Lifetime Care and Support (Catastrophic Injuries) Act 2014

The LTCS commissioner must pay all the reasonable expenses (if any) incurred by or on behalf of an injured person in relation to the injured person’s assessed treatment and care needs while the injured person is a participant in the LTCS scheme.

Expenses are not payable in relation to—

excluded treatment and care; or

Note Excluded treatment and care—see s 9.

treatment and care that is not assessed treatment and care needs.

Note Treatment and care needs, of a participant in the LTCS scheme—see s 9.

The LTCS commissioner may pay a participant’s expenses (if any) in relation to the participant’s assessed treatment and care needs—

when the expenses are incurred; or

by giving the participant an amount to cover the expenses over a stated period under—

a payment agreement with the participant; or

a periodic payment agreement with the participant under section 30A; or

a lump sum agreement with the participant under section 30B (Lump sum payment—foreign national participant).

The LTCS commissioner may only pay a participant’s expenses for treatment and care services that the LTCS commissioner has approved, unless the LTCS commissioner agrees otherwise.

The LTCS guidelines may make provision for determining which of an injured person’s treatment and care—

are reasonable and necessary in the circumstances; and

relate to the injury in relation to which the person is a participant in the LTCS scheme.

Note The LTCS guidelines are made under s 93.

This section is subject to section 31.

In this section:

payment agreement, between the LTCS commissioner and a participant in the LTCS scheme, means an agreement the LTCS commissioner has with the participant for the participant to pay the expenses relating to the participant’s assessed treatment and care needs.