In the province of Alberta, many, though not all, of the medical services provided to parties who are injured in motor vehicle accidents are paid for by Alberta Health Services (AHS). This includes hospital stays, surgeries and certain adaptive aids government programs provide. Where things can get confusing for personal injury claimants is through a process called “subrogation.”
What is “subrogation”?
In the personal injury context, in certain scenarios where AHS spends resources to treat the injuries of a party who has suffered injury as a result of the defendant’s negligence, they are entitled under statute to recover the costs that they have expended and costs that they likely will incur in the future. Where there is a finding of contributory negligence, the Crown’s right to recover will be diminished by the degree to which the plaintiff was contributorily negligent.
What Does This Practically Mean for the Plaintiff?
In a sense, Alberta Health Services gets to “piggyback” off the plaintiff’s lawsuit. The plaintiff initiates the lawsuit, then AHS will recover their costs through the plaintiff’s efforts.
This is because under s 14 of the Crown’s Right of Recovery Act, plaintiffs have a duty to cooperate in establishing and proving the crown’s right of recovery ie their right to recover the expenses spent by AHS.
Is There a Chance That AHS Will Get to Recover Their Expenses Before I Get My Settlement?
While this is a valid concern, the law establishes that this is not something plaintiffs need to concern themselves with. As per s 10 of the Crown’s Right of Recovery Act, any funds paid out to the claimant have priority over the crown’s right to recover its expenses.
In a Motor Vehicle Accident Where Will Subrogation by Alberta Health Services Be Engaged?
In most circumstances, the crown will have no right of recovery. As the Alberta Government website makes clear, personal injuries caused by an act or omission of a wrongdoer in their use or operation of an automobile is not recoverable provided the wrongdoer has insurance, the insurance covers the loss, and the insurer is licensed in Alberta and also contributed to what is called the “aggregate assessment for that calendar year”. As defined under s 22, of the Crowns Right of Recovery Act this is effectively an assessment made by the minister as to how much personal injuries suffered in auto accidents will cost the province each year that auto insurers are to pay into.
There are exceptions to this however, including if: the wrongdoer is not operating an “automobile” as defined by the statutory regime, if the wrongdoer was not insured, or if the wrongdoer’s insurer was not licensed in Alberta/did not contribute to the aggregate assessment for the year of the accident. This ultimately means that situations such as those involving: out of province insurers, some self-insurers, multiple wrongdoers other than those with auto insurance such as municipalities are involved, and accidents involving farm machinery will enable AHS involvement to recover expenditures.
Have More Questions About Subrogation? James H. Brown and Associates is Here To Help!
In almost all cases involving motor vehicle accidents in the province of Alberta, AHS will have no involvement in recovering their expenditures. The cases where you may see AHS involvement are relatively limited as far as motor vehicle accidents go. Even where there is involvement, however, it tends to be more behind the scenes as your lawyer deals with them, and it should not be construed as an overly intrusive process.
Though what this will mean is that where AHS is involved, you may see an entry for the figure paid to them on the accounts when your case settles.
AHS involvement and subrogation can be fairly complex topics. If you have questions about how health expenditures used on your treatment will affect your personal injury case or questions about how involved Alberta Health Services really is in determining the relevant steps in your personal injury case call James H. Brown & Associates! Alberta’s precedent-setting injury law team. Call 780-428-0088 for your free consultation today!