Category: FAQ

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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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Steps To Take When You Get Into A Car Accident

 

How can I protect y legal rights at the scene of a car accident?

With the cool fall weather approaching and traffic on the roads increasing as many of us head back to school and work, it’s possible to see an increase in the number of car accidents on the road as people adjust to changing conditions.

While none of us wish to be involved in a car accident, it is helpful to review what steps we should be taking at the scene of an accident to maintain our legal rights.

What should I do to protect myself if I’m in an accident?

 

  1. Remain at the scene;

  2. Call the police if the accident involved injury or death, or if there was significant property damage (over $2,000);

  3. Call EMS if anyone involved requires medical attention;

  4. Exchange information with the other driver or drivers. Write down or take a picture of their:

– Driver’s licence

– Insurance information (i.e. the company name and their policy number)

– Licence plate number

– Make, model and year of their car

  1. Take pictures of the scene of whatever you feel will be necessary to handle a possible legal claim in the future. It is important to take pictures of the original scene if you can as circumstances may change down the line when it comes to advancing your claim and presenting information about it.

  • For example, these photos could include photos of yours and other person’s vehicles’ damage, your injuries, the weather, the traffic conditions, signs around the area, and more.

  1. Collect information from any witnesses at the scene. You can write it down or make a recording of it. Ask for their:

  • Full Name
  • Contact information (phone and email)
  • Description of what they witnessed

  1. Be courteous to the other driver or drivers but avoid speaking to them any more than necessary to exchange information. Specifically, avoid speaking to them about what happened with respect to the accident, how the accident happened, or whoever was responsible for the accident. Leave these discussions for your insurance company and potentially legal counsel to handle down the line for you if you wish to advance a claim;

  2. Once you can leave the scene – contact your insurance company as soon as you can after the accident to provide a report of it.

We here at Moustarah & Company hope everyone has a safe and happy back-to-school and back-to-work fall season.

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Will my personal injury settlement have any impact on my AISH benefits?

Navigating the recovery process after being injured in an accident can be daunting on its own, and you may have additional considerations if you are also receiving AISH benefits. It is important to know and consider how a personal injury pay out can affect your financial situation if you are receiving AISH.

What are the eligibility requirements for AISH?

Assured income for the Severely Handicapped (AISH), is a government program which provides financial as well as health benefits to those with permanent medical conditions, if the medical conditions prevent someone from being able to support themselves.

There are certain eligibility criteria in order to qualify and continue to receive AISH. Typically, your eligibility is determined based on you and your spouse’s income, as well as any assets that you may have. The total value of your assets cannot exceed $100,000.

Certain forms of income and assets are considered exempt when considering eligibility. These exemptions include but are not limited to income tax refunds, or disability savings plan (RDSP) payments.  Other forms of income and assets, however are considered non exempt. A settlement can be an asset which is considered non-exempt, and is counted when it comes to eligibility.

Temporary Asset Exemption

You have 365 days to invest money that is not considered income into an exempted asset, otherwise, the money will be considered non exempt. An option for a client who is receiving AISH and receives a personal injury settlement would be looking into a structured settlement. A structured settlement is when the settlement is paid out regularly, over a period of time. Typically, the payments are once a month.  A structured settlement may be a good option because it is exempt by AISH. Another option could be investing the money into a trust or a Registered Disability Savings Plan, or another exempt asset.

What should I do if I receive a settlement for my personal injuries?

You remain responsible for reporting any changes to your financial or medical situation. If you receive a settlement, it is important to report your settlement to your AISH caseworker. Your settlement pay out may impact your eligibility for AISH, and your caseworker is also typically in the best position to be able to determine this for you.

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What happens to my existing personal injury claim if I get into another car accident?

After being injured in a car accident, a lawyer can help guide you through the process of putting forward a claim to compensate you for the injuries you sustained in that accident. But what happens if you get into another accident before you are able to settle the claim for your first accident? This blog will look at the options that you have if you find yourself in this common situation.

What should I do if I am in a second accident?

If you are in a second accident while you still have an existing claim open for a first accident, the steps taken immediately following the accident will be no different than your first accident. You can read about the steps to take in our FAQ here.

However, one additional step will be contacting your personal injury lawyer as soon as possible to discuss how this new accident can impact your existing claim. Depending on the circumstances of your case, your lawyer may recommend looking at proceeding with a “global settlement” for your claims.

What is a global settlement?

A global settlement involves settling more than one claim at the same time. Although you will need to file a separate lawsuit for each accident you are involved in, and potentially deal with different insurance companies for each accident, with a global settlement, each of these claims would be dealt with at the same time and settled together.

Should I settle my accident claims together or separately?

There are a couple of factors to be considered in determining whether to settle your car accident claims together as part of a global settlement, or separately as individual claims. Some of these factors include:

  • The time between the accidents
  • The status of your existing injuries from earlier accidents at the time of the later accidents
  • Whether any new injuries were sustained in the later accidents

A personal injury lawyer will be able to look at the facts of your specific case to determine the best course of action for settling your claims, to make sure that you are being fully compensated for all of your injuries.