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Motor Accidents Board First Annual Report

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Motor Accidents Board First Annual Report 1974-75 VICTORIA MOTOR ACCIDENTS BOARD FIRST ANNUAL REPORT FOR THE PERIOD ENDED 30 JUNE 197 4 PRESENTED TO BOTH HOUSES OF PARLIAMENT PURSUANT TO THE PROVISIONS OF SECTION 86 OF THE MOTOR ACCIDENTS ACT 1973. Ordered by the Legislative Assembly to be printed, 29th April, 1975. By Authority: C. H. RIXON, GOVERNMENT PRINTER, MELBOURNE. No. 53-861 /75.-PRICE 70 cents CONTENTS PAGE No. AcT PRocLAMATION 5 BoARD MEMBERS 5 THE No FAuLT ScHEME 5 APPEALS 8 FINANCE 8 WORKERS COMPENSATION •• 9 EXCLUSIONS FROM BENEFITS 9 EARLY PAYMENT OF BENEFITS 9 STATISTICS 10 DATA PROCESSING 10 AccouNTS 10 CosT oF No FAULT ScHEME 10 PROPOSALS FOR IMPROVED HOSPITAL FACILITIES 11 REHABILITATION .. 11 COUNTRY REPRESENTATION 11 AMENDMENTs TO AcT 11 AUSTRALIAN GOVERNMENT PROPOSALS 12 (A)-Payments under National Scheme 12 (B)-Abolition of right to sue for damages 12 DIFFICULTIES WITH AUSTRALIAN GOVERNMENT AGENCIES 13 INDEX TO APPENDICES 14 5 First Annual Report of the Motor Accidents Board The Hon. J. F. Rossiter, M.P., Chief Secretary, Spring Street, Melbourne. Sir, 1. This is the first Report of the Motor Accidents Board pursuant to Section 86 of the Motor Accidents Act 1973. The Act received Royal Assent on 17th April, 1973. The main administrative provisions were brought into force on 19th September, 1973 (including the appointment of the Board) and the benefit provisions on 12th February, 1974. The members of the Board are- Victor Henry Arnold, F.I.A., A.A.I.L, A.S.A., Chairman ; Sir Benjamin Keith Rank, C.M.G., M.B., M.S., LR.C.P., F.R.C.S., F.R.A.C.S., F.A.C.S. ; and Jack Stanley Barwick, A.A.I.I., A.A.S.A. 2. THE No FAULT SCHEME The broad object of the legislation is to provide a substantial part of the personal injury losses and expenses incurred by road accident victims regardless of negligence. Such a system is commonly referred to as a' no fault' scheme, whereby payment is made to and in respect of practi­ cally all accident victims including what amounts to a pre-payment of the bulk of special damages to those who elect to proceed at common law. Thus common law rights are left intact and the ' no fault ' benefits should enable a common Jaw claimant to avoid any premature settlements due to the financial pressures caused by unpaid medical and hospital accounts and loss of wages. Under the previous system less than 55 per cent. of casualties received any benefit. To qualify for such payments the accident must have occurred in Victoria. Additionally the person concerned must have been a resident in Victoria or one motor car registered in Victoria must have been involved in the accident or the motor car concerned must have been unidentifiable. Persons in or on railway trains, tramcars, tram motors or omnibuses are not eligible unless an agreement as provided in Sections 71 to 74 has been made between the authority operating such railway trains, omnibuses etc., and the Motor Accidents Board. No such agreements have yet been entered into. Loss of income benefits are not payable in respect of a person who is injured as a result of an accident and is convicted of driving under the influence of intoxicating liquor or a drug or if being a driver he has never held a licence, or if his licence had been suspended or cancelled at the time of the accident, or being the owner of the car he was an occupant of an uninsured car ; also if the person had been using the motor car in the commission of certain criminal offences or was in the motor car and the accident took place other than on a highway taking part in a race or trial. Appropriate provisions have been made covering learner drivers. Where workers com­ pensation benefits appear to be payable in respect of a person who is injured or killed the Board is not required to make payments in respect of that injury or death but it has the power to make payments ifit so determines. The intention is that the Board shall pay the benefits or part thereof not covered under workers compensation provisions. 3. The liability of the Board to make payments in respect of persons who are killed or injured falls under the following headings: (a) Ambulance Services (b) Medical Services (c) Hospital Services (d) Nursing Services (e) Therapeutic Services (/) Medicines and curative appliances (g) Replacement of housekeeping services (h) Other reasonable costs or expenses 6 (i) Funeral expenses (j) Compensation for loss of income to the injured persons (k) Payments to dependants for loss of income in respect of deceased persons. To obtain such payments the initial application for benefits must be made within three years of the injury or death. 4. The Board's activities and policy under each of these headings is detailed below :­ (a) Ambulance Services Section 67 provides that the Board may enter into an agreement with an ambulance service in respect of the payment by the Board of reasonable fees for injured persons requiring ambulance service, in Victoria. Interim agreements have been entered into with twenty-one ambulance services as detailed in Appendix 1. The preparation of a suitable formal agreement is proceeding. The effect of the agreement is to provide ambulance service at no cost to the persons injured. Briefly the agreement provides that subject to the qualifications stated previously in this report as to residency, accident in Victoria etc., the ambulance service will submit accounts directly to the Board and the Board will pay the " reasonable " cost of the various services rendered in Victoria in full discharge of the patient's liability. If ambulance service is provided where there is no such agreement Section 30 provides that 70 per cent. of the reasonable cost will be paid by the Board provided it occurs within five years of the date of accident. Since the Act provides that the service must have been rendered in Victoria, only mileage within Victoria can be the subject of payment. This has caused disappointment to some injured persons who regard themselves as adversely affected when transport to another State is unavoidable. (b) Medical Services Section 68 provides the Board may enter into an agreement with a medical practitioner in respect of the payment of reasonable fees for medical services provided in Victoria for persons who are injured or subsequently die from an accident. Interim agreements have been made with 2,850 medical practitioners who represent by far the majority of doctors associated with accident cases and only about 2 · 5 per cent. of Board payments for medical services relate to doctors not under an agreement. Under the agreement medical practitioners submit accounts directly to the Board and provided the fee is not more than stipulated in the List of Medical Services and Fees published by the Australian Medical Association the Board accepts the fee as being " reasonable " pursuant to the Act and makes payment on a monthly basis. Such payment becomes a full discharge of the patient's liability. Preparation of a formal agreement is in the hands of the Board's solicitors. The effect of the agreement is to provide medical services at no cost to the persons injured. Section 30 provides that where medical services are rendered by a medical practitioner with whom the Board does not have an agreement the Board will pay 80 per cent of the reasonable cost of such services. Appendix 2 details the names of medical practitioners who provide medical services under interim agreements with the Board. The Board has encountered difficulties in rela­ tion to payments to doctors employed whole time in hospitals. Such payments are apparently payable to a Special Purposes Fund administered by a representative committee. Although these arrangements have been set up on principles established by the " Dillon " report in 1959 there are many aspects of the arrangements which the Board believes are unsatisfactory. The Board has written to the Chief Secretary seeking clarification of the issues involved. (c) Hospital Services Interim agreements have been entered into with 258 hospitals as listed in Appendix 3. The preparation of a suitable agreement has been completed and is being considered by the Hospital and Charities Commission. The effect of the agreement is to provide hospital services at no cost to the persons injured. 7 Where a person is injured as a result of an accident as defined in the Motor Accidents Act and there does not appear to be an entitlement to workers compensation the Board in respect of public hospitals will pay 80 per cent. of the daily bed cost or outpatient cost pertaining to the hospital as specified in the Appendix to the Annual Report of the Hospital and Charities Commission for year ended 30th June, 1974. Similar arrangements have been made with private hospitals and mutually acceptable fees agreed upon. Hospitals have agreed to provide a standard of hospital and medical service which is generally understood to include " intermediate " type accommodation but not a private room unless this is a medical necessity. If a private room is requested by an injured person the hospital may make an additional charge for this provided the Board agrees, and in general, the Board would agree to the difference between the intermediate and the private rate per day being paid by the injured person. Hospitals have agreed not to render accounts to patients for any of the costs for which the Motor Accidents Board has agreed to make payments. Hospitals further agree they will permit an injured person to retain a medical practitioner of his choice to provide medical services whilst he is in hospital subject only to the approval of the medical practitioner by the hospital.
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