Answer
Does a compensation scheme stop NDIS access?
From 1 January 2028 a person does not meet the alternative support requirements where every impairment they qualify on is excluded. An impairment is excluded if a motor accident or a work related injury caused it and a Commonwealth, State or Territory compensation law provides compensation or benefits for it.
Is one excluded impairment enough to refuse access?
No. At least one qualifying impairment must not be excluded. A person with several impairments can still enter the scheme on an impairment that is not excluded. The analysis is impairment by impairment, and a file that treats the person as a single unit will get it wrong.
What makes a compensation law count?
The law must provide compensation or other benefits for the impairment. The rules may prescribe when a law counts as providing, or as not providing, compensation, including by reference to whether an application could be made, or has been made, granted or refused. Until the rules are read, the answer is conditional on them.
Does this create a subrogation right?
No. The Act changes who may enter the scheme and on what impairment. It does not create a right for an insurer to recover from the Agency, and it does not make an insurer's liability primary in terms. Those conclusions come from the compensation law and the policy, not from this Act.
What should an insurer do before 2028?
Segment the portfolio by motor accident and workers compensation exposure, and identify files where the impairment is compensable. Check whether any access decision in progress relies on an impairment that will be excluded. Do not rewrite a recovery note to say the NDIS is the funder of a compensable injury without checking this section.
The duties behind this answer
- Other compensation excludes access
- Reasonable and necessary rewritten
- Permanence needs treatment first
Not legal advice; does not certify. Read the provision at https://www.legislation.gov.au/C2026A00066/latest/text. Last updated .