Alberta Health’s right to recover cost of care in certain situations

Alberta Health can recover cost of care from the wrongdoer if they injury a person

What is the Crown’s Right of Recovery?

 It may come as a surprise to many, but in certain situations, the Alberta government can sue you for healthcare costs. An example of this would be when someone suffers injuries as a result of somebody else’s wrongdoing (e.g., slips and falls, social host liability, dog bites, assaults). In this case, the government may sue the at-fault party to recover the healthcare costs of treating the injured person. In Alberta, it is the Crown’s Right of Recovery Act that gives the government or “Crown,” the right to recover healthcare costs. Recoverable healthcare costs include, but not limited to:

 

  • Hospital Services (in-patient and out-patient)
  • Ambulance Services (air and ground)
  • Drug costs
  • Mental health costs
  • Home care
  • Future cost of healthcare
  • Services provided under the Alberta Healthcare Insurance Act

Does the Crown’s Right of Recovery apply to Motor Vehicle Accidents?

In many cases of motor vehicle accidents, the Alberta government will not be able to recover health service-associated costs. The legislation states that the government will not have a claim to recover health service costs for motor vehicle accidents if:

 

  • The personal injuries are caused by the wrongdoer’s operation of a vehicle,
  • The wrongdoer is insured under a “motor vehicle liability” policy,
  • The policy covers the injured parties’ injuries, and
  • The insurer is licenced in Alberta and contributed to the aggregate assessment in the year of the accident, in accordance with division 2 of the legislation.

If any of the above are not satisfied, the government will have a claim to recover the costs of health services provided. The Crown’s right to recover cost may also exist in vehicle accidents involving out-of-province insurance companies and against other defendants not insured under the vehicles’ liability policy.

Duty to notify the Crown

The legislation imposes certain obligations on insurance companies and injured parties. One of these obligations requires insurance companies, and injured parties who receive treatment, to notify the government of a potential claim against an at-fault party.  Insurance companies must notify the government as soon as they learn about a situation, in which the government may have a claim to recover health care costs. An injured party must give notice if they or someone on their behalf talks to a lawyer about injuries they suffered. The injured party must also fully cooperate with the government in their claim against the at-fault party for healthcare costs. If the injured party fails to cooperate, the government may pursue a claim against them for the costs.

How does the Crown pursue a claim?

 The legislation gives the government two main methods to recover healthcare costs from the at-fault party. The government may file its own lawsuit against the wrongdoer to recover the costs they spent treating the injured party. Alternatively, the government can join a lawsuit that the injured party may have launched against the at-fault party. In this case, the government would simply request the injured party or their lawyer to add the healthcare costs claim to their lawsuit. Since the injured party must cooperate, they can either allow the government to join the lawsuit or potentially be personally liable for the healthcare costs.

 

 

 

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