The Lifetime Care and Support (LTCS) Scheme is a no-fault insurance scheme to support people who are catastrophically injured in a motor accident to enable them to manage their ongoing care needs into the future.
The LTCS Scheme was introduced in the ACT on 1 July 2014 as part of the implementation in the ACT of a nationally agreed scheme, which transformed the way the ACT community support people with a disability, their families and carers.
The LTCS Scheme aims to provide eligible catastrophically injured persons the best opportunity to recover and participate in society through provision of specialised early intervention medical and rehabilitation care.
Delivery of treatment and care to ACT Scheme participants is coordinated by allied health professionals (not claims managers) and independent qualified case managers who are trained in supporting seriously injured persons with complex medical needs.
The LTCS Scheme provides eligible catastrophically injured persons with access to ongoing reasonable and necessary treatment and care they need for life.
The Scheme was introduced in 2014 as part of the ACT Government’s commitment to introduce a National Injury Insurance Scheme (NIIS) in the ACT as a companion Scheme to the National Disability Insurance Scheme (NDIS).
At the time the LTCS Scheme commenced in ACT in 2014, the ACT Compulsory Third-Party (CTP) Insurance Scheme provided coverage for motor accident injuries limited to persons who could prove someone else was at fault. The LTCS Scheme covers all eligible persons in the ACT who sustains a catastrophic motor accident injury regardless of fault, including those involved in a single vehicle accident or a blameless accident.
The CTP Scheme was replaced by the MAI Scheme in 2019.
As a no-fault scheme, the LTCS Scheme offers persons with catastrophic motor accident injuries a continuum of care during their whole life, with their treatment and care needs met in a timely manner without the added stress of litigation or managing a financial settlement.
The LTCS Scheme applies to persons who sustain a catastrophic injury resulting from a motor accident, regardless of fault that occurred in the ACT from 1 July 2014.
It covers pedestrians, cyclists, motor bikes and motor vehicles so long as at least one vehicle involved in the motor accident had Motor Accident Injuries Insurance cover.
The motor accident injury must be a catastrophic injury type mentioned in the Lifetime Care and Support (Catastrophic Injuries) Act 2014; and satisfy the criteria as set out in the LTCS Scheme Guidelines.
The criteria for catastrophic injuries are nationally agreed minimum benchmarks that have been developed for the National Injury Insurance Scheme for motor accidents.
Catastrophic injuries covered under the LTCS Scheme include spinal cord injuries, moderate to severe brain injury, amputations, severe burns or permanent blindness. For more information, please see the Lifetime Care and Support Scheme Guidelines.
The LTCS Scheme covers reasonable and necessary treatment and care needs related to a catastrophic motor accident injury.
Section 9 of the Lifetime Care and Support (Catastrophic Injuries) Act 2014 outlines a range of treatment and care needs that are covered, including:
- medical treatment (including pharmaceutical treatment);
- dental treatment;
- rehabilitation;
- ambulance transportation;
- respite care;
- attendant care services;
- aids and appliances;
- prostheses;
- education and vocational training;
- home and transport modification; and
- workplace and educational facility modifications.
If you’re accepted as a lifetime participant in the LTCS Scheme as a result of a motor accident injury, you can expect your reasonable and necessary treatment and care needs to be met for life.
Yes.
The LTCS Scheme covers reasonable and necessary lifetime treatment and care for catastrophic injuries. However, it does not provide income replacement benefits, a quality of life benefit for significant and permanent injuries, or any other benefits that you may be entitled to under the Motor Accident Injuries (MAI) Scheme.
As such, a participant in the LTCS Scheme can still apply for all defined benefits under the MAI Scheme, other than when they are already receiving treatment and care benefits through the LTCS Scheme.
For more information about the MAI Scheme, please see the MAI Commission’s website.
You will need to apply to the authority operating the National Injury Insurance Scheme or equivalent LTCS Scheme in that state or territory. For example, people catastrophically injured in a motor accident in New South Wales should contact iCare (Insurance & Care NSW).