gives a preservation notice, the agency is liable to contribute towards the insurer’s liability, if any, on the claim for treatment, care and support damages. For the awarding of damages in relation to a participant’s treatment, care and support needs, see the Civil Liability Act 2003 , chapter 3 , part 2A . For the role of the agency in relation to a claim that the agency is liable to contribute towards, see the Insurance Act , part 4 , division 8 .\n(sec.42-ssec.2) However, the agency stops being liable to contribute if— a court decides, or the parties to the claim agree by way of settlement, that— the participant is guilty of contributory negligence in relation to the claim; and the damages that the participant would otherwise be entitled to in the absence of contributory negligence are to be reduced, because of the contributory negligence, by 50% or more; or a court decides, under section 41 (7) , not to sanction the preservation notice; or a court makes an order, under section 43 , preventing the participant from being awarded treatment, care and support damages; or for a participant other than a participant whose preservation notice has been sanctioned by a court—the participant, by notice to the agency and the insurer, withdraws the preservation notice.\n(sec.42-ssec.3) In this section— party , to the claim, includes the agency.\n- 1 For the awarding of damages in relation to a participant’s treatment, care and support needs, see the Civil Liability Act 2003 , chapter 3 , part 2A .\n- 2 For the role of the agency in relation to a claim that the agency is liable to contribute towards, see the Insurance Act , part 4 , division 8 .\n- (a) a court decides, or the parties to the claim agree by way of settlement, that— (i) the participant is guilty of contributory negligence in relation to the claim; and (ii) the damages that the participant would otherwise be entitled to in the absence of contributory negligence are to be reduced, because of the contributory negligence, by 50% or more; or\n- (i) the participant is guilty of contributory negligence in relation to the claim; and\n- (ii) the damages that the participant would otherwise be entitled to in the absence of contributory negligence are to be reduced, because of the contributory negligence, by 50% or more; or\n- (b) a court decides, under section 41 (7) , not to sanction the preservation notice; or\n- (c) a court makes an order, under section 43 , preventing the participant from being awarded treatment, care and support damages; or\n- (d) for a participant other than a participant whose preservation notice has been sanctioned by a court—the participant, by notice to the agency and the insurer, withdraws the preservation notice.\n- (i) the participant is guilty of contributory negligence in relation to the claim; and\n- (ii) the damages that the participant would otherwise be entitled to in the absence of contributory negligence are to be reduced, because of the contributory negligence, by 50% or more; or","sortOrder":56},{"sectionNumber":"sec.43","sectionType":"section","heading":"Application to court for order","content":"### sec.43 Application to court for order\n\nThe agency may apply to the court for an order preventing the participant from being awarded treatment, care and support damages under a final judgment of a court or a binding settlement.\nAn application under subsection (1) may be made whether or not the participant has given a notice under section 41 (1) .\nThe participant is the respondent to the application.\nIn deciding whether to make the order, the court—\nmust consider the participant’s ability to manage an award of treatment, care and support damages in a way that will not compromise the participant’s—\nprospects of improvement or rehabilitation; or\nfuture health and wellbeing; and\nmust consider whether the participant is a person under a legal disability; and\nmay consider any other matter the court considers relevant.\nIf the court makes the order—\nthe participant may not give a preservation notice; and\nany preservation notice given by the participant is taken not to have been given.\nIf the participant is an adult, the court may exercise all the powers of QCAT under the Guardianship and Administration Act 2000 , chapter 3 .\nIf the court exercises a power mentioned in subsection (6) , the Guardianship and Administration Act 2000 , section 245 (3) to (6) applies in relation to the exercise of the power as if the court were acting under section 245 (2) of that Act.\nIn this section—\ncourt means—\nif a proceeding in relation to the claim has been brought in the District Court or the Supreme Court—the court hearing the proceeding; or\notherwise—the District Court or the Supreme Court.\n(sec.43-ssec.1) The agency may apply to the court for an order preventing the participant from being awarded treatment, care and support damages under a final judgment of a court or a binding settlement.\n(sec.43-ssec.2) An application under subsection (1) may be made whether or not the participant has given a notice under section 41 (1) .\n(sec.43-ssec.3) The participant is the respondent to the application.\n(sec.43-ssec.4) In deciding whether to make the order, the court— must consider the participant’s ability to manage an award of treatment, care and support damages in a way that will not compromise the participant’s— prospects of improvement or rehabilitation; or future health and wellbeing; and must consider whether the participant is a person under a legal disability; and may consider any other matter the court considers relevant.\n(sec.43-ssec.5) If the court makes the order— the participant may not give a preservation notice; and any preservation notice given by the participant is taken not to have been given.\n(sec.43-ssec.6) If the participant is an adult, the court may exercise all the powers of QCAT under the Guardianship and Administration Act 2000 , chapter 3 .\n(sec.43-ssec.7) If the court exercises a power mentioned in subsection (6) , the Guardianship and Administration Act 2000 , section 245 (3) to (6) applies in relation to the exercise of the power as if the court were acting under section 245 (2) of that Act.\n(sec.43-ssec.8) In this section— court means— if a proceeding in relation to the claim has been brought in the District Court or the Supreme Court—the court hearing the proceeding; or otherwise—the District Court or the Supreme Court.\n- (a) must consider the participant’s ability to manage an award of treatment, care and support damages in a way that will not compromise the participant’s— (i) prospects of improvement or rehabilitation; or (ii) future health and wellbeing; and\n- (i) prospects of improvement or rehabilitation; or\n- (ii) future health and wellbeing; and\n- (b) must consider whether the participant is a person under a legal disability; and\n- (c) may consider any other matter the court considers relevant.\n- (i) prospects of improvement or rehabilitation; or\n- (ii) future health and wellbeing; and\n- (a) the participant may not give a preservation notice; and\n- (b) any preservation notice given by the participant is taken not to have been given.\n- (a) if a proceeding in relation to the claim has been brought in the District Court or the Supreme Court—the court hearing the proceeding; or\n- (b) otherwise—the District Court or the Supreme Court.","sortOrder":57},{"sectionNumber":"sec.44","sectionType":"section","heading":"Acceptance of treatment, care and support damages","content":"### sec.44 Acceptance of treatment, care and support damages\n\nThis section applies if—\nthe participant is awarded treatment, care and support damages under a final judgment of a court or a binding settlement; and\nthe agency is liable, under section 42 , to contribute towards the insurer’s liability on the claim for treatment, care and support damages.\nThe participant must, within the acceptance period, give notice to the agency and the insurer stating whether or not the participant accepts the awarded treatment, care and support damages.\nIf the participant states in the notice given under subsection (2) that the participant accepts the awarded treatment, care and support damages—\nthe agency must pay to the participant the amount of the awarded treatment, care and support damages, less any amount that relates to the period of the participant’s participation in the scheme; and\nthe participant stops being a participant in the scheme when the participant receives the payment under paragraph (a) ; and\ndespite the final judgment of the court or the terms of the binding settlement—\nthe insurer is not liable to pay to the participant the amount of the awarded treatment, care and support damages; and\nthe agency is not liable to pay to the participant any amount of the awarded treatment, care and support damages that relates to the period of the participant’s participation in the scheme.\nSubsection (5) applies if the participant gives a notice under subsection (2) stating that the participant does not accept the awarded treatment, care and support damages.\nDespite the final judgment of the court or the terms of the binding settlement, neither the agency nor the insurer is liable to pay the amount of the awarded treatment, care and support damages.\nFor this section, a payment of an amount of damages is taken to have been paid to, or received by, the participant if the payment is paid to, or received by, a person who may lawfully receive the payment for the participant.\nThis section applies despite the Civil Proceedings Act 2011 , part 13 .\nIn this section—\nacceptance period means—\nif the binding settlement or final judgment under which the treatment, care and support damages are awarded must, under another Act, be sanctioned by a court or the public trustee—the period of 14 days after the sanction is given; or\nif the treatment, care and support damages are awarded under a binding settlement and paragraph (a) does not apply—the period of 14 days after the settlement is made; or\nif the treatment, care and support damages are awarded under a final judgment of a court and paragraph (a) does not apply—the period of 14 days after the period for lodging an appeal against the judgment ends.\n(sec.44-ssec.1) This section applies if— the participant is awarded treatment, care and support damages under a final judgment of a court or a binding settlement; and the agency is liable, under section 42 , to contribute towards the insurer’s liability on the claim for treatment, care and support damages.\n(sec.44-ssec.2) The participant must, within the acceptance period, give notice to the agency and the insurer stating whether or not the participant accepts the awarded treatment, care and support damages.\n(sec.44-ssec.3) If the participant states in the notice given under subsection (2) that the participant accepts the awarded treatment, care and support damages— the agency must pay to the participant the amount of the awarded treatment, care and support damages, less any amount that relates to the period of the participant’s participation in the scheme; and the participant stops being a participant in the scheme when the participant receives the payment under paragraph (a) ; and despite the final judgment of the court or the terms of the binding settlement— the insurer is not liable to pay to the participant the amount of the awarded treatment, care and support damages; and the agency is not liable to pay to the participant any amount of the awarded treatment, care and support damages that relates to the period of the participant’s participation in the scheme.\n(sec.44-ssec.4) Subsection (5) applies if the participant gives a notice under subsection (2) stating that the participant does not accept the awarded treatment, care and support damages.\n(sec.44-ssec.5) Despite the final judgment of the court or the terms of the binding settlement, neither the agency nor the insurer is liable to pay the amount of the awarded treatment, care and support damages.\n(sec.44-ssec.6) For this section, a payment of an amount of damages is taken to have been paid to, or received by, the participant if the payment is paid to, or received by, a person who may lawfully receive the payment for the participant.\n(sec.44-ssec.7) This section applies despite the Civil Proceedings Act 2011 , part 13 .\n(sec.44-ssec.8) In this section— acceptance period means— if the binding settlement or final judgment under which the treatment, care and support damages are awarded must, under another Act, be sanctioned by a court or the public trustee—the period of 14 days after the sanction is given; or if the treatment, care and support damages are awarded under a binding settlement and paragraph (a) does not apply—the period of 14 days after the settlement is made; or if the treatment, care and support damages are awarded under a final judgment of a court and paragraph (a) does not apply—the period of 14 days after the period for lodging an appeal against the judgment ends.\n- (a) the participant is awarded treatment, care and support damages under a final judgment of a court or a binding settlement; and\n- (b) the agency is liable, under section 42 , to contribute towards the insurer’s liability on the claim for treatment, care and support damages.\n- (a) the agency must pay to the participant the amount of the awarded treatment, care and support damages, less any amount that relates to the period of the participant’s participation in the scheme; and\n- (b) the participant stops being a participant in the scheme when the participant receives the payment under paragraph (a) ; and\n- (c) despite the final judgment of the court or the terms of the binding settlement— (i) the insurer is not liable to pay to the participant the amount of the awarded treatment, care and support damages; and (ii) the agency is not liable to pay to the participant any amount of the awarded treatment, care and support damages that relates to the period of the participant’s participation in the scheme.\n- (i) the insurer is not liable to pay to the participant the amount of the awarded treatment, care and support damages; and\n- (ii) the agency is not liable to pay to the participant any amount of the awarded treatment, care and support damages that relates to the period of the participant’s participation in the scheme.\n- (i) the insurer is not liable to pay to the participant the amount of the awarded treatment, care and support damages; and\n- (ii) the agency is not liable to pay to the participant any amount of the awarded treatment, care and support damages that relates to the period of the participant’s participation in the scheme.\n- (a) if the binding settlement or final judgment under which the treatment, care and support damages are awarded must, under another Act, be sanctioned by a court or the public trustee—the period of 14 days after the sanction is given; or\n- (b) if the treatment, care and support damages are awarded under a binding settlement and paragraph (a) does not apply—the period of 14 days after the settlement is made; or\n- (c) if the treatment, care and support damages are awarded under a final judgment of a court and paragraph (a) does not apply—the period of 14 days after the period for lodging an appeal against the judgment ends.","sortOrder":58},{"sectionNumber":"ch.2-pt.5","sectionType":"part","heading":"Reviewing participation","content":"# Reviewing participation","sortOrder":59},{"sectionNumber":"sec.45","sectionType":"section","heading":"Reviewing participation of interim participant","content":"### sec.45 Reviewing participation of interim participant\n\nThe agency may review the participation of an interim participant at any time during the participation period.\nAt least 1 review must be carried out before the end of the participation period.\nThe agency must give the interim participant notice of the review at least 28 days before carrying out the review.\nIn carrying out the review, the agency may ask the participant to give the agency information needed to make a decision under section 46 .\n(sec.45-ssec.1) The agency may review the participation of an interim participant at any time during the participation period.\n(sec.45-ssec.2) At least 1 review must be carried out before the end of the participation period.\n(sec.45-ssec.3) The agency must give the interim participant notice of the review at least 28 days before carrying out the review.\n(sec.45-ssec.4) In carrying out the review, the agency may ask the participant to give the agency information needed to make a decision under section 46 .","sortOrder":60},{"sectionNumber":"sec.46","sectionType":"section","heading":"Decision about review","content":"### sec.46 Decision about review\n\nAfter carrying out a review, the agency must make a decision about—\nwhether or not the participant is still eligible to participate in the scheme; and\nif the agency decides that the participant is still eligible to participate in the scheme—whether or not the agency is satisfied that the participant’s injury is likely to continue to meet the eligibility criteria for the injury after the participation period ends.\nA decision under subsection (1) must be made before the end of the participation period.\nSubsection (4) applies if the agency decides that—\nthe participant is still eligible to participate in the scheme; and\nthe agency is satisfied that the participant’s injury is likely to continue to meet the eligibility criteria after the participation period ends.\nThe agency must accept the person as a participant in relation to the injury for the rest of the person’s life.\nIf subsection (4) does not apply, the participant stops being a participant—\nat the end of the participation period; or\nif the agency decides the participant is no longer eligible to participate in the scheme—on an earlier day stated in the notice given to the participant under section 47 .\n(sec.46-ssec.1) After carrying out a review, the agency must make a decision about— whether or not the participant is still eligible to participate in the scheme; and if the agency decides that the participant is still eligible to participate in the scheme—whether or not the agency is satisfied that the participant’s injury is likely to continue to meet the eligibility criteria for the injury after the participation period ends.\n(sec.46-ssec.2) A decision under subsection (1) must be made before the end of the participation period.\n(sec.46-ssec.3) Subsection (4) applies if the agency decides that— the participant is still eligible to participate in the scheme; and the agency is satisfied that the participant’s injury is likely to continue to meet the eligibility criteria after the participation period ends.\n(sec.46-ssec.4) The agency must accept the person as a participant in relation to the injury for the rest of the person’s life.\n(sec.46-ssec.5) If subsection (4) does not apply, the participant stops being a participant— at the end of the participation period; or if the agency decides the participant is no longer eligible to participate in the scheme—on an earlier day stated in the notice given to the participant under section 47 .\n- (a) whether or not the participant is still eligible to participate in the scheme; and\n- (b) if the agency decides that the participant is still eligible to participate in the scheme—whether or not the agency is satisfied that the participant’s injury is likely to continue to meet the eligibility criteria for the injury after the participation period ends.\n- (a) the participant is still eligible to participate in the scheme; and\n- (b) the agency is satisfied that the participant’s injury is likely to continue to meet the eligibility criteria after the participation period ends.\n- (a) at the end of the participation period; or\n- (b) if the agency decides the participant is no longer eligible to participate in the scheme—on an earlier day stated in the notice given to the participant under section 47 .","sortOrder":61},{"sectionNumber":"sec.47","sectionType":"section","heading":"Notice of review decision","content":"### sec.47 Notice of review decision\n\nWithin 14 days after making a decision under section 46 , the agency must give notice of the decision to—\nthe participant; and\nif a claim has been made against an insurer for the participant’s injury and the claim has not been finalised—the insurer.\nIf the agency makes either of the following decisions, the notice must be an information notice—\na decision that the participant is no longer eligible to participate in the scheme;\na decision that the agency is not satisfied that the participant’s injury is likely to continue to meet the eligibility criteria for the injury after the participation period ends.\n(sec.47-ssec.1) Within 14 days after making a decision under section 46 , the agency must give notice of the decision to— the participant; and if a claim has been made against an insurer for the participant’s injury and the claim has not been finalised—the insurer.\n(sec.47-ssec.2) If the agency makes either of the following decisions, the notice must be an information notice— a decision that the participant is no longer eligible to participate in the scheme; a decision that the agency is not satisfied that the participant’s injury is likely to continue to meet the eligibility criteria for the injury after the participation period ends.\n- (a) the participant; and\n- (b) if a claim has been made against an insurer for the participant’s injury and the claim has not been finalised—the insurer.\n- (a) a decision that the participant is no longer eligible to participate in the scheme;\n- (b) a decision that the agency is not satisfied that the participant’s injury is likely to continue to meet the eligibility criteria for the injury after the participation period ends.","sortOrder":62},{"sectionNumber":"sec.48","sectionType":"section","heading":"Failure to make review decision","content":"### sec.48 Failure to make review decision\n\nIf the agency does not make a decision under section 47 about a review before the end of the participation period—\nthe agency is taken to have decided that the participant is no longer eligible to participate in the scheme; and\nthe participant stops being a participant in the scheme at the end of the participation period.\nIf the agency is taken, under this section, to have decided that the participant is no longer eligible to participate in the scheme, the following persons are entitled to be given an information notice by the agency for the decision—\nthe participant;\nif a claim has been made against an insurer for the participant’s injury and the claim has not been finalised—the insurer.\n(sec.48-ssec.1) If the agency does not make a decision under section 47 about a review before the end of the participation period— the agency is taken to have decided that the participant is no longer eligible to participate in the scheme; and the participant stops being a participant in the scheme at the end of the participation period.\n(sec.48-ssec.2) If the agency is taken, under this section, to have decided that the participant is no longer eligible to participate in the scheme, the following persons are entitled to be given an information notice by the agency for the decision— the participant; if a claim has been made against an insurer for the participant’s injury and the claim has not been finalised—the insurer.\n- (a) the agency is taken to have decided that the participant is no longer eligible to participate in the scheme; and\n- (b) the participant stops being a participant in the scheme at the end of the participation period.\n- (a) the participant;\n- (b) if a claim has been made against an insurer for the participant’s injury and the claim has not been finalised—the insurer.","sortOrder":63},{"sectionNumber":"ch.2-pt.6","sectionType":"part","heading":"Participants absent from Australia","content":"# Participants absent from Australia","sortOrder":64},{"sectionNumber":"sec.49","sectionType":"section","heading":"Application of part","content":"### sec.49 Application of part\n\nThis part applies to a participant in the scheme if—\nthe participant leaves Australia; and\nwhile the participant is absent from Australia, expenses are, or are likely to be, incurred by or for the participant for the participant’s treatment, care or support; and\nthe agency did not, in deciding the approved services for the participant, consider the need for treatment, care and support to be provided outside Australia as a result of the participant’s absence.\n- (a) the participant leaves Australia; and\n- (b) while the participant is absent from Australia, expenses are, or are likely to be, incurred by or for the participant for the participant’s treatment, care or support; and\n- (c) the agency did not, in deciding the approved services for the participant, consider the need for treatment, care and support to be provided outside Australia as a result of the participant’s absence.","sortOrder":65},{"sectionNumber":"sec.50","sectionType":"section","heading":"Participant must notify agency of absence","content":"### sec.50 Participant must notify agency of absence\n\nAt least 1 month before leaving Australia, the participant must give notice of the absence to the agency, unless the participant has a reasonable excuse.\nMaximum penalty—10 penalty units.\nThe notice must state—\nthe day the participant intends to leave Australia; and\nif the participant intends to return to Australia—the day the participant intends to return; and\nthe participant’s address while outside Australia; and\nany treatment, care and support to be provided outside Australia that the participant wants the agency to fund.\nHowever, this section does not apply if, before the participant leaves Australia, a service request is made, or a funding agreement is entered into, for the treatment, care and support to be provided to the participant outside Australia.\n(sec.50-ssec.1) At least 1 month before leaving Australia, the participant must give notice of the absence to the agency, unless the participant has a reasonable excuse. Maximum penalty—10 penalty units.\n(sec.50-ssec.2) The notice must state— the day the participant intends to leave Australia; and if the participant intends to return to Australia—the day the participant intends to return; and the participant’s address while outside Australia; and any treatment, care and support to be provided outside Australia that the participant wants the agency to fund.\n(sec.50-ssec.3) However, this section does not apply if, before the participant leaves Australia, a service request is made, or a funding agreement is entered into, for the treatment, care and support to be provided to the participant outside Australia.\n- (a) the day the participant intends to leave Australia; and\n- (b) if the participant intends to return to Australia—the day the participant intends to return; and\n- (c) the participant’s address while outside Australia; and\n- (d) any treatment, care and support to be provided outside Australia that the participant wants the agency to fund.","sortOrder":66},{"sectionNumber":"sec.51","sectionType":"section","heading":"Reviewing support plan or service request approval","content":"### sec.51 Reviewing support plan or service request approval\n\nThis section applies if—\na support plan has been made for the participant; or\na support plan has not been made for the participant, but a service request approval relating to the participant has been given.\nTo the extent the support plan or service request approval relates to the period the participant is, or intends to be, absent from Australia, the agency may—\nreview the plan or approval; and\nmake any amendments to the plan or approval the agency considers appropriate.\nWithout limiting subsection (2) , the agency may amend the approved services for the participant by—\nremoving or rescheduling any treatment, care or support that is to be provided in Australia while the person is absent from Australia; or\nincluding any treatment, care or support that is to be provided outside Australia while the person is absent from Australia, if the agency considers the treatment, care or support should be funded, in whole or part, under the scheme, having regard to the following matters—\nthe length of the absence;\nwhether the treatment, care or support is to be, or could be, provided or funded in another way during the absence;\nwhether the treatment, care or support is excluded treatment, care and support;\nany other matter the agency considers relevant.\nHowever, the agency may amend the approved services to include treatment, care or support that is to be provided outside Australia only if a service request has not been made for the treatment, care or support.\nIf the agency decides to amend the support plan or the service request approval, the agency must, within 14 days of making the decision, give the participant—\na copy of the amended plan or approval; and\nif the decision is to amend approved services—an information notice for the decision.\nTo remove any doubt, it is declared that the agency is not required to carry out an assessment under section 25 before amending a support plan under this section.\n(sec.51-ssec.1) This section applies if— a support plan has been made for the participant; or a support plan has not been made for the participant, but a service request approval relating to the participant has been given.\n(sec.51-ssec.2) To the extent the support plan or service request approval relates to the period the participant is, or intends to be, absent from Australia, the agency may— review the plan or approval; and make any amendments to the plan or approval the agency considers appropriate.\n(sec.51-ssec.3) Without limiting subsection (2) , the agency may amend the approved services for the participant by— removing or rescheduling any treatment, care or support that is to be provided in Australia while the person is absent from Australia; or including any treatment, care or support that is to be provided outside Australia while the person is absent from Australia, if the agency considers the treatment, care or support should be funded, in whole or part, under the scheme, having regard to the following matters— the length of the absence; whether the treatment, care or support is to be, or could be, provided or funded in another way during the absence; whether the treatment, care or support is excluded treatment, care and support; any other matter the agency considers relevant.\n(sec.51-ssec.4) However, the agency may amend the approved services to include treatment, care or support that is to be provided outside Australia only if a service request has not been made for the treatment, care or support.\n(sec.51-ssec.5) If the agency decides to amend the support plan or the service request approval, the agency must, within 14 days of making the decision, give the participant— a copy of the amended plan or approval; and if the decision is to amend approved services—an information notice for the decision.\n(sec.51-ssec.6) To remove any doubt, it is declared that the agency is not required to carry out an assessment under section 25 before amending a support plan under this section.\n- (a) a support plan has been made for the participant; or\n- (b) a support plan has not been made for the participant, but a service request approval relating to the participant has been given.\n- (a) review the plan or approval; and\n- (b) make any amendments to the plan or approval the agency considers appropriate.\n- (a) removing or rescheduling any treatment, care or support that is to be provided in Australia while the person is absent from Australia; or\n- (b) including any treatment, care or support that is to be provided outside Australia while the person is absent from Australia, if the agency considers the treatment, care or support should be funded, in whole or part, under the scheme, having regard to the following matters— (i) the length of the absence; (ii) whether the treatment, care or support is to be, or could be, provided or funded in another way during the absence; (iii) whether the treatment, care or support is excluded treatment, care and support; (iv) any other matter the agency considers relevant.\n- (i) the length of the absence;\n- (ii) whether the treatment, care or support is to be, or could be, provided or funded in another way during the absence;\n- (iii) whether the treatment, care or support is excluded treatment, care and support;\n- (iv) any other matter the agency considers relevant.\n- (i) the length of the absence;\n- (ii) whether the treatment, care or support is to be, or could be, provided or funded in another way during the absence;\n- (iii) whether the treatment, care or support is excluded treatment, care and support;\n- (iv) any other matter the agency considers relevant.\n- (a) a copy of the amended plan or approval; and\n- (b) if the decision is to amend approved services—an information notice for the decision.","sortOrder":67},{"sectionNumber":"sec.52","sectionType":"section","heading":"Suspending participation","content":"### sec.52 Suspending participation\n\nThe agency may suspend the participant’s participation in the scheme if—\nthe agency is satisfied the participant has left Australia for more than 3 consecutive months; and\neither of the following applies—\na claim has not been made against an insurer for the participant’s injury;\na claim has been made against an insurer for the participant’s injury, but the insurer has denied liability on the claim or has been held by a court not to be liable for the participant’s injury.\nAlso, the agency may suspend the participant’s participation in the scheme if the agency considers that the participant’s absence from Australia will, or is likely to, adversely affect—\nthe participant’s condition as a result of the participant’s injury; or\nthe participant’s prospects of improvement or rehabilitation.\nThe participant’s participation in the scheme may be suspended for all or part of the period the participant is absent from Australia.\nIf the agency decides to suspend the participant’s participation, the agency must give the participant an information notice for the decision.\nThe information notice—\nmust state the period of the suspension; and\nmay state that the period of suspension starts on the day the person left Australia, even if the information notice is given after that day.\nFor part 4 , division 3 , the participant is taken not to be a participant in the scheme for the period of the suspension.\nThis section applies subject to section 14 (6) .\n(sec.52-ssec.1) The agency may suspend the participant’s participation in the scheme if— the agency is satisfied the participant has left Australia for more than 3 consecutive months; and either of the following applies— a claim has not been made against an insurer for the participant’s injury; a claim has been made against an insurer for the participant’s injury, but the insurer has denied liability on the claim or has been held by a court not to be liable for the participant’s injury.\n(sec.52-ssec.2) Also, the agency may suspend the participant’s participation in the scheme if the agency considers that the participant’s absence from Australia will, or is likely to, adversely affect— the participant’s condition as a result of the participant’s injury; or the participant’s prospects of improvement or rehabilitation.\n(sec.52-ssec.3) The participant’s participation in the scheme may be suspended for all or part of the period the participant is absent from Australia.\n(sec.52-ssec.4) If the agency decides to suspend the participant’s participation, the agency must give the participant an information notice for the decision.\n(sec.52-ssec.5) The information notice— must state the period of the suspension; and may state that the period of suspension starts on the day the person left Australia, even if the information notice is given after that day.\n(sec.52-ssec.6) For part 4 , division 3 , the participant is taken not to be a participant in the scheme for the period of the suspension.\n(sec.52-ssec.7) This section applies subject to section 14 (6) .\n- (a) the agency is satisfied the participant has left Australia for more than 3 consecutive months; and\n- (b) either of the following applies— (i) a claim has not been made against an insurer for the participant’s injury; (ii) a claim has been made against an insurer for the participant’s injury, but the insurer has denied liability on the claim or has been held by a court not to be liable for the participant’s injury.\n- (i) a claim has not been made against an insurer for the participant’s injury;\n- (ii) a claim has been made against an insurer for the participant’s injury, but the insurer has denied liability on the claim or has been held by a court not to be liable for the participant’s injury.\n- (i) a claim has not been made against an insurer for the participant’s injury;\n- (ii) a claim has been made against an insurer for the participant’s injury, but the insurer has denied liability on the claim or has been held by a court not to be liable for the participant’s injury.\n- (a) the participant’s condition as a result of the participant’s injury; or\n- (b) the participant’s prospects of improvement or rehabilitation.\n- (a) must state the period of the suspension; and\n- (b) may state that the period of suspension starts on the day the person left Australia, even if the information notice is given after that day.","sortOrder":68},{"sectionNumber":"ch.2-pt.7","sectionType":"part","heading":"Miscellaneous","content":"# Miscellaneous","sortOrder":69},{"sectionNumber":"sec.53","sectionType":"section","heading":"Requirement to notify of claim","content":"### sec.53 Requirement to notify of claim\n\nThis section applies if—\na person makes an application in relation to a serious personal injury and, before the application is decided, a claim is made for the injury; or\na person makes a claim for a participant’s injury after the participant is accepted into the scheme.\nWithin 14 days of making the claim, the person must give the agency notice stating—\nthat the person has made the claim; and\nthe day the claim was made; and\nthe insurer against whom the claim has been made.\nMaximum penalty—10 penalty units.\n(sec.53-ssec.1) This section applies if— a person makes an application in relation to a serious personal injury and, before the application is decided, a claim is made for the injury; or a person makes a claim for a participant’s injury after the participant is accepted into the scheme.\n(sec.53-ssec.2) Within 14 days of making the claim, the person must give the agency notice stating— that the person has made the claim; and the day the claim was made; and the insurer against whom the claim has been made. Maximum penalty—10 penalty units.\n- (a) a person makes an application in relation to a serious personal injury and, before the application is decided, a claim is made for the injury; or\n- (b) a person makes a claim for a participant’s injury after the participant is accepted into the scheme.\n- (a) that the person has made the claim; and\n- (b) the day the claim was made; and\n- (c) the insurer against whom the claim has been made.","sortOrder":70},{"sectionNumber":"sec.54","sectionType":"section","heading":"Electronic applications","content":"### sec.54 Electronic applications\n\nWithout limiting the Electronic Transactions (Queensland) Act 2001 , a person is taken to have complied with the requirements for making an application stated in section 19 (1) (a) and (b) if the person—\ngives the information required on the approved form by a method acceptable to the agency; and\ngives the agency any information that must, under section 19 (1) (b) , be included in or accompany the application within the reasonable period decided by the agency.\nIf the person’s signature is required on the approved form, the requirement is met if—\na method is used to identify the person and to indicate the person’s approval of the information given under subsection (1) ; and\nhaving regard to all the relevant circumstances when the method was used, the method was as reliable as was appropriate for the purposes for which the information was communicated; and\nthe agency consents to the requirement being met by using the method mentioned in paragraph (a) .\n(sec.54-ssec.1) Without limiting the Electronic Transactions (Queensland) Act 2001 , a person is taken to have complied with the requirements for making an application stated in section 19 (1) (a) and (b) if the person— gives the information required on the approved form by a method acceptable to the agency; and gives the agency any information that must, under section 19 (1) (b) , be included in or accompany the application within the reasonable period decided by the agency.\n(sec.54-ssec.2) If the person’s signature is required on the approved form, the requirement is met if— a method is used to identify the person and to indicate the person’s approval of the information given under subsection (1) ; and having regard to all the relevant circumstances when the method was used, the method was as reliable as was appropriate for the purposes for which the information was communicated; and the agency consents to the requirement being met by using the method mentioned in paragraph (a) .\n- (a) gives the information required on the approved form by a method acceptable to the agency; and\n- (b) gives the agency any information that must, under section 19 (1) (b) , be included in or accompany the application within the reasonable period decided by the agency.\n- (a) a method is used to identify the person and to indicate the person’s approval of the information given under subsection (1) ; and\n- (b) having regard to all the relevant circumstances when the method was used, the method was as reliable as was appropriate for the purposes for which the information was communicated; and\n- (c) the agency consents to the requirement being met by using the method mentioned in paragraph (a) .","sortOrder":71},{"sectionNumber":"ch.3-pt.1","sectionType":"part","heading":"Establishment, functions and powers","content":"# Establishment, functions and powers","sortOrder":72},{"sectionNumber":"ch.3-pt.1-div.1","sectionType":"division","heading":"Establishment of agency","content":"## Establishment of agency","sortOrder":73},{"sectionNumber":"sec.55","sectionType":"section","heading":"Establishment","content":"### sec.55 Establishment\n\nThe National Injury Insurance Agency, Queensland is established.\nThe agency is governed by the chief executive officer.\ns 55 amd 2021 No. 12 s 160\n(sec.55-ssec.1) The National Injury Insurance Agency, Queensland is established.\n(sec.55-ssec.2) The agency is governed by the chief executive officer.","sortOrder":74},{"sectionNumber":"sec.56","sectionType":"section","heading":"Legal status","content":"### sec.56 Legal status\n\nThe agency—\nis a body corporate; and\nhas perpetual succession; and\nmay sue and be sued in its corporate name.\n- (a) is a body corporate; and\n- (b) has perpetual succession; and\n- (c) may sue and be sued in its corporate name.","sortOrder":75},{"sectionNumber":"sec.57","sectionType":"section","heading":"Relationship with State","content":"### sec.57 Relationship with State\n\nThe agency represents the State.\nWithout limiting subsection (1) , the agency has the status, privileges and immunities of the State.\n(sec.57-ssec.1) The agency represents the State.\n(sec.57-ssec.2) Without limiting subsection (1) , the agency has the status, privileges and immunities of the State.","sortOrder":76},{"sectionNumber":"ch.3-pt.1-div.2","sectionType":"division","heading":"Functions and powers","content":"## Functions and powers","sortOrder":77},{"sectionNumber":"sec.58","sectionType":"section","heading":"Functions","content":"### sec.58 Functions\n\nThe main functions of the agency are to—\nadminister the scheme; and\nprovide information to the community about the scheme; and\nmonitor and review the operation of the scheme, including the treatment, care and support received by participants under the scheme; and\nconduct research and collect statistics about the scheme; and\ngive advice and information to the Treasurer and the commission about the administration, efficiency and effectiveness of the scheme; and\nprovide support and funding for programs, research and education relevant to the treatment, care and support of participants in the scheme; and\nmanage the fund; and\nset investment objectives for the fund or part of the fund and establish investment strategies and policies to achieve the objectives; and\nkeep a register of providers of services under the scheme.\nThe agency’s functions also include any other function given to it under this Act or another Act.\nThe agency may appoint an entity to perform, or advise the agency about performing, the function under subsection (1) (h) .\nAn entity appointed under subsection (3) must be—\nan entity nominated by the Treasurer; or\nif the Treasurer has not nominated an entity—the advisory board known as the State Investment Advisory Board established under the Queensland Treasury Corporation Act 1988 , section 10 .\ns 58 amd 2021 No. 12 s 161\n(sec.58-ssec.1) The main functions of the agency are to— administer the scheme; and provide information to the community about the scheme; and monitor and review the operation of the scheme, including the treatment, care and support received by participants under the scheme; and conduct research and collect statistics about the scheme; and give advice and information to the Treasurer and the commission about the administration, efficiency and effectiveness of the scheme; and provide support and funding for programs, research and education relevant to the treatment, care and support of participants in the scheme; and manage the fund; and set investment objectives for the fund or part of the fund and establish investment strategies and policies to achieve the objectives; and keep a register of providers of services under the scheme.\n(sec.58-ssec.2) The agency’s functions also include any other function given to it under this Act or another Act.\n(sec.58-ssec.3) The agency may appoint an entity to perform, or advise the agency about performing, the function under subsection (1) (h) .\n(sec.58-ssec.4) An entity appointed under subsection (3) must be— an entity nominated by the Treasurer; or if the Treasurer has not nominated an entity—the advisory board known as the State Investment Advisory Board established under the Queensland Treasury Corporation Act 1988 , section 10 .\n- (a) administer the scheme; and\n- (b) provide information to the community about the scheme; and\n- (c) monitor and review the operation of the scheme, including the treatment, care and support received by participants under the scheme; and\n- (d) conduct research and collect statistics about the scheme; and\n- (e) give advice and information to the Treasurer and the commission about the administration, efficiency and effectiveness of the scheme; and\n- (f) provide support and funding for programs, research and education relevant to the treatment, care and support of participants in the scheme; and\n- (g) manage the fund; and\n- (h) set investment objectives for the fund or part of the fund and establish investment strategies and policies to achieve the objectives; and\n- (i) keep a register of providers of services under the scheme.\n- (a) an entity nominated by the Treasurer; or\n- (b) if the Treasurer has not nominated an entity—the advisory board known as the State Investment Advisory Board established under the Queensland Treasury Corporation Act 1988 , section 10 .","sortOrder":78},{"sectionNumber":"sec.59","sectionType":"section","heading":"General principles for performing functions","content":"### sec.59 General principles for performing functions\n\nIn performing its functions under this Act, the agency must have regard to the following principles—\nparticipants in the scheme should be assisted to set and achieve individual goals;\nparticipants should be supported to maximise independence, participation in the community and employment;\nparticipants should be encouraged, and given the opportunity, to take part in decision-making and exercise choice and control;\nthe dignity and rights of participants is to be respected;\nidentifying effective treatment, care and support for a participant requires collaboration and open communication between the participant, the agency, the participant’s family and caregivers, and service providers;\nthe level of treatment, care and support received by participants under the scheme is to—\nbe evidence-based; and\nreflect community expectations; and\nprovide value for money;\nas far as possible, the scheme is to be managed in a way that ensures its operation is financially sustainable.\nSubsection (1) does not limit the matters the agency may have regard to in performing its functions.\n(sec.59-ssec.1) In performing its functions under this Act, the agency must have regard to the following principles— participants in the scheme should be assisted to set and achieve individual goals; participants should be supported to maximise independence, participation in the community and employment; participants should be encouraged, and given the opportunity, to take part in decision-making and exercise choice and control; the dignity and rights of participants is to be respected; identifying effective treatment, care and support for a participant requires collaboration and open communication between the participant, the agency, the participant’s family and caregivers, and service providers; the level of treatment, care and support received by participants under the scheme is to— be evidence-based; and reflect community expectations; and provide value for money; as far as possible, the scheme is to be managed in a way that ensures its operation is financially sustainable.\n(sec.59-ssec.2) Subsection (1) does not limit the matters the agency may have regard to in performing its functions.\n- (a) participants in the scheme should be assisted to set and achieve individual goals;\n- (b) participants should be supported to maximise independence, participation in the community and employment;\n- (c) participants should be encouraged, and given the opportunity, to take part in decision-making and exercise choice and control;\n- (d) the dignity and rights of participants is to be respected;\n- (e) identifying effective treatment, care and support for a participant requires collaboration and open communication between the participant, the agency, the participant’s family and caregivers, and service providers;\n- (f) the level of treatment, care and support received by participants under the scheme is to— (i) be evidence-based; and (ii) reflect community expectations; and (iii) provide value for money;\n- (i) be evidence-based; and\n- (ii) reflect community expectations; and\n- (iii) provide value for money;\n- (g) as far as possible, the scheme is to be managed in a way that ensures its operation is financially sustainable.\n- (i) be evidence-based; and\n- (ii) reflect community expectations; and\n- (iii) provide value for money;","sortOrder":79},{"sectionNumber":"sec.60","sectionType":"section","heading":"Agency may agree to perform functions of support entity","content":"### sec.60 Agency may agree to perform functions of support entity\n\nThe agency may enter into an agreement with a support entity that provides for the agency to perform a function of the entity under a care and support scheme law.\nThe agreement may deal with any matter necessary or convenient to help the agency perform the function of the support entity, including, for example—\nhow the performance of the function is to be funded; and\narrangements for sharing information that is relevant to the performance of the function.\nIf an agreement is entered into with a support entity, the agency may, subject to the agreement, perform the function of the entity stated in the agreement.\nIn this section—\ncare and support scheme law means an Act, or a law of the Commonwealth or another State, that provides for—\na scheme that is substantially the same as, or similar to, the scheme; or\na scheme for the payment of compensation, or providing other care and support, to persons who have suffered injury, whether or not the injury was caused by an incident involving a prescribed vehicle.\nsupport entity means an entity that has functions under a care and support scheme law, including functions under a contract of insurance required, or provided for, by a care and support scheme law.\n(sec.60-ssec.1) The agency may enter into an agreement with a support entity that provides for the agency to perform a function of the entity under a care and support scheme law.\n(sec.60-ssec.2) The agreement may deal with any matter necessary or convenient to help the agency perform the function of the support entity, including, for example— how the performance of the function is to be funded; and arrangements for sharing information that is relevant to the performance of the function.\n(sec.60-ssec.3) If an agreement is entered into with a support entity, the agency may, subject to the agreement, perform the function of the entity stated in the agreement.\n(sec.60-ssec.4) In this section— care and support scheme law means an Act, or a law of the Commonwealth or another State, that provides for— a scheme that is substantially the same as, or similar to, the scheme; or a scheme for the payment of compensation, or providing other care and support, to persons who have suffered injury, whether or not the injury was caused by an incident involving a prescribed vehicle. support entity means an entity that has functions under a care and support scheme law, including functions under a contract of insurance required, or provided for, by a care and support scheme law.\n- (a) how the performance of the function is to be funded; and\n- (b) arrangements for sharing information that is relevant to the performance of the function.\n- (a) a scheme that is substantially the same as, or similar to, the scheme; or\n- (b) a scheme for the payment of compensation, or providing other care and support, to persons who have suffered injury, whether or not the injury was caused by an incident involving a prescribed vehicle.","sortOrder":80},{"sectionNumber":"sec.61","sectionType":"section","heading":"Powers","content":"### sec.61 Powers\n\nThe agency has all the powers of an individual and may, for example—\nenter into contracts; and\nacquire, hold, deal with and dispose of property; and\nemploy staff; and\nappoint agents and attorneys; and\nengage consultants; and\ndo anything else necessary or convenient to be done in the performance of its functions.\nThe agency also has the powers given to it under this Act or another Act.\n(sec.61-ssec.1) The agency has all the powers of an individual and may, for example— enter into contracts; and acquire, hold, deal with and dispose of property; and employ staff; and appoint agents and attorneys; and engage consultants; and do anything else necessary or convenient to be done in the performance of its functions.\n(sec.61-ssec.2) The agency also has the powers given to it under this Act or another Act.\n- (a) enter into contracts; and\n- (b) acquire, hold, deal with and dispose of property; and\n- (c) employ staff; and\n- (d) appoint agents and attorneys; and\n- (e) engage consultants; and\n- (f) do anything else necessary or convenient to be done in the performance of its functions.","sortOrder":81},{"sectionNumber":"sec.62","sectionType":"section","heading":"Performing functions and exercising powers outside Queensland","content":"### sec.62 Performing functions and exercising powers outside Queensland\n\nThe agency may perform its functions, or exercise its powers, inside or outside Queensland, including outside Australia.","sortOrder":82},{"sectionNumber":"ch.3-pt.1-div.3","sectionType":"division","heading":"Administration","content":"## Administration","sortOrder":83},{"sectionNumber":"sec.63","sectionType":"section","heading":"Staff of agency","content":"### sec.63 Staff of agency\n\nThe agency may employ staff it considers appropriate to perform its functions.\nStaff are employed under this Act and not the Public Sector Act 2022 .\ns 63 amd 2022 No. 34 s 365 sch 3\n(sec.63-ssec.1) The agency may employ staff it considers appropriate to perform its functions.\n(sec.63-ssec.2) Staff are employed under this Act and not the Public Sector Act 2022 .","sortOrder":84},{"sectionNumber":"sec.64","sectionType":"section","heading":"Delegation","content":"### sec.64 Delegation\n\nThe agency may delegate the agency’s functions or powers under this Act to an appropriately qualified person who is—\nthe chief executive officer; or\nan employee of the agency; or\na person who performs work for the agency under a contractual or other arrangement; or\nan employee of an entity that performs work for the agency under a contractual or other arrangement.\ns 64 sub 2021 No. 12 s 162\n- (a) the chief executive officer; or\n- (b) an employee of the agency; or\n- (c) a person who performs work for the agency under a contractual or other arrangement; or\n- (d) an employee of an entity that performs work for the agency under a contractual or other arrangement.","sortOrder":85},{"sectionNumber":"sec.65","sectionType":"section","heading":"Advisory committees","content":"### sec.65 Advisory committees\n\nThe agency may establish 1 or more advisory committees to advise the agency on the performance of the agency’s functions under this Act.\nThe matters an advisory committee may advise on are to be decided by the agency, with the approval of the Minister.\nAn advisory committee consists of the persons appointed by the Minister on the agency’s recommendation.\nThe members of an advisory committee hold office on the terms decided by the Minister.\n(sec.65-ssec.1) The agency may establish 1 or more advisory committees to advise the agency on the performance of the agency’s functions under this Act.\n(sec.65-ssec.2) The matters an advisory committee may advise on are to be decided by the agency, with the approval of the Minister.\n(sec.65-ssec.3) An advisory committee consists of the persons appointed by the Minister on the agency’s recommendation.\n(sec.65-ssec.4) The members of an advisory committee hold office on the terms decided by the Minister.","sortOrder":86},{"sectionNumber":"ch.3-pt.2","sectionType":"part","heading":null,"content":"","sortOrder":87},{"sectionNumber":"ch.3-pt.2-div.1","sectionType":"division","heading":null,"content":"","sortOrder":88},{"sectionNumber":"sec.66","sectionType":"section","heading":null,"content":"### Section sec.66\n\ns 66 om 2021 No. 12 s 163","sortOrder":89},{"sectionNumber":"sec.67","sectionType":"section","heading":null,"content":"### Section sec.67\n\ns 67 om 2021 No. 12 s 163","sortOrder":90},{"sectionNumber":"sec.68","sectionType":"section","heading":null,"content":"### Section sec.68\n\ns 68 om 2021 No. 12 s 163","sortOrder":91},{"sectionNumber":"sec.69","sectionType":"section","heading":null,"content":"### Section sec.69\n\ns 69 om 2021 No. 12 s 163","sortOrder":92},{"sectionNumber":"sec.70","sectionType":"section","heading":null,"content":"### Section sec.70\n\ns 70 om 2021 No. 12 s 163","sortOrder":93},{"sectionNumber":"sec.71","sectionType":"section","heading":null,"content":"### Section sec.71\n\ns 71 om 2021 No. 12 s 163","sortOrder":94},{"sectionNumber":"sec.72","sectionType":"section","heading":null,"content":"### Section sec.72\n\ns 72 om 2021 No. 12 s 163","sortOrder":95},{"sectionNumber":"sec.73","sectionType":"section","heading":null,"content":"### Section sec.73\n\ns 73 om 2021 No. 12 s 163","sortOrder":96},{"sectionNumber":"ch.3-pt.2-div.2","sectionType":"division","heading":null,"content":"","sortOrder":97},{"sectionNumber":"sec.74","sectionType":"section","heading":null,"content":"### Section sec.74\n\ns 74 om 2021 No. 12 s 163","sortOrder":98},{"sectionNumber":"sec.75","sectionType":"section","heading":null,"content":"### Section sec.75\n\ns 75 om 2021 No. 12 s 163","sortOrder":99},{"sectionNumber":"sec.76","sectionType":"section","heading":null,"content":"### Section sec.76\n\ns 76 om 2021 No. 12 s 163","sortOrder":100},{"sectionNumber":"sec.77","sectionType":"section","heading":null,"content":"### Section sec.77\n\ns 77 om 2021 No. 12 s 163","sortOrder":101},{"sectionNumber":"sec.78","sectionType":"section","heading":null,"content":"### Section sec.78\n\ns 78 om 2021 No. 12 s 163","sortOrder":102},{"sectionNumber":"sec.79","sectionType":"section","heading":null,"content":"### Section sec.79\n\ns 79 om 2021 No. 12 s 163","sortOrder":103},{"sectionNumber":"ch.3-pt.2-div.3","sectionType":"division","heading":null,"content":"","sortOrder":104},{"sectionNumber":"sec.80","sectionType":"section","heading":null,"content":"### Section sec.80\n\ns 80 om 2021 No. 12 s 163","sortOrder":105},{"sectionNumber":"ch.3-pt.3","sectionType":"part","heading":"Chief executive officer","content":"# Chief executive officer","sortOrder":106},{"sectionNumber":"sec.81","sectionType":"section","heading":"Appointment","content":"### sec.81 Appointment\n\nThe agency must have a chief executive officer.\nThe chief executive officer is appointed by the Governor in Council.\nThe chief executive officer is appointed under this Act and not the Public Sector Act 2022 .\nThe Governor in Council may appoint a person who is a public service officer to hold the office of chief executive officer in conjunction with the person’s public service office.\ns 81 amd 2021 No. 12 s 164 ; 2022 No. 34 s 365 sch 3\n(sec.81-ssec.1) The agency must have a chief executive officer.\n(sec.81-ssec.2) The chief executive officer is appointed by the Governor in Council.\n(sec.81-ssec.3) The chief executive officer is appointed under this Act and not the Public Sector Act 2022 .\n(sec.81-ssec.4) The Governor in Council may appoint a person who is a public service officer to hold the office of chief executive officer in conjunction with the person’s public service office.","sortOrder":107},{"sectionNumber":"sec.82","sectionType":"section","heading":"Term of appointment","content":"### sec.82 Term of appointment\n\nThe chief executive officer holds office for the term, not longer than 5 years, stated in the instrument of the officer’s appointment.\nThe chief executive officer may be reappointed under subsection (1) even if the total of the terms of the appointment and reappointment is more than 5 years.\nThe Governor in Council may end the chief executive officer’s appointment for any reason or none.\nThe ending of the appointment under subsection (3) does not affect any rights to compensation that the chief executive officer is entitled to under the terms of the officer’s appointment.\nThe chief executive officer may resign by giving a signed notice of resignation to the Minister at least the required period before the notice is to take effect.\nIn this section—\nrequired period means the period—\nstated in the chief executive officer’s instrument of appointment or contract of employment; or\notherwise agreed with the Minister.\ns 82 amd 2021 No. 12 s 165\n(sec.82-ssec.1) The chief executive officer holds office for the term, not longer than 5 years, stated in the instrument of the officer’s appointment.\n(sec.82-ssec.2) The chief executive officer may be reappointed under subsection (1) even if the total of the terms of the appointment and reappointment is more than 5 years.\n(sec.82-ssec.3) The Governor in Council may end the chief executive officer’s appointment for any reason or none.\n(sec.82-ssec.4) The ending of the appointment under subsection (3) does not affect any rights to compensation that the chief executive officer is entitled to under the terms of the officer’s appointment.\n(sec.82-ssec.5) The chief executive officer may resign by giving a signed notice of resignation to the Minister at least the required period before the notice is to take effect.\n(sec.82-ssec.6) In this section— required period means the period— stated in the chief executive officer’s instrument of appointment or contract of employment; or otherwise agreed with the Minister.\n- (a) stated in the chief executive officer’s instrument of appointment or contract of employment; or\n- (b) otherwise agreed with the Minister.","sortOrder":108},{"sectionNumber":"sec.83","sectionType":"section","heading":"Conditions of appointment","content":"### sec.83 Conditions of appointment\n\nThe chief executive officer is to be paid the remuneration and allowances decided by the Governor in Council.\nThe chief executive officer holds office on the terms—\nprovided for by this Act; or\nstated in the chief executive officer’s contract of employment; or\ndecided by the Governor in Council.\nThis section does not apply to a public service officer appointed as the chief executive officer.\ns 83 sub 2021 No. 12 s 166\n(sec.83-ssec.1) The chief executive officer is to be paid the remuneration and allowances decided by the Governor in Council.\n(sec.83-ssec.2) The chief executive officer holds office on the terms— provided for by this Act; or stated in the chief executive officer’s contract of employment; or decided by the Governor in Council.\n(sec.83-ssec.3) This section does not apply to a public service officer appointed as the chief executive officer.\n- (a) provided for by this Act; or\n- (b) stated in the chief executive officer’s contract of employment; or\n- (c) decided by the Governor in Council.","sortOrder":109},{"sectionNumber":"sec.84","sectionType":"section","heading":"Chief executive officer’s functions","content":"### sec.84 Chief executive officer’s functions\n\nThe functions of the chief executive officer are to—\nmanage the agency; and\nensure the agency’s functions are performed in a proper, effective and efficient way; and\ndevelop strategies and policies about the performance of the agency’s functions.\nThe chief executive officer’s functions also include any other function given to the chief executive under this Act.\ns 84 sub 2021 No. 12 s 167\n(sec.84-ssec.1) The functions of the chief executive officer are to— manage the agency; and ensure the agency’s functions are performed in a proper, effective and efficient way; and develop strategies and policies about the performance of the agency’s functions.\n(sec.84-ssec.2) The chief executive officer’s functions also include any other function given to the chief executive under this Act.\n- (a) manage the agency; and\n- (b) ensure the agency’s functions are performed in a proper, effective and efficient way; and\n- (c) develop strategies and policies about the performance of the agency’s functions.","sortOrder":110},{"sectionNumber":"ch.3-pt.4","sectionType":"part","heading":"Reporting and accountability","content":"# Reporting and accountability","sortOrder":111},{"sectionNumber":"ch.3-pt.4-div.1","sectionType":"division","heading":"Application of financial Acts","content":"## Application of financial Acts","sortOrder":112},{"sectionNumber":"sec.85","sectionType":"section","heading":"Application of financial Acts","content":"### sec.85 Application of financial Acts\n\nThe agency is—\na statutory body under the Financial Accountability Act 2009 ; and\na statutory body under the Statutory Bodies Financial Arrangements Act 1982 .\nThe Statutory Bodies Financial Arrangements Act 1982 , part 2B sets out the way in which the agency’s powers under this Act are affected by the Statutory Bodies Financial Arrangements Act 1982 .\n(sec.85-ssec.1) The agency is— a statutory body under the Financial Accountability Act 2009 ; and a statutory body under the Statutory Bodies Financial Arrangements Act 1982 .\n(sec.85-ssec.2) The Statutory Bodies Financial Arrangements Act 1982 , part 2B sets out the way in which the agency’s powers under this Act are affected by the Statutory Bodies Financial Arrangements Act 1982 .\n- (a) a statutory body under the Financial Accountability Act 2009 ; and\n- (b) a statutory body under the Statutory Bodies Financial Arrangements Act 1982 .","sortOrder":113},{"sectionNumber":"ch.3-pt.4-div.2","sectionType":"division","heading":"Reporting generally","content":"## Reporting generally","sortOrder":114},{"sectionNumber":"sec.86","sectionType":"section","heading":"Quarterly reports","content":"### sec.86 Quarterly reports\n\nThe chief executive officer must give the Treasurer a report about the agency’s financial position and performance for each quarter in a financial year.\nA quarterly report must be given to the Treasurer within—\n4 weeks after the end of the quarter; or\nanother period after the end of the quarter agreed between the chief executive officer and the Treasurer.\nIn this section—\nquarter , in a financial year, means any of the following periods in the year—\n1 July to 30 September;\n1 October to 31 December;\n1 January to 31 March;\n1 April to 30 June.\ns 86 amd 2021 No. 12 s 168\n(sec.86-ssec.1) The chief executive officer must give the Treasurer a report about the agency’s financial position and performance for each quarter in a financial year.\n(sec.86-ssec.2) A quarterly report must be given to the Treasurer within— 4 weeks after the end of the quarter; or another period after the end of the quarter agreed between the chief executive officer and the Treasurer.\n(sec.86-ssec.3) In this section— quarter , in a financial year, means any of the following periods in the year— 1 July to 30 September; 1 October to 31 December; 1 January to 31 March; 1 April to 30 June.\n- (a) 4 weeks after the end of the quarter; or\n- (b) another period after the end of the quarter agreed between the chief executive officer and the Treasurer.\n- (a) 1 July to 30 September;\n- (b) 1 October to 31 December;\n- (c) 1 January to 31 March;\n- (d) 1 April to 30 June.","sortOrder":115},{"sectionNumber":"sec.87","sectionType":"section","heading":"Chief executive officer to inform Treasurer of particular issues","content":"### sec.87 Chief executive officer to inform Treasurer of particular issues\n\nThe chief executive officer must immediately inform the Treasurer if an issue arises that, in the chief executive officer’s opinion, may significantly affect—\nthe agency’s financial position; or\nthe ability of the agency to perform its functions.\nAs soon as practicable after informing the Treasurer of an issue, the chief executive officer must give the Treasurer—\na written report about the issue; and\nany other information about the issue required by the Treasurer to make an informed assessment of the issue.\ns 87 amd 2021 No. 12 s 169\n(sec.87-ssec.1) The chief executive officer must immediately inform the Treasurer if an issue arises that, in the chief executive officer’s opinion, may significantly affect— the agency’s financial position; or the ability of the agency to perform its functions.\n(sec.87-ssec.2) As soon as practicable after informing the Treasurer of an issue, the chief executive officer must give the Treasurer— a written report about the issue; and any other information about the issue required by the Treasurer to make an informed assessment of the issue.\n- (a) the agency’s financial position; or\n- (b) the ability of the agency to perform its functions.\n- (a) a written report about the issue; and\n- (b) any other information about the issue required by the Treasurer to make an informed assessment of the issue.","sortOrder":116},{"sectionNumber":"sec.88","sectionType":"section","heading":"Reporting to department","content":"### sec.88 Reporting to department\n\nThe Treasurer may act under this section for the purpose of monitoring, assessing or reporting on the agency’s performance of its functions.\nThe Treasurer may require the chief executive officer to report to the department by, for example, giving stated information at stated times to the chief executive.\nThe chief executive officer must comply with the requirement.\ns 88 amd 2021 No. 12 s 170\n(sec.88-ssec.1) The Treasurer may act under this section for the purpose of monitoring, assessing or reporting on the agency’s performance of its functions.\n(sec.88-ssec.2) The Treasurer may require the chief executive officer to report to the department by, for example, giving stated information at stated times to the chief executive.\n(sec.88-ssec.3) The chief executive officer must comply with the requirement.","sortOrder":117},{"sectionNumber":"ch.3-pt.4-div.3","sectionType":"division","heading":"Annual reports","content":"## Annual reports","sortOrder":118},{"sectionNumber":"sec.89","sectionType":"section","heading":"Information to be included in annual report","content":"### sec.89 Information to be included in annual report\n\nThe agency’s annual report under the Financial Accountability Act 2009 for a financial year must include—\nenough information to enable the Treasurer to make an informed assessment of the agency’s financial position and performance; and\ninformation about whether the agency has achieved the objectives stated in the agency’s strategic plan for the financial year; and\ninformation about the extent to which the scheme was fully funded in the financial year, based on actuarial advice; and\nif the Treasurer gave a direction to the agency under section 136 in the financial year—\na copy of the direction; and\ninformation about whether the direction affected the ability of the agency to achieve the objectives stated in the agency’s strategic plan for the financial year; and\nany other information that a guideline made by the Treasurer states must be included in the annual report.\nThis section does not limit the Financial Accountability Act 2009 , section 63 .\n(sec.89-ssec.1) The agency’s annual report under the Financial Accountability Act 2009 for a financial year must include— enough information to enable the Treasurer to make an informed assessment of the agency’s financial position and performance; and information about whether the agency has achieved the objectives stated in the agency’s strategic plan for the financial year; and information about the extent to which the scheme was fully funded in the financial year, based on actuarial advice; and if the Treasurer gave a direction to the agency under section 136 in the financial year— a copy of the direction; and information about whether the direction affected the ability of the agency to achieve the objectives stated in the agency’s strategic plan for the financial year; and any other information that a guideline made by the Treasurer states must be included in the annual report.\n(sec.89-ssec.2) This section does not limit the Financial Accountability Act 2009 , section 63 .\n- (a) enough information to enable the Treasurer to make an informed assessment of the agency’s financial position and performance; and\n- (b) information about whether the agency has achieved the objectives stated in the agency’s strategic plan for the financial year; and\n- (c) information about the extent to which the scheme was fully funded in the financial year, based on actuarial advice; and\n- (d) if the Treasurer gave a direction to the agency under section 136 in the financial year— (i) a copy of the direction; and (ii) information about whether the direction affected the ability of the agency to achieve the objectives stated in the agency’s strategic plan for the financial year; and\n- (i) a copy of the direction; and\n- (ii) information about whether the direction affected the ability of the agency to achieve the objectives stated in the agency’s strategic plan for the financial year; and\n- (e) any other information that a guideline made by the Treasurer states must be included in the annual report.\n- (i) a copy of the direction; and\n- (ii) information about whether the direction affected the ability of the agency to achieve the objectives stated in the agency’s strategic plan for the financial year; and","sortOrder":119},{"sectionNumber":"ch.3-pt.4-div.4","sectionType":"division","heading":"Strategic and operational plans","content":"## Strategic and operational plans","sortOrder":120},{"sectionNumber":"sec.90","sectionType":"section","heading":"Relationship with Financial Accountability Act 2009","content":"### sec.90 Relationship with Financial Accountability Act 2009\n\nIf something is required to be done under this division and the same thing, or something to the same effect, is required to be done under the Financial Accountability Act 2009 , compliance with this division is sufficient compliance with the Financial Accountability Act 2009 .\nOtherwise, the requirements under this division are in addition to the requirements under the Financial Accountability Act 2009 .\nIf there is an inconsistency between this division and the Financial Accountability Act 2009 , this division prevails to the extent of the inconsistency.\n(sec.90-ssec.1) If something is required to be done under this division and the same thing, or something to the same effect, is required to be done under the Financial Accountability Act 2009 , compliance with this division is sufficient compliance with the Financial Accountability Act 2009 .\n(sec.90-ssec.2) Otherwise, the requirements under this division are in addition to the requirements under the Financial Accountability Act 2009 .\n(sec.90-ssec.3) If there is an inconsistency between this division and the Financial Accountability Act 2009 , this division prevails to the extent of the inconsistency.","sortOrder":121},{"sectionNumber":"sec.91","sectionType":"section","heading":"Draft strategic and operational plans","content":"### sec.91 Draft strategic and operational plans\n\nBefore 31 March each year, the agency must prepare, and give to the Treasurer for agreement, a draft strategic plan and a draft operational plan for the next financial year.\nWhen the draft strategic plan or draft operational plan is agreed to in writing by the Treasurer, it becomes the agency’s strategic plan or operational plan for the relevant financial year.\ns 91 amd 2021 No. 12 s 171\n(sec.91-ssec.1) Before 31 March each year, the agency must prepare, and give to the Treasurer for agreement, a draft strategic plan and a draft operational plan for the next financial year.\n(sec.91-ssec.2) When the draft strategic plan or draft operational plan is agreed to in writing by the Treasurer, it becomes the agency’s strategic plan or operational plan for the relevant financial year.","sortOrder":122},{"sectionNumber":"sec.92","sectionType":"section","heading":"Modifications of strategic or operational plan","content":"### sec.92 Modifications of strategic or operational plan\n\nThe agency may modify the agency’s strategic plan or operational plan only with the written agreement of the Treasurer.\ns 92 amd 2021 No. 12 s 172","sortOrder":123},{"sectionNumber":"ch.4-pt.1","sectionType":"part","heading":"National injury insurance scheme fund, Queensland","content":"# National injury insurance scheme fund, Queensland","sortOrder":124},{"sectionNumber":"sec.93","sectionType":"section","heading":"Establishment of fund","content":"### sec.93 Establishment of fund\n\nThere is to be a fund called the national injury insurance scheme fund, Queensland.\nThe fund consists of—\nthe amounts received by the agency by way of the levy; and\nthe amounts received or recovered by the agency in connection with the scheme; and\nincome derived from the investment of the fund; and\nan amount transferred to the fund under section 95 ; and\nan amount paid to the agency under section 96 (2) .\nThe following amounts are to be paid from the fund—\nthe costs of administering the scheme, including payments made under chapter 2 , part 4 ;\nthe costs of managing the fund;\nthe costs of the agency in performing its functions and exercising its powers under this Act;\nan amount that must be paid under section 94 ;\nan amount to reimburse the Commonwealth for expenses incurred by the Commonwealth under the National Disability Insurance Scheme Act 2013 (Cwlth) in relation to persons suffering a serious personal injury in relation to which this Act applies.\nThe agency must, in managing the fund, consider the financial sustainability of the fund and seek actuarial advice as appropriate.\n(sec.93-ssec.1) There is to be a fund called the national injury insurance scheme fund, Queensland.\n(sec.93-ssec.2) The fund consists of— the amounts received by the agency by way of the levy; and the amounts received or recovered by the agency in connection with the scheme; and income derived from the investment of the fund; and an amount transferred to the fund under section 95 ; and an amount paid to the agency under section 96 (2) .\n(sec.93-ssec.3) The following amounts are to be paid from the fund— the costs of administering the scheme, including payments made under chapter 2 , part 4 ; the costs of managing the fund; the costs of the agency in performing its functions and exercising its powers under this Act; an amount that must be paid under section 94 ; an amount to reimburse the Commonwealth for expenses incurred by the Commonwealth under the National Disability Insurance Scheme Act 2013 (Cwlth) in relation to persons suffering a serious personal injury in relation to which this Act applies.\n(sec.93-ssec.4) The agency must, in managing the fund, consider the financial sustainability of the fund and seek actuarial advice as appropriate.\n- (a) the amounts received by the agency by way of the levy; and\n- (b) the amounts received or recovered by the agency in connection with the scheme; and\n- (c) income derived from the investment of the fund; and\n- (d) an amount transferred to the fund under section 95 ; and\n- (e) an amount paid to the agency under section 96 (2) .\n- (a) the costs of administering the scheme, including payments made under chapter 2 , part 4 ;\n- (b) the costs of managing the fund;\n- (c) the costs of the agency in performing its functions and exercising its powers under this Act;\n- (d) an amount that must be paid under section 94 ;\n- (e) an amount to reimburse the Commonwealth for expenses incurred by the Commonwealth under the National Disability Insurance Scheme Act 2013 (Cwlth) in relation to persons suffering a serious personal injury in relation to which this Act applies.","sortOrder":125},{"sectionNumber":"sec.94","sectionType":"section","heading":"Payments from fund for public hospital services and emergency services","content":"### sec.94 Payments from fund for public hospital services and emergency services\n\nAn amount decided by the Treasurer must be paid from the fund for each financial year to—\nthe department in which the Fire Services Act 1990 is administered; and\nthe department in which the Hospital and Health Boards Act 2011 is administered; and\nthe department in which the Ambulance Service Act 1991 is administered; and\nany other government entity, decided by the Treasurer, that is responsible for providing public hospital services or emergency services.\nThe amount decided by the Treasurer must cover a reasonable proportion of the estimated cost of providing public hospital services and emergency services for the financial year in which the amount is paid, having regard to the number of people who—\nare injured in motor accidents; and\nmake use of public hospital services and emergency services as a result of their injuries; and\nare participants, or eligible to participate, in the scheme.\ns 94 amd 2024 No. 22 s 92 sch 1\n(sec.94-ssec.1) An amount decided by the Treasurer must be paid from the fund for each financial year to— the department in which the Fire Services Act 1990 is administered; and the department in which the Hospital and Health Boards Act 2011 is administered; and the department in which the Ambulance Service Act 1991 is administered; and any other government entity, decided by the Treasurer, that is responsible for providing public hospital services or emergency services.\n(sec.94-ssec.2) The amount decided by the Treasurer must cover a reasonable proportion of the estimated cost of providing public hospital services and emergency services for the financial year in which the amount is paid, having regard to the number of people who— are injured in motor accidents; and make use of public hospital services and emergency services as a result of their injuries; and are participants, or eligible to participate, in the scheme.\n- (a) the department in which the Fire Services Act 1990 is administered; and\n- (b) the department in which the Hospital and Health Boards Act 2011 is administered; and\n- (c) the department in which the Ambulance Service Act 1991 is administered; and\n- (d) any other government entity, decided by the Treasurer, that is responsible for providing public hospital services or emergency services.\n- (a) are injured in motor accidents; and\n- (b) make use of public hospital services and emergency services as a result of their injuries; and\n- (c) are participants, or eligible to participate, in the scheme.","sortOrder":126},{"sectionNumber":"sec.95","sectionType":"section","heading":"Transfer of funds from the nominal defendant fund","content":"### sec.95 Transfer of funds from the nominal defendant fund\n\nThe Treasurer may transfer an amount decided by the Treasurer from the nominal defendant fund under the Insurance Act to the fund.\nThis section applies despite the Insurance Act , section 29(3) .\n(sec.95-ssec.1) The Treasurer may transfer an amount decided by the Treasurer from the nominal defendant fund under the Insurance Act to the fund.\n(sec.95-ssec.2) This section applies despite the Insurance Act , section 29(3) .","sortOrder":127},{"sectionNumber":"sec.96","sectionType":"section","heading":"Payment of unearned insurer’s premiums","content":"### sec.96 Payment of unearned insurer’s premiums\n\nThe Treasurer may decide, based on actuarial advice, an amount that is payable by a licensed insurer in relation to—\nthe amount derived, or to be derived, by the insurer from insurer’s premiums relating to its liability, or potential liability, for damages for the treatment, care and support needs of persons covered by a CTP insurance policy; and\nthe extent to which the liability, or potential liability, mentioned in paragraph (a) is reduced after the commencement.\nThe amount decided by the Treasurer for a licensed insurer must be paid by the licensed insurer to the agency at a time decided by the Treasurer.\nIn this section—\ninsurer’s premium see the Insurance Act , section 4 .\nlicensed insurer see the Insurance Act , section 4 .\n(sec.96-ssec.1) The Treasurer may decide, based on actuarial advice, an amount that is payable by a licensed insurer in relation to— the amount derived, or to be derived, by the insurer from insurer’s premiums relating to its liability, or potential liability, for damages for the treatment, care and support needs of persons covered by a CTP insurance policy; and the extent to which the liability, or potential liability, mentioned in paragraph (a) is reduced after the commencement.\n(sec.96-ssec.2) The amount decided by the Treasurer for a licensed insurer must be paid by the licensed insurer to the agency at a time decided by the Treasurer.\n(sec.96-ssec.3) In this section— insurer’s premium see the Insurance Act , section 4 . licensed insurer see the Insurance Act , section 4 .\n- (a) the amount derived, or to be derived, by the insurer from insurer’s premiums relating to its liability, or potential liability, for damages for the treatment, care and support needs of persons covered by a CTP insurance policy; and\n- (b) the extent to which the liability, or potential liability, mentioned in paragraph (a) is reduced after the commencement.","sortOrder":128},{"sectionNumber":"ch.4-pt.2","sectionType":"part","heading":"Fund levy","content":"# Fund levy","sortOrder":129},{"sectionNumber":"sec.97","sectionType":"section","heading":"Agency’s recommendation about levy","content":"### sec.97 Agency’s recommendation about levy\n\nAt least 5 months before the end of each financial year, the agency must—\ncalculate, based on actuarial advice, the amount required to be contributed to the fund for the next financial year—\nto fully fund the present and likely future liabilities of the agency under chapter 2 , part 4 in the financial year, other than a liability relating to a person accepted as a participant in the scheme under section 13 (2) ; and\nto meet other payments required to be made from the fund in the financial year; and\nto cover any other matter the agency considers appropriate; and\ngive a copy of the calculations to the commission; and\ngive the commission a written recommendation about the amount of the levy for the next financial year.\n- (a) calculate, based on actuarial advice, the amount required to be contributed to the fund for the next financial year— (i) to fully fund the present and likely future liabilities of the agency under chapter 2 , part 4 in the financial year, other than a liability relating to a person accepted as a participant in the scheme under section 13 (2) ; and (ii) to meet other payments required to be made from the fund in the financial year; and (iii) to cover any other matter the agency considers appropriate; and\n- (i) to fully fund the present and likely future liabilities of the agency under chapter 2 , part 4 in the financial year, other than a liability relating to a person accepted as a participant in the scheme under section 13 (2) ; and\n- (ii) to meet other payments required to be made from the fund in the financial year; and\n- (iii) to cover any other matter the agency considers appropriate; and\n- (b) give a copy of the calculations to the commission; and\n- (c) give the commission a written recommendation about the amount of the levy for the next financial year.\n- (i) to fully fund the present and likely future liabilities of the agency under chapter 2 , part 4 in the financial year, other than a liability relating to a person accepted as a participant in the scheme under section 13 (2) ; and\n- (ii) to meet other payments required to be made from the fund in the financial year; and\n- (iii) to cover any other matter the agency considers appropriate; and","sortOrder":130},{"sectionNumber":"sec.98","sectionType":"section","heading":"Commission’s recommendation about levy","content":"### sec.98 Commission’s recommendation about levy\n\nAt least 4 months before the end of each financial year, the commission must give the Treasurer a written recommendation about the amount of the levy for the next financial year.\nIn making the recommendation, the commission—\nmust consider—\nthe agency’s calculations and recommendation under section 97 for the financial year; and\nan analysis of the scheme prepared by an actuary; and\nmay consider any other matter the commission considers appropriate.\nSubsection (4) applies if—\nthere is an unexpected increase in the agency’s liabilities for a financial year; and\nthe commission is satisfied the increase requires the levy fixed for the financial year to be increased before the end of the financial year.\nThe commission may, at any time, recommend to the Treasurer a special increase in the levy.\n(sec.98-ssec.1) At least 4 months before the end of each financial year, the commission must give the Treasurer a written recommendation about the amount of the levy for the next financial year.\n(sec.98-ssec.2) In making the recommendation, the commission— must consider— the agency’s calculations and recommendation under section 97 for the financial year; and an analysis of the scheme prepared by an actuary; and may consider any other matter the commission considers appropriate.\n(sec.98-ssec.3) Subsection (4) applies if— there is an unexpected increase in the agency’s liabilities for a financial year; and the commission is satisfied the increase requires the levy fixed for the financial year to be increased before the end of the financial year.\n(sec.98-ssec.4) The commission may, at any time, recommend to the Treasurer a special increase in the levy.\n- (a) must consider— (i) the agency’s calculations and recommendation under section 97 for the financial year; and (ii) an analysis of the scheme prepared by an actuary; and\n- (i) the agency’s calculations and recommendation under section 97 for the financial year; and\n- (ii) an analysis of the scheme prepared by an actuary; and\n- (b) may consider any other matter the commission considers appropriate.\n- (i) the agency’s calculations and recommendation under section 97 for the financial year; and\n- (ii) an analysis of the scheme prepared by an actuary; and\n- (a) there is an unexpected increase in the agency’s liabilities for a financial year; and\n- (b) the commission is satisfied the increase requires the levy fixed for the financial year to be increased before the end of the financial year.","sortOrder":131},{"sectionNumber":"sec.99","sectionType":"section","heading":"Fixing levy","content":"### sec.99 Fixing levy\n\nThe levy for a financial year is the amount fixed by regulation for the financial year.\nA regulation for a financial year must be made at least 3 months before the start of the financial year.\nHowever, if a regulation fixing the levy for a financial year is not made at least 3 months before the start of the financial year, the levy last fixed continues as the levy for the financial year until a regulation for the financial year commences.\nA regulation made for a financial year that is not made at least 3 months before the start of the financial year commences—\n3 months after it is notified; or\non a later day stated in the regulation.\nIf the commission recommends a special increase in the levy and the Treasurer approves the increase, a regulation fixing the increased levy may be made at any time.\nIf a regulation fixes an increased levy, the increased levy becomes the levy fixed for the remainder of the financial year in which the regulation commences.\nSubsection (4) applies despite the Statutory Instruments Act 1992 , section 32 .\n(sec.99-ssec.1) The levy for a financial year is the amount fixed by regulation for the financial year.\n(sec.99-ssec.2) A regulation for a financial year must be made at least 3 months before the start of the financial year.\n(sec.99-ssec.3) However, if a regulation fixing the levy for a financial year is not made at least 3 months before the start of the financial year, the levy last fixed continues as the levy for the financial year until a regulation for the financial year commences.\n(sec.99-ssec.4) A regulation made for a financial year that is not made at least 3 months before the start of the financial year commences— 3 months after it is notified; or on a later day stated in the regulation.\n(sec.99-ssec.5) If the commission recommends a special increase in the levy and the Treasurer approves the increase, a regulation fixing the increased levy may be made at any time.\n(sec.99-ssec.6) If a regulation fixes an increased levy, the increased levy becomes the levy fixed for the remainder of the financial year in which the regulation commences.\n(sec.99-ssec.7) Subsection (4) applies despite the Statutory Instruments Act 1992 , section 32 .\n- (a) 3 months after it is notified; or\n- (b) on a later day stated in the regulation.","sortOrder":132},{"sectionNumber":"ch.4-pt.3","sectionType":"part","heading":"Recovery of amounts","content":"# Recovery of amounts","sortOrder":133},{"sectionNumber":"sec.100","sectionType":"section","heading":"Recovery in case of fraud","content":"### sec.100 Recovery in case of fraud\n\nThe agency may recover, as a debt, from a person who defrauds or attempts to defraud the agency in relation to a participant in the scheme any costs reasonably incurred by the agency because of the fraud.","sortOrder":134},{"sectionNumber":"sec.101","sectionType":"section","heading":"Recovery from persons in default","content":"### sec.101 Recovery from persons in default\n\nThis section applies if—\nan insurer has a right of recovery against a person under the Insurance Act , section 58 in relation to personal injury arising out of a motor vehicle accident; or\nthe nominal defendant has a right of recovery against a person under the Insurance Act , section 60 in relation to personal injury arising out of a motor vehicle accident.\nThe agency may exercise the same right of recovery against the person as the insurer or nominal defendant may exercise for the present value of the agency’s treatment, care and support liabilities for a participant in the scheme.\nHowever—\nthis section does not give a right of recovery against a participant; and\nthe agency may exercise its right of recovery against a person only if, and to the extent, the participant’s injury was caused, wholly or partly, by a wrongful act or omission of the person.\nThe Insurance Act , sections 58 and 60 (1) and (2) apply in relation to the agency’s right of recovery—\nas if a reference in section 58 to the claimant were a reference to the participant; and\nas if a reference in section 58 to the insurer were a reference to the agency; and\nas if a reference in section 60 (1) and (2) to the nominal defendant were a reference to the agency; and\nwith any other necessary changes.\nTo remove any doubt, it is declared that this section applies whether or not a claim has been made for the personal injury stated in subsection (1) (a) or (b) .\nIn this section—\nmotor vehicle accident see the Insurance Act , section 4 .\npersonal injury see the Insurance Act , section 4 .\n(sec.101-ssec.1) This section applies if— an insurer has a right of recovery against a person under the Insurance Act , section 58 in relation to personal injury arising out of a motor vehicle accident; or the nominal defendant has a right of recovery against a person under the Insurance Act , section 60 in relation to personal injury arising out of a motor vehicle accident.\n(sec.101-ssec.2) The agency may exercise the same right of recovery against the person as the insurer or nominal defendant may exercise for the present value of the agency’s treatment, care and support liabilities for a participant in the scheme.\n(sec.101-ssec.3) However— this section does not give a right of recovery against a participant; and the agency may exercise its right of recovery against a person only if, and to the extent, the participant’s injury was caused, wholly or partly, by a wrongful act or omission of the person.\n(sec.101-ssec.4) The Insurance Act , sections 58 and 60 (1) and (2) apply in relation to the agency’s right of recovery— as if a reference in section 58 to the claimant were a reference to the participant; and as if a reference in section 58 to the insurer were a reference to the agency; and as if a reference in section 60 (1) and (2) to the nominal defendant were a reference to the agency; and with any other necessary changes.\n(sec.101-ssec.5) To remove any doubt, it is declared that this section applies whether or not a claim has been made for the personal injury stated in subsection (1) (a) or (b) .\n(sec.101-ssec.6) In this section— motor vehicle accident see the Insurance Act , section 4 . personal injury see the Insurance Act , section 4 .\n- (a) an insurer has a right of recovery against a person under the Insurance Act , section 58 in relation to personal injury arising out of a motor vehicle accident; or\n- (b) the nominal defendant has a right of recovery against a person under the Insurance Act , section 60 in relation to personal injury arising out of a motor vehicle accident.\n- (a) this section does not give a right of recovery against a participant; and\n- (b) the agency may exercise its right of recovery against a person only if, and to the extent, the participant’s injury was caused, wholly or partly, by a wrongful act or omission of the person.\n- (a) as if a reference in section 58 to the claimant were a reference to the participant; and\n- (b) as if a reference in section 58 to the insurer were a reference to the agency; and\n- (c) as if a reference in section 60 (1) and (2) to the nominal defendant were a reference to the agency; and\n- (d) with any other necessary changes.","sortOrder":135},{"sectionNumber":"sec.102","sectionType":"section","heading":"Recovery from insurer for interstate vehicles","content":"### sec.102 Recovery from insurer for interstate vehicles\n\nThis section applies if—\na participant’s injury was caused, wholly or partly, by a wrongful act or omission of the owner or driver of a prescribed vehicle, other than the participant; and\nwhen the motor accident resulting in the injury happened, the vehicle was covered by a CTP insurance policy under the law of another State.\nThe agency may recover, as a debt, from the insurer under the CTP insurance policy the present value of the agency’s treatment, care and support liabilities for the participant.\nHowever, subsection (2) applies only to the extent the owner or driver of the prescribed vehicle is liable for the injury.\n(sec.102-ssec.1) This section applies if— a participant’s injury was caused, wholly or partly, by a wrongful act or omission of the owner or driver of a prescribed vehicle, other than the participant; and when the motor accident resulting in the injury happened, the vehicle was covered by a CTP insurance policy under the law of another State.\n(sec.102-ssec.2) The agency may recover, as a debt, from the insurer under the CTP insurance policy the present value of the agency’s treatment, care and support liabilities for the participant.\n(sec.102-ssec.3) However, subsection (2) applies only to the extent the owner or driver of the prescribed vehicle is liable for the injury.\n- (a) a participant’s injury was caused, wholly or partly, by a wrongful act or omission of the owner or driver of a prescribed vehicle, other than the participant; and\n- (b) when the motor accident resulting in the injury happened, the vehicle was covered by a CTP insurance policy under the law of another State.","sortOrder":136},{"sectionNumber":"ch.6-pt.1","sectionType":"part","heading":"Internal review","content":"# Internal review","sortOrder":137},{"sectionNumber":"sec.105","sectionType":"section","heading":"External review by QCAT starts with internal review","content":"### sec.105 External review by QCAT starts with internal review\n\nA person may not apply to QCAT for review of a decision unless the person has applied for an internal review of the decision under this part.","sortOrder":138},{"sectionNumber":"sec.106","sectionType":"section","heading":"Who may apply for internal review","content":"### sec.106 Who may apply for internal review\n\nA person who has been given, or is entitled to be given, an information notice for a decision made under this Act (an original decision ) may apply (an internal review application ) to the agency for a review (an internal review ) of the decision under this part.\nA person who has not been given, but is entitled to be given, an information notice for an original decision may ask the agency for an information notice for the decision.\nThe failure by the agency to give a person an information notice for an original decision does not limit or otherwise affect the person’s right to apply for an internal review of the decision under subsection (1) .\nAn internal review application does not stay the original decision to which it relates.\n(sec.106-ssec.1) A person who has been given, or is entitled to be given, an information notice for a decision made under this Act (an original decision ) may apply (an internal review application ) to the agency for a review (an internal review ) of the decision under this part.\n(sec.106-ssec.2) A person who has not been given, but is entitled to be given, an information notice for an original decision may ask the agency for an information notice for the decision.\n(sec.106-ssec.3) The failure by the agency to give a person an information notice for an original decision does not limit or otherwise affect the person’s right to apply for an internal review of the decision under subsection (1) .\n(sec.106-ssec.4) An internal review application does not stay the original decision to which it relates.","sortOrder":139},{"sectionNumber":"sec.107","sectionType":"section","heading":"Requirements for making application","content":"### sec.107 Requirements for making application\n\nAn internal review application must—\nbe in the approved form; and\nif the applicant is given an information notice for the original decision to which the application relates—\nbe supported by enough information to enable the agency to decide the application; and\nbe made within 28 days after the applicant is given the information notice.\nHowever, the agency may, at any time, extend the time for making an internal review application.\nIf an internal review application is made, the applicant must give a copy of the application to any other affected person for the application.\n(sec.107-ssec.1) An internal review application must— be in the approved form; and if the applicant is given an information notice for the original decision to which the application relates— be supported by enough information to enable the agency to decide the application; and be made within 28 days after the applicant is given the information notice.\n(sec.107-ssec.2) However, the agency may, at any time, extend the time for making an internal review application.\n(sec.107-ssec.3) If an internal review application is made, the applicant must give a copy of the application to any other affected person for the application.\n- (a) be in the approved form; and\n- (b) if the applicant is given an information notice for the original decision to which the application relates— (i) be supported by enough information to enable the agency to decide the application; and (ii) be made within 28 days after the applicant is given the information notice.\n- (i) be supported by enough information to enable the agency to decide the application; and\n- (ii) be made within 28 days after the applicant is given the information notice.\n- (i) be supported by enough information to enable the agency to decide the application; and\n- (ii) be made within 28 days after the applicant is given the information notice.","sortOrder":140},{"sectionNumber":"sec.108","sectionType":"section","heading":"Information request","content":"### sec.108 Information request\n\nThe agency may, by notice (an information request ), ask any of the following persons to give further information needed to decide an internal review application—\nthe applicant;\nanother affected person for the application.\nThe information request must be made within 28 days after the internal review application is received.\n(sec.108-ssec.1) The agency may, by notice (an information request ), ask any of the following persons to give further information needed to decide an internal review application— the applicant; another affected person for the application.\n(sec.108-ssec.2) The information request must be made within 28 days after the internal review application is received.\n- (a) the applicant;\n- (b) another affected person for the application.","sortOrder":141},{"sectionNumber":"sec.109","sectionType":"section","heading":"Internal review","content":"### sec.109 Internal review\n\nThe agency must, within the decision period—\nconduct an internal review of the original decision; and\nmake a decision (the internal review decision ) to—\nconfirm the original decision; or\namend the original decision; or\nsubstitute another decision for the original decision.\nThe application may be dealt with only by a person who—\ndid not make the original decision; and\nis in a more senior office than the person who made the original decision.\nSubsection (2) —\napplies despite the Acts Interpretation Act 1954 , section 27A ; and\ndoes not apply to an original decision made by the agency itself.\nIf the agency does not make a decision under subsection (1) (b) within the decision period, the agency is taken to have made an internal review decision confirming the original decision.\nIf the internal review decision confirms, or under subsection (4) or section 110 (3) , is taken to confirm, the original decision, for the purpose of an external review, the original decision is taken to be the internal review decision.\nIf the internal review decision amends the original decision, for the purpose of an external review, the original decision as amended is taken to be the internal review decision.\nIn this section—\ndecision period means—\nif an information request for the internal review application is made—the period of 28 days after the further information requested is given to the agency; or\notherwise—the period of 28 days after the agency receives the internal review application.\n(sec.109-ssec.1) The agency must, within the decision period— conduct an internal review of the original decision; and make a decision (the internal review decision ) to— confirm the original decision; or amend the original decision; or substitute another decision for the original decision.\n(sec.109-ssec.2) The application may be dealt with only by a person who— did not make the original decision; and is in a more senior office than the person who made the original decision.\n(sec.109-ssec.3) Subsection (2) — applies despite the Acts Interpretation Act 1954 , section 27A ; and does not apply to an original decision made by the agency itself.\n(sec.109-ssec.4) If the agency does not make a decision under subsection (1) (b) within the decision period, the agency is taken to have made an internal review decision confirming the original decision.\n(sec.109-ssec.5) If the internal review decision confirms, or under subsection (4) or section 110 (3) , is taken to confirm, the original decision, for the purpose of an external review, the original decision is taken to be the internal review decision.\n(sec.109-ssec.6) If the internal review decision amends the original decision, for the purpose of an external review, the original decision as amended is taken to be the internal review decision.\n(sec.109-ssec.7) In this section— decision period means— if an information request for the internal review application is made—the period of 28 days after the further information requested is given to the agency; or otherwise—the period of 28 days after the agency receives the internal review application.\n- (a) conduct an internal review of the original decision; and\n- (b) make a decision (the internal review decision ) to— (i) confirm the original decision; or (ii) amend the original decision; or (iii) substitute another decision for the original decision.\n- (i) confirm the original decision; or\n- (ii) amend the original decision; or\n- (iii) substitute another decision for the original decision.\n- (i) confirm the original decision; or\n- (ii) amend the original decision; or\n- (iii) substitute another decision for the original decision.\n- (a) did not make the original decision; and\n- (b) is in a more senior office than the person who made the original decision.\n- (a) applies despite the Acts Interpretation Act 1954 , section 27A ; and\n- (b) does not apply to an original decision made by the agency itself.\n- (a) if an information request for the internal review application is made—the period of 28 days after the further information requested is given to the agency; or\n- (b) otherwise—the period of 28 days after the agency receives the internal review application.","sortOrder":142},{"sectionNumber":"sec.110","sectionType":"section","heading":"Notice of internal review decision","content":"### sec.110 Notice of internal review decision\n\nWithin 14 days after making an internal review decision, the agency must give notice of the decision to—\nthe applicant; and\nanother affected person for the internal review application to which the decision relates.\nIf the internal review decision is not the decision sought by the applicant, the notice must be a decision notice.\nIf the agency does not give the notice under subsection (1) , the agency is taken to have made an internal review decision confirming the original decision.\nIf the agency is taken, under subsection (3) or section 109 (4) , to have made an internal review decision confirming the original decision, the persons stated in subsection (1) are entitled to be given a decision notice for the decision.\n(sec.110-ssec.1) Within 14 days after making an internal review decision, the agency must give notice of the decision to— the applicant; and another affected person for the internal review application to which the decision relates.\n(sec.110-ssec.2) If the internal review decision is not the decision sought by the applicant, the notice must be a decision notice.\n(sec.110-ssec.3) If the agency does not give the notice under subsection (1) , the agency is taken to have made an internal review decision confirming the original decision.\n(sec.110-ssec.4) If the agency is taken, under subsection (3) or section 109 (4) , to have made an internal review decision confirming the original decision, the persons stated in subsection (1) are entitled to be given a decision notice for the decision.\n- (a) the applicant; and\n- (b) another affected person for the internal review application to which the decision relates.","sortOrder":143},{"sectionNumber":"sec.111","sectionType":"section","heading":"Request for decision notice","content":"### sec.111 Request for decision notice\n\nA person who has not been given, but is entitled to be given, a decision notice for an internal review decision may ask the agency for a decision notice for the decision.\nThe failure by the agency to give a person a decision notice for an internal review decision does not limit or otherwise affect the person’s right to apply for an external review of the decision under section 127 .\n(sec.111-ssec.1) A person who has not been given, but is entitled to be given, a decision notice for an internal review decision may ask the agency for a decision notice for the decision.\n(sec.111-ssec.2) The failure by the agency to give a person a decision notice for an internal review decision does not limit or otherwise affect the person’s right to apply for an external review of the decision under section 127 .","sortOrder":144},{"sectionNumber":"ch.6-pt.2","sectionType":"part","heading":"External reviews","content":"# External reviews","sortOrder":145},{"sectionNumber":"ch.6-pt.2-div.1","sectionType":"division","heading":"Review by medical tribunal","content":"## Review by medical tribunal","sortOrder":146},{"sectionNumber":"sec.112","sectionType":"section","heading":"Request to refer medical matter to medical tribunal","content":"### sec.112 Request to refer medical matter to medical tribunal\n\nThis section applies if an internal review decision involves a decision on any of the following matters (each a medical matter )—\nwhether a motor accident is the medical cause of a serious personal injury;\nwhether a serious personal injury meets the eligibility criteria for the injury, to the extent the eligibility criteria relate to matters of a medical nature;\nwhether an interim participant’s injury is likely to continue to meet the eligibility criteria for the injury after the participation period ends, to the extent the eligibility criteria relate to matters of a medical nature;\nanother matter of a medical nature prescribed by regulation.\nA person who has been given, or is entitled to be given, a decision notice under section 110 (2) or (4) for the internal review decision may, by notice (a referral request ), ask the agency to refer the medical matter to a medical tribunal.\nThe referral request must be made within 28 days after the decision notice is given, or required to be given, to the person.\nIf a person makes a referral request, the person must give a copy of the request to any other affected person for the request.\nA medical tribunal has jurisdiction to make a decision about a medical matter referred to it.\n(sec.112-ssec.1) This section applies if an internal review decision involves a decision on any of the following matters (each a medical matter )— whether a motor accident is the medical cause of a serious personal injury; whether a serious personal injury meets the eligibility criteria for the injury, to the extent the eligibility criteria relate to matters of a medical nature; whether an interim participant’s injury is likely to continue to meet the eligibility criteria for the injury after the participation period ends, to the extent the eligibility criteria relate to matters of a medical nature; another matter of a medical nature prescribed by regulation.\n(sec.112-ssec.2) A person who has been given, or is entitled to be given, a decision notice under section 110 (2) or (4) for the internal review decision may, by notice (a referral request ), ask the agency to refer the medical matter to a medical tribunal.\n(sec.112-ssec.3) The referral request must be made within 28 days after the decision notice is given, or required to be given, to the person.\n(sec.112-ssec.4) If a person makes a referral request, the person must give a copy of the request to any other affected person for the request.\n(sec.112-ssec.5) A medical tribunal has jurisdiction to make a decision about a medical matter referred to it.\n- (a) whether a motor accident is the medical cause of a serious personal injury;\n- (b) whether a serious personal injury meets the eligibility criteria for the injury, to the extent the eligibility criteria relate to matters of a medical nature;\n- (c) whether an interim participant’s injury is likely to continue to meet the eligibility criteria for the injury after the participation period ends, to the extent the eligibility criteria relate to matters of a medical nature;\n- (d) another matter of a medical nature prescribed by regulation.","sortOrder":147},{"sectionNumber":"sec.113","sectionType":"section","heading":"Agency must refer medical matter","content":"### sec.113 Agency must refer medical matter\n\nIf the agency receives a referral request for a medical matter, the agency must refer the matter to a medical tribunal for decision on the matter.\nThe reference must—\nbe in the form approved by the Regulator under the Workers’ Compensation Act ; and\ninclude, or be accompanied by, a copy of all documents held by the agency that are relevant to the medical matter.\n(sec.113-ssec.1) If the agency receives a referral request for a medical matter, the agency must refer the matter to a medical tribunal for decision on the matter.\n(sec.113-ssec.2) The reference must— be in the form approved by the Regulator under the Workers’ Compensation Act ; and include, or be accompanied by, a copy of all documents held by the agency that are relevant to the medical matter.\n- (a) be in the form approved by the Regulator under the Workers’ Compensation Act ; and\n- (b) include, or be accompanied by, a copy of all documents held by the agency that are relevant to the medical matter.","sortOrder":148},{"sectionNumber":"sec.114","sectionType":"section","heading":"Constitution of medical tribunal","content":"### sec.114 Constitution of medical tribunal\n\nThis section applies—\nif a medical matter is referred to a medical tribunal under section 113 ; and\ndespite the Workers’ Compensation Act , section 494 .\nThe tribunal must not be constituted by a person who is an employee of—\nthe agency; or\nan insurer.\n(sec.114-ssec.1) This section applies— if a medical matter is referred to a medical tribunal under section 113 ; and despite the Workers’ Compensation Act , section 494 .\n(sec.114-ssec.2) The tribunal must not be constituted by a person who is an employee of— the agency; or an insurer.\n- (a) if a medical matter is referred to a medical tribunal under section 113 ; and\n- (b) despite the Workers’ Compensation Act , section 494 .\n- (a) the agency; or\n- (b) an insurer.","sortOrder":149},{"sectionNumber":"sec.115","sectionType":"section","heading":"Power of medical tribunal to carry out or arrange examination","content":"### sec.115 Power of medical tribunal to carry out or arrange examination\n\nIf a medical matter is referred to a medical tribunal under section 113 , the tribunal may—\nmake a personal examination of the injured person to whom the referral relates at any time; or\narrange for the examination to be made by a doctor nominated by the tribunal.\nThe Workers’ Compensation Act , section 510 (1A) to (3) applies in relation to the examination of the injured person as if—\na reference to the worker were a reference to the injured person; and\nthe reference in section 510 (3) to any entitlement the worker may have to compensation were a reference to an entitlement the injured person may have to a payment under chapter 2 , part 4 .\n(sec.115-ssec.1) If a medical matter is referred to a medical tribunal under section 113 , the tribunal may— make a personal examination of the injured person to whom the referral relates at any time; or arrange for the examination to be made by a doctor nominated by the tribunal.\n(sec.115-ssec.2) The Workers’ Compensation Act , section 510 (1A) to (3) applies in relation to the examination of the injured person as if— a reference to the worker were a reference to the injured person; and the reference in section 510 (3) to any entitlement the worker may have to compensation were a reference to an entitlement the injured person may have to a payment under chapter 2 , part 4 .\n- (a) make a personal examination of the injured person to whom the referral relates at any time; or\n- (b) arrange for the examination to be made by a doctor nominated by the tribunal.\n- (a) a reference to the worker were a reference to the injured person; and\n- (b) the reference in section 510 (3) to any entitlement the worker may have to compensation were a reference to an entitlement the injured person may have to a payment under chapter 2 , part 4 .","sortOrder":150},{"sectionNumber":"sec.116","sectionType":"section","heading":"Application of subdivision","content":"### sec.116 Application of subdivision\n\nThis subdivision applies to a proceeding of a medical tribunal for a medical matter referred to the tribunal under section 113 .\nThe Workers’ Compensation Act , chapter 11 , part 4 does not apply to a proceeding mentioned in subsection (1) .\n(sec.116-ssec.1) This subdivision applies to a proceeding of a medical tribunal for a medical matter referred to the tribunal under section 113 .\n(sec.116-ssec.2) The Workers’ Compensation Act , chapter 11 , part 4 does not apply to a proceeding mentioned in subsection (1) .","sortOrder":151},{"sectionNumber":"sec.117","sectionType":"section","heading":"Medical tribunal may request further information","content":"### sec.117 Medical tribunal may request further information\n\nThe medical tribunal may, by notice, ask any of the following persons to give the tribunal further information needed to make a decision on the medical matter—\nthe person who made the referral request;\nthe agency;\nanother affected person for the referral request.\nThe requested information must be given to the medical tribunal within the period stated in the notice.\n(sec.117-ssec.1) The medical tribunal may, by notice, ask any of the following persons to give the tribunal further information needed to make a decision on the medical matter— the person who made the referral request; the agency; another affected person for the referral request.\n(sec.117-ssec.2) The requested information must be given to the medical tribunal within the period stated in the notice.\n- (a) the person who made the referral request;\n- (b) the agency;\n- (c) another affected person for the referral request.","sortOrder":152},{"sectionNumber":"sec.118","sectionType":"section","heading":"Exchange of relevant documents before medical tribunal","content":"### sec.118 Exchange of relevant documents before medical tribunal\n\nAfter the agency refers the medical matter to the medical tribunal, relevant documents can only be exchanged between the tribunal, the agency and the injured person to whom the reference relates.\nThe tribunal must give the injured person a copy of a relevant document given by the agency to the tribunal—\nif the document is given under section 113 (2) (b) —within 10 business days after the medical matter is referred to the tribunal; or\notherwise—within 5 business days after the tribunal receives the document.\nAt least 10 business days before the injured person is scheduled to attend before the tribunal, the injured person must give the tribunal and the agency a copy of any relevant document the injured person wants considered by the tribunal.\nAt least 3 business days before the injured person is scheduled to attend before the tribunal, the agency may give the tribunal and the injured person a written submission on the factual matters referred to in the relevant documents given by the injured person under subsection (3) .\nThe tribunal may proceed to decide the matter even though the agency has not given a written submission to the tribunal and the injured person.\nThe tribunal can not consider or rely on any relevant document given by the agency or the injured person that has not been exchanged under this subdivision.\nHowever, subsection (6) does not prevent the tribunal from relying on either of the following—\na report (a doctor’s report ) resulting from an examination of the injured person by a doctor nominated by the tribunal under section 115 (1) (b) ;\na medical image given to the tribunal by the injured person.\nCT, MRI, ultrasound scan, X-ray\n(sec.118-ssec.1) After the agency refers the medical matter to the medical tribunal, relevant documents can only be exchanged between the tribunal, the agency and the injured person to whom the reference relates.\n(sec.118-ssec.2) The tribunal must give the injured person a copy of a relevant document given by the agency to the tribunal— if the document is given under section 113 (2) (b) —within 10 business days after the medical matter is referred to the tribunal; or otherwise—within 5 business days after the tribunal receives the document.\n(sec.118-ssec.3) At least 10 business days before the injured person is scheduled to attend before the tribunal, the injured person must give the tribunal and the agency a copy of any relevant document the injured person wants considered by the tribunal.\n(sec.118-ssec.4) At least 3 business days before the injured person is scheduled to attend before the tribunal, the agency may give the tribunal and the injured person a written submission on the factual matters referred to in the relevant documents given by the injured person under subsection (3) .\n(sec.118-ssec.5) The tribunal may proceed to decide the matter even though the agency has not given a written submission to the tribunal and the injured person.\n(sec.118-ssec.6) The tribunal can not consider or rely on any relevant document given by the agency or the injured person that has not been exchanged under this subdivision.\n(sec.118-ssec.7) However, subsection (6) does not prevent the tribunal from relying on either of the following— a report (a doctor’s report ) resulting from an examination of the injured person by a doctor nominated by the tribunal under section 115 (1) (b) ; a medical image given to the tribunal by the injured person. CT, MRI, ultrasound scan, X-ray\n- (a) if the document is given under section 113 (2) (b) —within 10 business days after the medical matter is referred to the tribunal; or\n- (b) otherwise—within 5 business days after the tribunal receives the document.\n- (a) a report (a doctor’s report ) resulting from an examination of the injured person by a doctor nominated by the tribunal under section 115 (1) (b) ;\n- (b) a medical image given to the tribunal by the injured person. Examples of medical images— CT, MRI, ultrasound scan, X-ray","sortOrder":153},{"sectionNumber":"sec.119","sectionType":"section","heading":"Right to appear and be heard before medical tribunal","content":"### sec.119 Right to appear and be heard before medical tribunal\n\nDespite any Act or other law, this section is the only provision of law under which a person may be heard in relation to a medical matter referred under this Act to a medical tribunal.\nOn a reference to a medical tribunal, the injured person to whom the reference relates is entitled to be heard before the tribunal in person or by the person’s representative.\nOnly the injured person and any representative of the injured person may be present or heard before the medical tribunal.\nTo remove any doubt, it is declared that the agency or any other person (not being the injured person) whose interests may be affected by a decision made by a medical tribunal can not be present, represented or heard before a medical tribunal.\n(sec.119-ssec.1) Despite any Act or other law, this section is the only provision of law under which a person may be heard in relation to a medical matter referred under this Act to a medical tribunal.\n(sec.119-ssec.2) On a reference to a medical tribunal, the injured person to whom the reference relates is entitled to be heard before the tribunal in person or by the person’s representative.\n(sec.119-ssec.3) Only the injured person and any representative of the injured person may be present or heard before the medical tribunal.\n(sec.119-ssec.4) To remove any doubt, it is declared that the agency or any other person (not being the injured person) whose interests may be affected by a decision made by a medical tribunal can not be present, represented or heard before a medical tribunal.","sortOrder":154},{"sectionNumber":"sec.120","sectionType":"section","heading":"New medical information","content":"### sec.120 New medical information\n\nThis section applies if—\nnew information about a medical matter, other than information in a relevant document, comes to a medical tribunal’s knowledge when an injured person attends before the tribunal; or\na medical tribunal receives a doctor’s report.\nThe medical tribunal is not required to give the information or report to the agency or to anyone else for any purpose, either before or after the tribunal makes its decision.\n(sec.120-ssec.1) This section applies if— new information about a medical matter, other than information in a relevant document, comes to a medical tribunal’s knowledge when an injured person attends before the tribunal; or a medical tribunal receives a doctor’s report.\n(sec.120-ssec.2) The medical tribunal is not required to give the information or report to the agency or to anyone else for any purpose, either before or after the tribunal makes its decision.\n- (a) new information about a medical matter, other than information in a relevant document, comes to a medical tribunal’s knowledge when an injured person attends before the tribunal; or\n- (b) a medical tribunal receives a doctor’s report.","sortOrder":155},{"sectionNumber":"sec.121","sectionType":"section","heading":"Record keeping by medical tribunal","content":"### sec.121 Record keeping by medical tribunal\n\nA medical tribunal must keep a record of—\nrelevant documents exchanged in relation to a reference of a medical matter; and\nthe reasons for the tribunal’s decision on the reference.\nHowever, the tribunal is not required to make a transcript or recording of an injured person’s attendance before the tribunal.\nA transcript or recording, if made, can only be disclosed to an injured person and a representative of the injured person.\nThis section does not limit section 124 .\n(sec.121-ssec.1) A medical tribunal must keep a record of— relevant documents exchanged in relation to a reference of a medical matter; and the reasons for the tribunal’s decision on the reference.\n(sec.121-ssec.2) However, the tribunal is not required to make a transcript or recording of an injured person’s attendance before the tribunal.\n(sec.121-ssec.3) A transcript or recording, if made, can only be disclosed to an injured person and a representative of the injured person.\n(sec.121-ssec.4) This section does not limit section 124 .\n- (a) relevant documents exchanged in relation to a reference of a medical matter; and\n- (b) the reasons for the tribunal’s decision on the reference.","sortOrder":156},{"sectionNumber":"sec.122","sectionType":"section","heading":"Deferral of decisions","content":"### sec.122 Deferral of decisions\n\nA medical tribunal may defer its decision on a reference to it.\nHowever, a deferral must not be for longer than 3 months at any 1 time.\n(sec.122-ssec.1) A medical tribunal may defer its decision on a reference to it.\n(sec.122-ssec.2) However, a deferral must not be for longer than 3 months at any 1 time.","sortOrder":157},{"sectionNumber":"sec.123","sectionType":"section","heading":"Finality of medical tribunal’s decision","content":"### sec.123 Finality of medical tribunal’s decision\n\nA decision of a medical tribunal on a medical matter referred to it is final and is not reviewable by QCAT.","sortOrder":158},{"sectionNumber":"sec.124","sectionType":"section","heading":"Decisions of medical tribunal","content":"### sec.124 Decisions of medical tribunal\n\nAfter a medical tribunal makes a decision on a medical matter referred to it, the tribunal must give notice of the decision, including the reasons for the decision, to—\nthe person who made the referral request; and\nthe agency; and\nanother affected person for the referral request.\nIf a medical matter referred to a medical tribunal involves other matters that are not medical matters, the notice given under subsection (1) must—\nnote the other matters; and\nstate the tribunal has not made a decision on the other matters.\n(sec.124-ssec.1) After a medical tribunal makes a decision on a medical matter referred to it, the tribunal must give notice of the decision, including the reasons for the decision, to— the person who made the referral request; and the agency; and another affected person for the referral request.\n(sec.124-ssec.2) If a medical matter referred to a medical tribunal involves other matters that are not medical matters, the notice given under subsection (1) must— note the other matters; and state the tribunal has not made a decision on the other matters.\n- (a) the person who made the referral request; and\n- (b) the agency; and\n- (c) another affected person for the referral request.\n- (a) note the other matters; and\n- (b) state the tribunal has not made a decision on the other matters.","sortOrder":159},{"sectionNumber":"sec.125","sectionType":"section","heading":"Protection from liability","content":"### sec.125 Protection from liability\n\nA member of a medical tribunal does not incur civil liability for an act done, or omission made, honestly and without negligence under this Act.\nIf subsection (1) prevents a civil liability attaching to a member of the tribunal, the liability attaches instead to the State.\n(sec.125-ssec.1) A member of a medical tribunal does not incur civil liability for an act done, or omission made, honestly and without negligence under this Act.\n(sec.125-ssec.2) If subsection (1) prevents a civil liability attaching to a member of the tribunal, the liability attaches instead to the State.","sortOrder":160},{"sectionNumber":"sec.126","sectionType":"section","heading":"Agency must review internal review decision","content":"### sec.126 Agency must review internal review decision\n\nWithin 14 days after receiving notice of a medical tribunal’s decision under section 124 , the agency must—\nreview the internal review decision to which the tribunal’s decision relates; and\nif the internal review decision is inconsistent with the tribunal’s decision—make a new internal review decision under section 109 .\n- (a) review the internal review decision to which the tribunal’s decision relates; and\n- (b) if the internal review decision is inconsistent with the tribunal’s decision—make a new internal review decision under section 109 .","sortOrder":161},{"sectionNumber":"ch.6-pt.2-div.2","sectionType":"division","heading":"External review by QCAT","content":"## External review by QCAT","sortOrder":162},{"sectionNumber":"sec.127","sectionType":"section","heading":"Who may apply for review by QCAT","content":"### sec.127 Who may apply for review by QCAT\n\nA person who is given, or is entitled to be given, a decision notice under section 110 (2) or (4) for an internal review decision may apply, as provided under the QCAT Act , to QCAT for review of the decision.\nSubsection (3) applies if—\nan internal review decision involves a decision on a medical matter; and\nthe medical matter is referred to a medical tribunal under section 113 .\nAn application for review of the internal review decision may be made within 28 days after the medical tribunal gives notice, under section 124 , of its decision on the medical matter.\nIf a person applies to QCAT for a review, the person must give a copy of the application to any other person who was given, or was entitled to be given, a decision notice for the internal review decision to which the application relates.\n(sec.127-ssec.1) A person who is given, or is entitled to be given, a decision notice under section 110 (2) or (4) for an internal review decision may apply, as provided under the QCAT Act , to QCAT for review of the decision.\n(sec.127-ssec.2) Subsection (3) applies if— an internal review decision involves a decision on a medical matter; and the medical matter is referred to a medical tribunal under section 113 .\n(sec.127-ssec.3) An application for review of the internal review decision may be made within 28 days after the medical tribunal gives notice, under section 124 , of its decision on the medical matter.\n(sec.127-ssec.4) If a person applies to QCAT for a review, the person must give a copy of the application to any other person who was given, or was entitled to be given, a decision notice for the internal review decision to which the application relates.\n- (a) an internal review decision involves a decision on a medical matter; and\n- (b) the medical matter is referred to a medical tribunal under section 113 .","sortOrder":163},{"sectionNumber":"sec.128","sectionType":"section","heading":"Receiving or adopting things in other proceedings","content":"### sec.128 Receiving or adopting things in other proceedings\n\nDuring the hearing of a proceeding for the review of an internal review decision, QCAT may—\nreceive in evidence a transcript, or part of a transcript, of evidence taken in a relevant proceeding before a court, tribunal or other entity, and draw conclusions of fact from the evidence that QCAT considers appropriate; or\nadopt, as QCAT considers appropriate, decisions, findings, judgments, or reasons for judgment, of a court, tribunal or other entity that may be relevant to the hearing.\nIn this section—\nrelevant proceeding means a proceeding for, or relating to, an action for damages for a personal injury that—\narises out of a motor vehicle accident, as defined in the Insurance Act ; and\nrelates to the internal review decision.\n(sec.128-ssec.1) During the hearing of a proceeding for the review of an internal review decision, QCAT may— receive in evidence a transcript, or part of a transcript, of evidence taken in a relevant proceeding before a court, tribunal or other entity, and draw conclusions of fact from the evidence that QCAT considers appropriate; or adopt, as QCAT considers appropriate, decisions, findings, judgments, or reasons for judgment, of a court, tribunal or other entity that may be relevant to the hearing.\n(sec.128-ssec.2) In this section— relevant proceeding means a proceeding for, or relating to, an action for damages for a personal injury that— arises out of a motor vehicle accident, as defined in the Insurance Act ; and relates to the internal review decision.\n- (a) receive in evidence a transcript, or part of a transcript, of evidence taken in a relevant proceeding before a court, tribunal or other entity, and draw conclusions of fact from the evidence that QCAT considers appropriate; or\n- (b) adopt, as QCAT considers appropriate, decisions, findings, judgments, or reasons for judgment, of a court, tribunal or other entity that may be relevant to the hearing.\n- (a) arises out of a motor vehicle accident, as defined in the Insurance Act ; and\n- (b) relates to the internal review decision.","sortOrder":164},{"sectionNumber":"sec.129","sectionType":"section","heading":"Proceedings involving medical matters referred to medical tribunal","content":"### sec.129 Proceedings involving medical matters referred to medical tribunal\n\nThis section applies to a proceeding before QCAT for the review of an internal review decision if—\nthe internal review decision involves a decision on a medical matter; and\nthe medical matter is referred to a medical tribunal under section 113 .\nQCAT must not make a decision in the proceeding until the medical tribunal makes a decision on the medical matter.\nSee also section 123 .\n(sec.129-ssec.1) This section applies to a proceeding before QCAT for the review of an internal review decision if— the internal review decision involves a decision on a medical matter; and the medical matter is referred to a medical tribunal under section 113 .\n(sec.129-ssec.2) QCAT must not make a decision in the proceeding until the medical tribunal makes a decision on the medical matter.\n- (a) the internal review decision involves a decision on a medical matter; and\n- (b) the medical matter is referred to a medical tribunal under section 113 .","sortOrder":165},{"sectionNumber":"ch.8-pt.1","sectionType":"part","heading":"Offences, evidence and proceedings","content":"# Offences, evidence and proceedings","sortOrder":166},{"sectionNumber":"sec.132","sectionType":"section","heading":"Offences involving fraud","content":"### sec.132 Offences involving fraud\n\nA person must not—\ndefraud or attempt to defraud the agency; or\ndeliberately mislead or attempt deliberately to mislead the agency; or\nconnive at conduct by another that contravenes paragraph (a) or (b) .\nMaximum penalty—400 penalty units or 18 months imprisonment.\nIf conduct that constitutes an offence defined in subsection (1) is recurrent so that, but for this subsection, each instance of the conduct would constitute a separate offence, 2 or more instances of the conduct are to be taken to constitute but 1 offence committed over a period specified in the complaint laid in relation to the conduct, and may be charged and be dealt with on 1 complaint.\n(sec.132-ssec.1) A person must not— defraud or attempt to defraud the agency; or deliberately mislead or attempt deliberately to mislead the agency; or connive at conduct by another that contravenes paragraph (a) or (b) . Maximum penalty—400 penalty units or 18 months imprisonment.\n(sec.132-ssec.2) If conduct that constitutes an offence defined in subsection (1) is recurrent so that, but for this subsection, each instance of the conduct would constitute a separate offence, 2 or more instances of the conduct are to be taken to constitute but 1 offence committed over a period specified in the complaint laid in relation to the conduct, and may be charged and be dealt with on 1 complaint.\n- (a) defraud or attempt to defraud the agency; or\n- (b) deliberately mislead or attempt deliberately to mislead the agency; or\n- (c) connive at conduct by another that contravenes paragraph (a) or (b) .","sortOrder":167},{"sectionNumber":"sec.133","sectionType":"section","heading":"False or misleading information","content":"### sec.133 False or misleading information\n\nA person must not, in relation to the administration of this Act, give the agency information the person knows is false or misleading in a material particular.\nMaximum penalty—150 penalty units or 1 year’s imprisonment.\nSubsection (1) does not apply to a person if the person, when giving information in a document—\ntells the agency, to the best of the person’s ability, how the document is false or misleading; and\nif the person has, or can reasonably obtain, the correct information—gives the correct information.\n(sec.133-ssec.1) A person must not, in relation to the administration of this Act, give the agency information the person knows is false or misleading in a material particular. Maximum penalty—150 penalty units or 1 year’s imprisonment.\n(sec.133-ssec.2) Subsection (1) does not apply to a person if the person, when giving information in a document— tells the agency, to the best of the person’s ability, how the document is false or misleading; and if the person has, or can reasonably obtain, the correct information—gives the correct information.\n- (a) tells the agency, to the best of the person’s ability, how the document is false or misleading; and\n- (b) if the person has, or can reasonably obtain, the correct information—gives the correct information.","sortOrder":168},{"sectionNumber":"sec.134","sectionType":"section","heading":"Offences against this Act","content":"### sec.134 Offences against this Act\n\nAn offence against this Act is a summary offence.\nA proceeding for the offence must start within—\n1 year after the commission of the offence; or\n6 months after the offence comes to the complainant’s knowledge, but within 2 years after the commission of the offence.\n(sec.134-ssec.1) An offence against this Act is a summary offence.\n(sec.134-ssec.2) A proceeding for the offence must start within— 1 year after the commission of the offence; or 6 months after the offence comes to the complainant’s knowledge, but within 2 years after the commission of the offence.\n- (a) 1 year after the commission of the offence; or\n- (b) 6 months after the offence comes to the complainant’s knowledge, but within 2 years after the commission of the offence.","sortOrder":169},{"sectionNumber":"sec.135","sectionType":"section","heading":"Statement of complainant’s knowledge","content":"### sec.135 Statement of complainant’s knowledge\n\nIn a complaint starting a proceeding for an offence against this Act, a statement that the matter of the complaint came to the complainant’s knowledge on a stated day is evidence the matter came to the complainant’s knowledge on that day.","sortOrder":170},{"sectionNumber":"ch.8-pt.2","sectionType":"part","heading":"Other provisions","content":"# Other provisions","sortOrder":171},{"sectionNumber":"sec.136","sectionType":"section","heading":"Direction to agency or chief executive officer about functions and powers","content":"### sec.136 Direction to agency or chief executive officer about functions and powers\n\nThe Treasurer may give a written direction to the following entities about the performance of the entity’s functions or the exercise of the entity’s powers—\nthe agency;\nthe chief executive officer.\nHowever, a direction must not be about the content of advice or information, or a recommendation or report, prepared by the agency.\nThe entity must comply with the direction.\ns 136 amd 2021 No. 12 s 173\n(sec.136-ssec.1) The Treasurer may give a written direction to the following entities about the performance of the entity’s functions or the exercise of the entity’s powers— the agency; the chief executive officer.\n(sec.136-ssec.2) However, a direction must not be about the content of advice or information, or a recommendation or report, prepared by the agency.\n(sec.136-ssec.3) The entity must comply with the direction.\n- (a) the agency;\n- (b) the chief executive officer.","sortOrder":172},{"sectionNumber":"sec.137","sectionType":"section","heading":"Direction to agency or commission about alternative service delivery","content":"### sec.137 Direction to agency or commission about alternative service delivery\n\nThe Treasurer may give a written direction to the agency or the commission requiring the preparation of a report about alternative ways of providing insurance or funding for the treatment, care and support of persons who are eligible to participate in the scheme.\nIf a direction is given under subsection (1) , the agency or commission must, within the period stated in the direction—\nprepare the report; and\ngive the report to the Treasurer.\n(sec.137-ssec.1) The Treasurer may give a written direction to the agency or the commission requiring the preparation of a report about alternative ways of providing insurance or funding for the treatment, care and support of persons who are eligible to participate in the scheme.\n(sec.137-ssec.2) If a direction is given under subsection (1) , the agency or commission must, within the period stated in the direction— prepare the report; and give the report to the Treasurer.\n- (a) prepare the report; and\n- (b) give the report to the Treasurer.","sortOrder":173},{"sectionNumber":"sec.138","sectionType":"section","heading":null,"content":"### Section sec.138\n\ns 138 exp 1 July 2021 (see s 138(3))","sortOrder":174},{"sectionNumber":"sec.139","sectionType":"section","heading":"Approved forms","content":"### sec.139 Approved forms\n\nThe chief executive officer may approve forms for use under this Act.\ns 139 amd 2021 No. 12 s 174","sortOrder":175},{"sectionNumber":"sec.140","sectionType":"section","heading":"Regulation-making power","content":"### sec.140 Regulation-making power\n\nThe Governor in Council may make regulations under this Act.\nA regulation may—\nprescribe the circumstances in which a person is entitled to a rebate on, or refund of, the payment of the levy and the process for applying for a rebate or refund; and\nprescribe fees payable under the Act ; and\nprovide for a maximum penalty of 20 penalty units for a contravention of a regulation.\n(sec.140-ssec.1) The Governor in Council may make regulations under this Act.\n(sec.140-ssec.2) A regulation may— prescribe the circumstances in which a person is entitled to a rebate on, or refund of, the payment of the levy and the process for applying for a rebate or refund; and prescribe fees payable under the Act ; and provide for a maximum penalty of 20 penalty units for a contravention of a regulation.\n- (a) prescribe the circumstances in which a person is entitled to a rebate on, or refund of, the payment of the levy and the process for applying for a rebate or refund; and\n- (b) prescribe fees payable under the Act ; and\n- (c) provide for a maximum penalty of 20 penalty units for a contravention of a regulation.","sortOrder":176},{"sectionNumber":"ch.9-pt.1","sectionType":"part","heading":"Transitional provisions for Act No. 34 of 2016","content":"# Transitional provisions for Act No. 34 of 2016","sortOrder":177},{"sectionNumber":"sec.141","sectionType":"section","heading":"Definition for part","content":"### sec.141 Definition for part\n\nIn this part—\ninsurance commissioner means the insurance commissioner under the Insurance Act in the commissioner’s official capacity, but not in the capacity of insurance commissioner or nominal defendant under that Act.\ns 141 amd 2021 No. 12 s 176","sortOrder":178},{"sectionNumber":"sec.142","sectionType":"section","heading":"Insurance commissioner is first board","content":"### sec.142 Insurance commissioner is first board\n\nThe insurance commissioner constitutes the board until it first consists of at least 4 members appointed under this Act.\nFor subsection (1), the insurance commissioner has the functions and powers of the board stated in—\nsection 67(1) and (3); and\nsections 86 to 88; and\nsections 91 and 92; and\nsection 139.\n(sec.142-ssec.1) The insurance commissioner constitutes the board until it first consists of at least 4 members appointed under this Act.\n(sec.142-ssec.2) For subsection (1), the insurance commissioner has the functions and powers of the board stated in— section 67(1) and (3); and sections 86 to 88; and sections 91 and 92; and section 139.\n- (a) section 67(1) and (3); and\n- (b) sections 86 to 88; and\n- (c) sections 91 and 92; and\n- (d) section 139.","sortOrder":179},{"sectionNumber":"sec.143","sectionType":"section","heading":"Insurance commissioner is first chief executive officer","content":"### sec.143 Insurance commissioner is first chief executive officer\n\nThe insurance commissioner is the chief executive officer of the agency until the earlier of the following events happens—\nthe board, consisting of at least 4 members, appoints a chief executive officer under section 81(2);\nthe Governor in Council appoints a chief executive officer under subsection (4).\nSection 83(2) does not apply to the insurance commissioner in relation to the commissioner’s role as chief executive officer.\nSubsections (4) and (5) apply until the board first consists of at least 4 members.\nThe Governor in Council may, on the recommendation of the Treasurer, appoint a chief executive officer of the agency.\nA person appointed as the chief executive officer under subsection (4) holds office on the terms, not provided for under this Act, decided by the Governor in Council.\n(sec.143-ssec.1) The insurance commissioner is the chief executive officer of the agency until the earlier of the following events happens— the board, consisting of at least 4 members, appoints a chief executive officer under section 81(2); the Governor in Council appoints a chief executive officer under subsection (4).\n(sec.143-ssec.2) Section 83(2) does not apply to the insurance commissioner in relation to the commissioner’s role as chief executive officer.\n(sec.143-ssec.3) Subsections (4) and (5) apply until the board first consists of at least 4 members.\n(sec.143-ssec.4) The Governor in Council may, on the recommendation of the Treasurer, appoint a chief executive officer of the agency.\n(sec.143-ssec.5) A person appointed as the chief executive officer under subsection (4) holds office on the terms, not provided for under this Act, decided by the Governor in Council.\n- (a) the board, consisting of at least 4 members, appoints a chief executive officer under section 81(2);\n- (b) the Governor in Council appoints a chief executive officer under subsection (4).","sortOrder":180},{"sectionNumber":"sec.144","sectionType":"section","heading":"Agency’s first strategic and operational plans","content":"### sec.144 Agency’s first strategic and operational plans\n\nThis section applies—\nto the agency’s first strategic plan and operational plan; and\ndespite section 91.\nThe period within which the board must prepare, and give to the Treasurer, a draft strategic plan and a draft operational plan is—\n1 month after the agency is established; or\nanother period agreed between the board and the Treasurer.\nThe strategic plan or operational plan mentioned in subsection (2) becomes the agency’s strategic plan or operational plan for—\nthe remainder of the financial year in which the plan is agreed to in writing by the Treasurer; and\nif the board and the Treasurer agree the plan is also to apply for the following financial year—that financial year.\n(sec.144-ssec.1) This section applies— to the agency’s first strategic plan and operational plan; and despite section 91.\n(sec.144-ssec.2) The period within which the board must prepare, and give to the Treasurer, a draft strategic plan and a draft operational plan is— 1 month after the agency is established; or another period agreed between the board and the Treasurer.\n(sec.144-ssec.3) The strategic plan or operational plan mentioned in subsection (2) becomes the agency’s strategic plan or operational plan for— the remainder of the financial year in which the plan is agreed to in writing by the Treasurer; and if the board and the Treasurer agree the plan is also to apply for the following financial year—that financial year.\n- (a) to the agency’s first strategic plan and operational plan; and\n- (b) despite section 91.\n- (a) 1 month after the agency is established; or\n- (b) another period agreed between the board and the Treasurer.\n- (a) the remainder of the financial year in which the plan is agreed to in writing by the Treasurer; and\n- (b) if the board and the Treasurer agree the plan is also to apply for the following financial year—that financial year.","sortOrder":181},{"sectionNumber":"sec.145","sectionType":"section","heading":"Levy for the 2016-2017 financial year","content":"### sec.145 Levy for the 2016-2017 financial year\n\nSection 99(2) and (4) does not apply to a regulation fixing the levy for the 2016-2017 financial year.\nIf a regulation fixing the levy for the 2016-2017 financial year commences after the start of the financial year, the regulation fixes the levy for the remainder of the financial year.\n(sec.145-ssec.1) Section 99(2) and (4) does not apply to a regulation fixing the levy for the 2016-2017 financial year.\n(sec.145-ssec.2) If a regulation fixing the levy for the 2016-2017 financial year commences after the start of the financial year, the regulation fixes the levy for the remainder of the financial year.","sortOrder":182},{"sectionNumber":"ch.9-pt.2","sectionType":"part","heading":"Transitional provisions for Queensland Future Fund (Titles Registry) Act 2021","content":"# Transitional provisions for Queensland Future Fund (Titles Registry) Act 2021","sortOrder":183},{"sectionNumber":"sec.146","sectionType":"section","heading":"Dissolution of board","content":"### sec.146 Dissolution of board\n\nOn the commencement—\nthe board of the agency is abolished; and\neach member of the board goes out of office.\ns 146 ins 2021 No. 12 s 177\n- (a) the board of the agency is abolished; and\n- (b) each member of the board goes out of office.","sortOrder":184},{"sectionNumber":"sec.147","sectionType":"section","heading":"Existing chief executive officer","content":"### sec.147 Existing chief executive officer\n\nOn the commencement—\nthe person holding office as the chief executive officer immediately before the commencement goes out of office; and\nthe person’s contract of employment mentioned in former section 82 ends.\nNo compensation is payable to the person because of subsection (1), other than as expressly provided under the person’s contract of employment.\nTo remove any doubt, it is declared that this section does not limit or otherwise affect the person’s right to a benefit or entitlement that had accrued or was accruing before the commencement.\nIn this section—\nformer section 82 means section 82 as in force from time to time before the commencement.\ns 147 ins 2021 No. 12 s 177\n(sec.147-ssec.1) On the commencement— the person holding office as the chief executive officer immediately before the commencement goes out of office; and the person’s contract of employment mentioned in former section 82 ends.\n(sec.147-ssec.2) No compensation is payable to the person because of subsection (1), other than as expressly provided under the person’s contract of employment.\n(sec.147-ssec.3) To remove any doubt, it is declared that this section does not limit or otherwise affect the person’s right to a benefit or entitlement that had accrued or was accruing before the commencement.\n(sec.147-ssec.4) In this section— former section 82 means section 82 as in force from time to time before the commencement.\n- (a) the person holding office as the chief executive officer immediately before the commencement goes out of office; and\n- (b) the person’s contract of employment mentioned in former section 82 ends.","sortOrder":185},{"sectionNumber":"sec.148","sectionType":"section","heading":"Insurance commissioner holds office as chief executive officer","content":"### sec.148 Insurance commissioner holds office as chief executive officer\n\nThis section applies until the Governor in Council appoints a chief executive officer under section 81.\nThe insurance commissioner—\nis the chief executive officer of the agency; and\nis taken to have been appointed under section 81.\nIn this section—\ninsurance commissioner means the insurance commissioner under the Insurance Act in the commissioner’s official capacity, but not in the capacity of insurance commissioner or nominal defendant under that Act.\ns 148 ins 2021 No. 12 s 177\n(sec.148-ssec.1) This section applies until the Governor in Council appoints a chief executive officer under section 81.\n(sec.148-ssec.2) The insurance commissioner— is the chief executive officer of the agency; and is taken to have been appointed under section 81.\n(sec.148-ssec.3) In this section— insurance commissioner means the insurance commissioner under the Insurance Act in the commissioner’s official capacity, but not in the capacity of insurance commissioner or nominal defendant under that Act.\n- (a) is the chief executive officer of the agency; and\n- (b) is taken to have been appointed under section 81.","sortOrder":186},{"sectionNumber":"sec.149","sectionType":"section","heading":"References to approved forms","content":"### sec.149 References to approved forms\n\nA reference in this Act to an approved form includes a reference to a form approved by the board under section 139 as in force immediately before the commencement.\ns 149 ins 2021 No. 12 s 177","sortOrder":187}],"analysis":{"issue_detection":{"absurdities":[],"contradictions":[]},"summary":{"complexity_score":8,"scope_assessment":{"changed":false,"description":"The Act appears to have remained focused on its stated purpose of providing no-fault treatment, care and support for seriously injured motor accident victims in Queensland. The structure, eligibility framework, and payment mechanisms are internally consistent with the stated purpose of establishing a national injury insurance scheme for Queensland. The 2024 amendment noted (s.9) appears to be a minor consequential amendment rather than a scope change. There is no evidence from the available text that the Act's scope has materially expanded or contracted from its original intent."},"complexity_factors":["Multiple interlocking participant categories (interim, lifetime, buy-in) with different rights and obligations","Complex interaction with multiple other Queensland Acts including the Insurance Act, Civil Liability Act 2003, Guardianship and Administration Act 2000, Transport Operations (Road Use Management) Act 1995, and Hospital and Health Boards Act 2011","Three separate payment mechanisms (funding agreements, payment requests, agency contribution to damages) each with distinct rules and timeframes","Extensive use of regulation-making powers, meaning key eligibility criteria, payment caps, and procedural requirements are not contained in the Act itself","Nuanced exclusion provisions with multiple exceptions to exceptions (e.g., uninsured vehicles on public roads, machinery on roads)","Sophisticated interaction between the no-fault scheme and the fault-based tort/damages system, including preservation notices, contributory negligence thresholds, and court sanction requirements","Time-critical decision points for participants (14-day preservation notice window, 1-year application period) with serious consequences for missing deadlines","Court involvement for participants under legal disability, with QCAT powers being exercisable by courts in certain circumstances","Definitions heavily dependent on cross-references to other legislation (e.g., 'prescribed vehicle', 'act of terrorism', 'mobile machinery', 'road', 'public place')","Content was truncated, suggesting significant additional complexity in later chapters covering the agency's governance, funding, and enforcement provisions"],"plain_english_summary":"The Act creates a no‑fault scheme (from 1 July 2016) providing funded, necessary treatment, care and support to Queenslanders with serious injuries from motor vehicle incidents, regardless of who caused the crash. It’s administered by the National Injury Insurance Agency Queensland; people apply (ideally within 1 year) and may be accepted as interim or lifetime participants with tailored support plans. Lifetime participants must decide quickly whether to preserve any legal right to sue for care damages."},"flash_summary":{"complexity_score":7,"scope_assessment":{"changed":false,"description":"The supplied notes describe the Act's structure, eligibility, governance and funding as enacted. They do not include any comparison to an earlier text or original intent, so no change of scope can be identified from the material provided."},"complexity_factors":["Detailed eligibility and exclusion rules that vary by vehicle type, location and prior settlements (secs 4, 12, 9).","Multiple participant streams and buy‑in arrangements with differing rights and exclusions (secs 13–14).","Layered decision pathways: applications, needs assessments, support plans, service requests, funding agreements and payment requests, each with timing, notice and information requirements (secs 16–37).","Discretionary necessary-and-reasonable test and list of assessment matters that guide funding but leave scope for agency judgement (secs 15, 26(1)(e)).","Interaction with existing insurer claims, nominal defendant provisions and CTP arrangements requiring coordination and information exchange (secs 11, 18–20, 96).","Complex funding and finance mechanics: a dedicated fund, Treasurer payments to public services, transfers from nominal defendant fund, insurer contributions and actuarial-driven levies (secs 93–99, 94, 95, 96, 97–99).","Substantial administrative and compliance burden: mandatory reporting, timetables for decisions, information requests, penalties for failures to notify or to comply with absence rules (secs 21, 22, 24, 36, 50, 53).","Significant agency powers and governance design including corporate status, CEO appointment, delegations, investment functions and Treasurer oversight (secs 55–66, 81–89, 58, 61).","Cross-jurisdictional and cross-border provisions (scheme may operate outside Queensland and fund services outside Australia, with special rules for absences/suspensions) (secs 62, 50–52, 51).","Regulation‑making and actuarial inputs that fix levies and caps and can materially change entitlements or costs through subordinate instruments (secs 15, 26(1)(e), 34, 37, 99)."],"plain_english_summary":"Establishes a Queensland National Injury Insurance Scheme and a statutory agency to assess and pay for necessary and reasonable treatment, care and support for people with serious motor‑accident injuries regardless of fault. It sets eligibility rules, application and assessment processes, service‑level decisions and payment routes, and funds the scheme through a dedicated fund, levies and insurer contributions."},"flash_summary_failed":{"failed":true,"reason":"A positive credit balance is required for all requests, including BYOK, so fallback providers remain available. Add credits at https://vercel.com/d?to=%2F%5Bteam%5D%2F%7E%2Fai%3Fmodal%3Dtop-up to continue.","source":"analysis-cron"},"kimi_summary":{"_metrics":{"completionTokens":655},"content_quality":"ok","complexity_score":7,"scope_assessment":{"changed":false,"description":"The legislation appears consistent with its original purpose as a no-fault catastrophic injury insurance scheme. The 2021 amendments (sections 146-149) streamlined governance by abolishing the board and appointing the Insurance Commissioner as interim CEO, but did not expand the substantive scope."},"complexity_factors":["Multiple nested eligibility conditions with exceptions (e.g., section 4 has 4 layers of application/exclusion)","Extensive cross-referencing to other Queensland legislation (Insurance Act, Transport Operations Act, Civil Liability Act, etc.)","Three-tiered review system (internal review → medical tribunal → QCAT) with specific procedural rules","Complex interaction between scheme participation and common law damages claims (sections 40-44)","Multiple participant categories (interim, lifetime, buy-in) with different rules","Detailed procedural requirements for applications, service requests, and payment requests with strict timeframes","Substantial delegated legislation framework (many matters 'prescribed by regulation')","Financial sustainability mechanisms including levy calculations and fund management"],"plain_english_summary":"This Act establishes Queensland's **National Injury Insurance Scheme (NIIS)** — a no-fault insurance system for people who suffer **serious personal injuries** in **motor vehicle accidents**.\n\n**What it does:**\n- Provides **lifetime treatment, care and support** for eligible participants, regardless of who was at fault in the accident\n- Covers needs like medical treatment, rehabilitation, attendant care, home modifications, and prosthetics\n- Establishes the **National Injury Insurance Agency, Queensland** to administer the scheme\n- Creates a **dedicated fund** (the NIIS Fund) financed by a levy on CTP insurance policies\n\n**Who it covers:**\n- People with serious injuries from motor accidents in Queensland on or after 1 July 2016\n- Injuries must meet eligibility criteria prescribed by regulation (typically catastrophic injuries like spinal cord damage, severe brain injury, or multiple amputations)\n- **Exclusions apply**: injuries from uninsured vehicles (unless on roads), certain off-road vehicles, and terrorist acts\n\n**How it works:**\n- Injured people **apply** to the agency for acceptance as participants\n- The agency **assesses needs** and creates a **support plan**\n- Participants can request **funding for services** through service requests or payment requests\n- **Interim participants** are reviewed after a set period; those with permanent needs become **lifetime participants**\n- The scheme interacts with **CTP insurance claims** — insurers may contribute to damages, and participants can choose to accept lump-sum damages instead of ongoing scheme support\n\n**Key features:**\n- **No-fault system** — participants don't need to prove someone else caused the accident\n- **Choice and control** — participants are involved in decisions about their care\n- **Review rights** — decisions can be reviewed internally, then by QCAT (Queensland Civil and Administrative Tribunal), with medical matters referred to specialist medical tribunals\n- **Recovery powers** — the agency can recover costs from fraudulent claims or from third parties at fault"}},"importantCases":[],"_links":{"self":"/api/acts/national-injury-insurance-scheme-queensland-act-2016","history":"/api/acts/national-injury-insurance-scheme-queensland-act-2016/history","analysis":"/api/acts/national-injury-insurance-scheme-queensland-act-2016/analysis","conflicts":"/api/acts/national-injury-insurance-scheme-queensland-act-2016/conflicts","importantCases":"/api/acts/national-injury-insurance-scheme-queensland-act-2016/important-cases","documents":"/api/acts/national-injury-insurance-scheme-queensland-act-2016/documents"}}