Part 17 – Buying into the Scheme

1.1This Part is made under sections 6 and 56 of the Act.
1.2A person 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.
1.3The LSA will calculate the amount required to provide services to meet the person’s necessary and reasonable TCS 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 person.

2.1A request to buy into the Scheme can be made by or on behalf of the person. A request 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 person would have been eligible to participate in the Scheme, had their Motor Vehicle Accident occurred after the applicable Scheme commencement date.
2.2The LSA may refuse a request 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 request to buy in. If a request to buy in is denied, the person may dispute the LSA’s decision about their eligibility to buy into the Scheme in accordance with Part 3 of the Rules.

3.1The LSA requires information about the person’s previous and current TCS needs in order to calculate the cost for buying into the Scheme. This information includes, but is not limited to:
- 3.1.1the current age of the person, and their age at the time of injury;
- 3.1.2the nature and severity of the person’s injury;
- 3.1.3current objective evidence of the persons injury and function;

For example, using the FIM™ or WeeFIM® and ASIA Impairment Scale Score.

3.1.4objective assessments of the person’s previous and current TCS needs; and
3.1.5the nature, frequency and duration of services used to meet these TCS needs, including any variations in needs during periods of transition.

3.2The LSA may arrange for the person 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 person.

4.1The amount determined by the LSA to buy into the Scheme will consider:
- 4.1.1the full estimated lifetime expenses in providing for the person’s necessary and reasonable TCS needs as they relate to the eligible Motor Vehicle Injury, as determined by an assessment and actuarial valuation, discounted by a reasonable amount to account for return on investment; and
- 4.1.2the administrative and associated costs incurred by the LSA in managing the person as a Lifetime Participant in the Scheme, discounted by a reasonable amount to account for return on investment.
4.2The agreement will be structured to cover the rest of the person’s lifetime and may include a guaranteed minimum time period.

For example, a minimum time period may be 10 or 20 years.

5.1The LSA will notify the person, In Writing, of the amount required for the person to buy in, which includes information as to how the LSA has calculated the buy in amount.
5.2The entire buy in amount will be paid to the LSA upfront.
5.3Once the funds are received, the LSA will pay the buy in amount into the Fund.
5.4The LSA may consider reaching agreement in relation to the structure of the buy in amount (e.g., security over real property in lieu of cash payment after liquidation of personal assets to meet the buy in amount).

6.1After the person has paid the buy in amount to the LSA in full, the LSA will write to the person or Decision Maker or both, as the case may require, 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 Lifetime Participant or Decision Maker or both, as the case may require, during the term of the agreement once a buy in amount has been paid.
6.2The person who has bought in has the same obligations and entitlements as any other Lifetime Participant of the Scheme.

7.1The buy-in agreement reached with the person or Decision Maker or both, as the case may require, may provide for reimbursement by the LSA of a portion of the buy-in amount in certain circumstances.

For example, if the buy-in Lifetime Participant dies within a minimum guaranteed period that has been agreed.