Research Reports - Outcomes after traumatic brain injury under no-fault versus fault-based motor accident insurance

Brain Inj. 2015 Dec;29(13-14):1561-71. doi: 10.3109/02699052.2015.1075142. Epub
2015 Sep 18.

Harrington R(1,)(2), Foster M(1), Fleming J(3).

PRIMARY OBJECTIVE: To explore experiences of pathways, outcomes and choice after
motor vehicle accident (MVA) acquired severe traumatic brain injury (sTBI) under
fault-based vs no-fault motor accident insurance (MAI).
METHODS: In-depth qualitative interviews with 10 adults with sTBI and 17 family
members examined experiences of pathways, outcomes and choice and how these were
shaped by both compensable status and interactions with service providers and
service funders under a no-fault and a fault-based MAI scheme. Participants were
sampled to provide variation in compensable status, injury severity, time
post-injury and metropolitan vs regional residency. Interviews were recorded,
transcribed and thematically analysed to identify dominant themes under each
scheme.
RESULTS: Dominant themes emerging under the no-fault scheme included: (a)
rehabilitation-focused pathways; (b) a sense of security; and (c) bounded
choices. Dominant themes under the fault-based scheme included: (a)
resource-rationed pathways; (b) pressured lives; and (c) unknown choices.
Participants under the no-fault scheme experienced superior access to specialist
rehabilitation services, greater surety of support and more choice over how
rehabilitation and life-time care needs were met.
CONCLUSIONS: This study provides valuable insights into individual experiences
under fault-based vs no-fault MAI. Implications for an injury insurance scheme
design to optimize pathways, outcomes and choice after sTBI are discussed. 

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