RSNL1990 CHAPTER H-7 - HOSPITAL INSURANCE AGREEMENT ACT - Point in time

Short title

1. This Act may be cited as the Hospital Insurance Agreement Act.

RSN1970 c157 s1

Interpretation

2. (1) In this Act

(a) "agreement" means an agreement made under section 3; and

(b) "minister" means the minister appointed under the Executive Council Act to administer this Act.

(2) Other words and expressions in this Act have the meanings assigned to them in the Canada Health Act.

RSN1970 c157 s2; 2006 c40 s21

Agreements respecting contributions

3. (1) The minister may, with the approval of the Lieutenant-Governor in Council and on behalf of the government of the province, enter into an agreement with the Government of Canada to provide for the payment by Canada to the province, in accordance with the Canada Health Act and regulations made under that Act, of contributions in respect of the cost of insured services incurred by the province pursuant to regulations made under section 4 of this Act.

(2) The minister may, with the approval of the Lieutenant-Governor in Council and on behalf of the government of the province, enter into an agreement to amend or terminate an agreement.

RSN1970 c157 s3

Regulations

4. (1) The minister may make regulations

(a) for the provision by hospitals of insured services upon uniform terms and conditions to residents of the province under the conditions specified in the Canada Health Act and regulations made under that Act; and

(b) for the payment of amounts to hospitals from funds voted by the Legislature in respect of the cost of insured services, and the payment of those amounts that may be specified in an agreement when insured services are provided to residents of the province, who are eligible for them and entitled to them by hospitals that are owned or operated by Canada or are situated outside the province.

(2) Regulations made under subsection (1) may be made with retroactive effect to a date stated in the regulations, which date shall not be earlier than a date 12 months before the date of their publication in the Gazette.

RSN1970 c157 s5; 1978 c76 s1

Levy

4.1 (1) This section applies where insured services are provided with respect to an injury or disability where the injury or disability was caused by, or contributed to by, or results from, a motor vehicle accident occurring on or after this section comes into force in which the person, whose fault, negligence or other wrongful act or omission caused, contributed to or resulted in the injury or disability, is insured, at the date of the accident, by a policy of insurance through a licensed insurer carrying on business in the province.

(2) In this section

(a) "earned vehicles" means the aggregate exposure, in car years, for automobile liability coverage derived from all statistical experience reported and accepted by the Superintendent of Insurance under all types of business other than type 3, miscellaneous and fleets on an earnings, receipts or payroll basis, for those vehicle types exhibited annually in the Actual Loss Ratio Exhibits covering the general categories of private passenger, farmers, commercial, motor cycles, snow vehicles and interurban trucks; and

(b) "levy year" means a calendar year in which a levy is due from insurance companies with respect to automobile insurance business transacted in the province.

(3) The minister shall impose a levy to be paid by every licensed motor vehicle insurer with respect to each vehicle insured by that insurer for the purpose of recovering insured services incurred by insured persons as a result of personal injury or disability where the injury or disability was caused by, or contributed to by, or results from, motor vehicle accidents.

(4) Every licensed insurer who carries on the business of automobile insurance in the province shall, in respect of each levy year, pay to the minister a levy determined by multiplying the base rate per vehicle by the number of earned vehicles at the end of each levy year.

(5) Every licensed insurer liable to pay a levy under subsection (4) shall before the last day of March, June, September and December in each levy year pay 1/4 of the levy estimated to be payable as calculated by the minister or his or her representative by reference to the number of earned vehicles and the base rate per vehicle for the immediately preceding levy year.

(6) Where a licensed insurer provides the minister with satisfactory proof that the actual earned vehicle count will vary significantly from the previous year on which the estimated levy is based, the minister may adjust the estimated levy.

(7) The Superintendent of Insurance shall provide annually to the minister, a report detailing actual automobile experience including the number of earned vehicles and the number of claims for every licensed insurer as provided under the Insurance Companies Act .

(8) Based on the report in subsection (7), the minister shall issue an adjustment invoice or credit as applicable to licensed insurers in respect of the immediately preceding levy year payable or refundable within 30 days of issuance.

(9) Where the levy is not paid in full on the due date, the licensed insurer shall pay to the minister, interest on the unpaid portion calculated at the rate of prime plus 2% from the due date of payment.

(10) The insurer shall pay any levy payable under this section prior to the issuance or renewal of a licence under the Insurance Companies Act .

(11) An amount payable under this section and unpaid constitutes a debt due the Crown and the minister may sue for its recovery in a court in the province.

(12) The minister may make regulations

(a) establishing an initial base rate per vehicle on the coming into force of this section;

(b) establishing a formula for the determination of the base rate for each vehicle in subsequent years;

(d) generally, to give effect to the purpose of this section.

1994 c43 s1

Action in respect of injury

5. (1) This section applies where insured services are provided to an injured or disabled person, in this section referred to as the "insured person", with respect to an injury or disability where the injury or disability was caused by, or contributed to by, or results from an occurrence other than a motor vehicle accident in which the person, whose fault, negligence or other wrongful act or omission caused, contributed to or resulted in the injury or disability, in this section referred to as the "tortfeasor", is insured at the date of the accident, by a policy of insurance through a licensed insurer carrying on business in the province.

(1.1) An insured person who receives insured services in respect of an injury or disability caused or contributed to by or resulting from the fault, negligence or other wrongful act or omission of a tortfeasor has the same right to recover the cost of those insured services from the tortfeasor as the insured person would have had if the insured person had personally been required to pay for the services.

(2) An insured person who, under subsection (1), recovers from another person the whole or part of the cost of insured services shall, on recovery from that other person, pay to the minister the amount recovered and the minister may if the amount so recovered is not paid to him or her within a reasonable time recover the amount from the insured person as a debt due the Crown in right of the province.

(3) Where the cost of insured services referred to in subsection (1) is paid, or an agreement has been entered into covering payment, by the minister on behalf of the government of the province to a person or hospital or where the services are provided in a hospital controlled by, or by a person employed in, the Department of Health, the minister may bring an action in his or her own name or in the name of the insured person for the recovery of the cost of the insured services.

(4) The rights conferred upon the minister by subsection (3) shall not be considered to restrict other rights of recovery of the insured person in respect of the injury or disability referred to in subsection (1) for loss or damage not the subject of insured services and if the insured person starts an action in respect of that loss or damage he or she shall include a claim on behalf of the minister for the cost of the insured services provided to the insured person.

(5) It is not a defence to an action brought by the minister under subsection (3) that a claim for damages has been adjudicated upon unless that claim included a claim for the sum paid for insured services and it is not a defence to an action for damages for personal injuries brought by an insured person that an action taken by the minister under subsection (3) has been adjudicated upon.

(6) Where as a result of a claim under this section there are insufficient funds to provide complete recovery to an insured person for his or her losses or injury and to pay the cost of insured services, that person and the minister shall share to that extent in proportion to their respective losses in a recovery, but nothing in this provision prevents the minister from waiving in whole or in part his or her share of an amount recovered where in the minister's opinion the circumstances so warrant.

(7) A release or settlement of claim which includes the cost of insured services is not effective unless the minister has consented to the release or settlement or unless the minister is satisfied with the provisions of the release or settlement.

(8) The costs of an action by or on behalf of an insured person in which a claim has been included on behalf of the minister under subsection (4) shall be borne by the minister in the same proportion as the claim of the minister for the cost of insured services provided bears to the total claimed by or on behalf of the insured person in the action.

(9) If within 2 months after the last act or omission which caused the injury or disability of an insured person an action has not been started by or on behalf of that person under subsection (1) for the recovery of damages arising out of the injury or disability, the minister upon service of notice on the insured person may start an action in his or her own name or in the name of that person for the recovery of the cost of the insured services, and at a time before trial of the action that person may join in the action another claim arising out of the same occurrence upon those conditions as to costs or otherwise that the court considers just and may in that case effect settlement of that claim.

(10) A liability insurer shall pay to the minister an amount referable to a claim for recovery of the cost of insured services that would otherwise be payable to an insured person and payment of that amount to the minister discharges the liability of the insurer to pay that amount to the insured person or to a person claiming under or on behalf of the insured person.

(11) For the purpose of subsection (10) a "liability insurer" means a person regularly engaged in the business of underwriting risks in respect of negligence.

(12) For the purposes of this section

(a) "insured services" means insured services as defined in regulations made under this Act; and

(b) the cost of insured services provided is

(i) in the province the cost as established by the minister,

(ii) in a participating province the cost as established by the provincial authority which administers the hospital insurance program in that participating province, or

(iii) elsewhere than in the province or a participating province the cost calculated at a rate which, in the opinion of the minister, is fair having regard to the services provided and the hospital which provided the services.

RSN1970 c157 s6; 1977 c27 s1; 1994 c43 s2