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NHS Costs Recovery

As many readers of this will know the Road Traffic (NHS Charges) Act 1999 means that compensators who agree to pay compensation for injuries suffered by another person in a road traffic accident are obliged to meet the cost of any necessary NHS hospital treatment received by the injured person up to a fixed ceiling per claim. This scheme is currently administered by the Compensation Recovery Unit who also administer the scheme for recovery of state benefits.

It has long been anticipated that the scheme would be extended to cover all personal injury cases. Originally it was anticipated the scheme would be extended from 1st April 2005, although that date was subsequently postponed. The Compensation Recovery Unit have this week issued guidance advising that subject to parliamentary approval of the regulations to support the legislative framework, the extended scheme is due to commence on 29th January 2007, for all accidents occurring on or after that date. For cases involving accidents before that date it is envisaged the existing system will still apply.

The intention is that the scheme will operate as far as possible in the same way as the current road traffic scheme. The enabling legislation will be the Health and Social Care (Community Health and Standards) Act 2003, with supporting regulations being enacted by both the English and Scottish Parliaments for their respective jurisdictions.

There are however several changes that should be noted.

Contributory negligence can be taken into account in cases where it is a factor in a primary compensation claim. The regulations will set out the evidence compensators need to provide to show all parties to the compensation claim have reached an agreement on contributory negligence. For example, if it is agreed that a Claimant was 50% to blame for an accident then the compensator would only be responsible for 50% of the NHS Charges.

 



NHS motor ambulance charges can be collected for the first time. There will be a standard charge per journey that has not yet been specified.

 



Compensators will be able to apply for a waiver on grounds of excessive hardship.

 



The new legislation will apply to all compensators.

 



The new scheme will extend to include foreign compensators and accidents abroad providing NHS treatment is provided in either England, Scotland or Wales.

 



NHS Trusts and Boards who are also the compensator will be exempt from repaying their own NHS Charges. However they will be liable to repay any other NHS Trusts up to the maximum amount.

 



Registration of claims will be made by way of form CRU1 in the usual fashion. This can be found on-line at www.dwp.gov.uk/cru/notification.pdf.

The NHS Charges will be capped with a yearly scale being provided. The present ceiling (which applies to road traffic cases only) is £37,100 for accidents occurring on or after 1st April 2006. No figures are yet available for 2007. It is envisaged that certificates of NHS Charges will be issued along with Certificates of Recoverable Benefits as presently happens in just road traffic cases. Provision will be made for review and appeal rights in the same way as presently exists.

The DWP have helpfully provided the following contact details for any specific queries that compensators may have in the meantime.

DWP Contact: Steve Dibdin NHS Costs Recovery, Room 4W04, Quarry House, Quarry Hill, LEEDS LS7 2UE Tel: 0113 254 5819? Fax: 0113 254 7350 Email: steve.dibdin@dh.gsi.gov.uk

We will issue a further update in the New Year to confirm if the regulations have been passed to enable the scheme to commence on 29th January 2007. However in the meantime we would encourage all those concerned to make allowance for the apparently imminent inclusion of NHS charges in all personal injury cases. For payment of compensation arising out of accidents from 29th January 2007 onwards compensators should also consider recording any agreement on contributory negligence, thereby limiting exposure to NHS Charges.

Ranald Macpherson / Bruce Goodbrand

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