1.1 This part is made under sections 6 and 56 of the Act.
1.2 An applicant who sustained a motor vehicle injury prior to the commencement of the Scheme may buy in to become a lifetime participant in the Scheme under the criteria specified in section 6 of the Act and the conditions below.
1.3 The LSA will calculate the amount required to provide services to meet the applicant’s necessary and reasonable treatment, care and support needs as a result of the motor vehicle injury, for their lifetime. Buying into the Scheme is voluntary and will be subject to an agreement between the LSA and the applicant.
2.1 An application to buy into the Scheme can be made by or on behalf of the applicant. An application must be in writing and must be accompanied by sufficient information to allow the LSA to determine that the motor vehicle injury meets the criteria in the Rules and the applicant would have been eligible to participate in the Scheme, had their motor vehicle accident occurred after the applicable Scheme commencement date.
2.2 The LSA may refuse an application to buy into the Scheme if the injury does not meet the eligibility criteria in Part 2 of the Rules being the current version in force at the time of the application to buy in. If an application is denied, the applicant may dispute the LSA’s decision about their eligibility to buy into the Scheme in accordance with Part 3 of the Rules.
3.1 The LSA requires information about the applicant’s previous and current treatment, care and support needs in order to calculate the cost for buying into the Scheme. This information includes, but is not limited to:
3.1.1 the current age of the applicant, and their age at the time of injury;
3.1.2 the nature and severity of the applicant’s injury;
3.1.3 current objective assessment of the applicant’s functional status, for example, using the FIM™ or WeeFIM® and ASIA Impairment Scale Score;
3.1.4 objective assessments of the applicant’s previous and current treatment, care and support needs; and
3.1.5 the nature, frequency and duration of services used to meet these treatment, care and support needs, including any variations in needs during periods of transition.
3.2 The LSA may arrange for the applicant to be assessed in order for the above information to be obtained. The LSA funds the necessary and reasonable cost of any assessments required. A copy of the assessments will be provided to the applicant.
4.1 The amount determined by the LSA to buy into the Scheme will include:
4.1.1 the full lifetime expenses in providing for the applicant’s necessary and reasonable treatment, care and support needs as they relate to the eligible motor vehicle injury, as determined by an assessment and actuarial valuation; and
4.1.2 the administrative and associated costs incurred by the LSA in managing the applicant as a lifetime participant in the Scheme and discounted by a reasonable amount to account for return on investment of the buy in amount.
5.1 The LSA will notify the applicant, in writing, of the amount required for the applicant to buy in, which includes information as to how the LSA has calculated the buy in amount.
5.2 The entire buy in amount will be paid to the LSA upfront.
5.3 Once the funds are received, the LSA will pay the buy in amount into the Lifetime Support Authority Fund (the Fund).
5.4 In exceptional cases the LSA may consider security over real property in lieu of cash payment after liquidation of personal assets to meet the buy in amount.
6.1 After the applicant has paid the buy in amount to the LSA in full, the LSA will write to the participant to confirm that they have become a lifetime participant and that the buy in amount has been paid into the Fund. The LSA cannot request any additional payments from the participant once a buy in amount has been paid.
6.2 Once the participant has become a lifetime participant, the participant has the same obligations and entitlements as any other lifetime participant of the Scheme.
7.1 If a buy-in participant dies, the LSA will refund the unspent funds to the estate, less the amount spent on treatment, care and support; necessary and reasonable administrative expenses and the investment return (or loss) over the participation period.