Separate Queensland scheme-funded treatment and care from damages still claimed
MaintainedLast reviewed
Key facts
- Human involvement
- YellowClose supervision
- How AI is used
- Split the invoices the lawyer marks into treatment and care that section 42(3) says the compulsory insurer need not pay, and loss still sought as damages. Do not value either column and do not decide scheme eligibility.
- What the lawyer must review
- You decide which loss remains in the damages claim.
- Do not move a treatment invoice into damages while the person is a scheme participant.
- This split is not a decision that the person is eligible for the scheme.
- Use a firm-controlled tool. Check ASCR r 9, APP 11 and any notifiable breach.
Rules that apply
The document starts from the task name. Change it if this piece of work is different.
The work product
Forum. Queensland compulsory third party and the injury insurance scheme
Produce. Two columns, unvalued: scheme treatment and care, and damages still claimed.
Have ready. The invoices the lawyer marks; Whether the person is a scheme participant; The heads still claimed as damages.
Example of the limit. Illustrative example: An attendant-care invoice falls in a month of scheme participation, and a wage loss is also claimed. The care invoice goes in the scheme column. The wage loss stays in damages. No dollar value is entered.
Stop and hand it back when
- Participation dates are unknown.
- The task is to decide eligibility or to calculate damages.
Sources for this task were checked on 2026-10-23.
Who does what
| Role | What they do |
|---|---|
| Assistance | Do not begin AI assistance until the responsible lawyer has defined and confirmed its permitted scope. |
| Lawyer | Set the scope, supervise the work closely, verify every part relied on, resolve omissions and exceptions, and approve the exact output. |
Checklist
- Put treatment, care and support needs during participation in the scheme column.
- Leave income loss in the damages column.
- Do not decide eligibility.
Sources
- Motor Accident Insurance Act 1994 (Qld) s 42 · 2026-10-23
- NIISQ: NIISQ and the NDIS · 2026-10-23
Health, wage and scheme records stay in a firm-controlled tool. Check ASCR r 9, APP 11, and whether a disclosure is notifiable under the Privacy Act 1988 (Cth).
Section 42 applies only once liability is admitted, and then to private hospital, medical and pharmaceutical expenses, or a proportionate part if contributory negligence is asserted. Section 42(3) says the insurer need not pay treatment, care and support needs if, when the needs arise, the claimant is a scheme participant for a serious personal injury from that accident, or if the needs arise after a payment under section 44(3)(a) of the National Injury Act. The text of that National Injury Act provision was not opened. Section 42(4) applies subsection (3) whether or not the injury is a serious personal injury, whether or not the needs are an approved service, whether or not the agency must pay, and whether or not the care is provided without charge.
The NIISQ page says NIISQ funds necessary and reasonable treatment, care and support for the accident while the person is a participant. Income loss is not in section 42(3). This split is not an eligibility decision.