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NHS CHARGES

Section 1 of the Road Traffic (NHS Charges) Act 1999 imposes an obligation on Compensators in road traffic accident claims to pay appropriate NHS charges to the Secretary of State in respect of any treatment administered to the Claimant at an NHS Hospital as a result of injuries sustained in that accident.

Section 1(3) of that Act defines the three situations in which payment in settlement of a claim, whether in whole or in part, is considered a compensation payment:

1. a payment made by an authorised insurer under, or in consequence of, a policy issued under section 145 of the Road Traffic Act 1988; or

2. a payment made by the owner of the vehicle in question in a case where they have paid a deposit or security to the Court under part VI of the Road Traffic Act 1988; or

3. A payment made in pursuance of a compensation scheme for motor accidents.

The result of the manner in which this legislation was drafted is that Compensators who have a high policy excess and are therefore effectively "self-insured" do not require to reimburse NHS Charges. As long as the Compensator does not breach their policy excess by making the payment, it is not considered to be made under or in consequence of an insurance policy. The practical implication is that self-insured Compensators are exempt from recoverable NHS Charges.

The Compensation Recovery Unit (the CRU) previously required a letter from the Compensator or their representatives confirming that the Compensator is effectively self-insured and that they did not breach their policy excess when settling the specific claim. Upon receipt of such correspondence, the CRU automatically issued a Certificate of NHS Charges with a nil balance.

During recent discussions with the CRU however, it has been brought to our attention that a policy review has been carried out between the relevant departments within the NHS and CRU. Due to an increasing number of claims slipping through the net where a payment was made under an insurance policy on behalf of a "self-insured" Compensator but a Nil Certificate of NHS Charges was issued, procedural changes have been implemented.

With effect from May no Compensator will be automatically exempt from NHS Charges by way of a letter stating that they have not breached their policy excess. All self-insured Compensators now require to submit a copy of their insurance policy to be registered with the CRU which clearly displays the excess applicable. It must also indicate on what basis this is calculated, for example, whether it is a "per claim" excess or if it is calculated on an aggregation of settlements paid.

Self-insured Compensators will therefore require to contact their insurers or brokers and request a copy of the necessary policy documentation showing the information outlined above in order that it may be registered with the CRU. The relevant policy only requires to be registered once in respect of each Compensator. Compensators or their representatives will subsequently require to write to the CRU in every individual case where NHS Charges apply upon its conclusion in order to confirm that the excess has not been breached, making reference to the policy previously provided.

We have also been informed that under a current "NHS expansion programme" future changes relating to recoverable NHS Charges are in the pipeline. A wider range of services are being considered for inclusion under NHS Charges. Furthermore, it has been suggested that the "poorly drafted" legislation should be amended to include any compensation payment made, whether under an insurance policy or not. The practical implication of such a change would be to remove the present "exemption" for self-insured Compensators, the result being that they would be liable for any relevant NHS Charges in each case.

We understand that this consultation process has been delayed, but we have been put on notice of the recommendations being discussed. We shall provide updates of any further developments as and when we are made aware of them.

Contributed by Steven Smart

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