I had a recent knee injury, requiring a trip to my local urgent care center, a follow up MRI and doctor appointments. My son tripped and sprained his ankle a few weeks prior to that. In both cases, my health insurance provider used letters, questionnaires and phone calls looking desperately for some third party liability to pay for the care resulting from these injuries.
Did they happen at work? Then make worker’s comp pay. In an auto accident? Then the auto insurance would have to cover it. At a home or business that can be faulted for not maintaining the building or grounds?
In places with state-provided health care, is this even an issue? Does your auto or homeowner’s insurance have to cover the possibility of you or someone else getting injured? Or since everyone’s covered under the same health care, the auto and homeowner’s stuff just covers the normal theft, fire, flood, accident type of issues.
I’m by no means an expert, but the way I believe it works is that because everyone has healthcare, it doesn’t matter who is liable for genuine accidents. You just go to the hospital if you’re hurt.
That is not to say you can’t be sued for damages due to negligence like not shoveling your walk or something. Workplace accidents do require some forms to be sent to worker’s compensation ASAP regardless of severity. But anytime I have been injured no matter the cause, I just go to a Dr/hospital no questions asked.
So, it depends a bit. Basic emergency health care is provided, period.
If you require physiotherapy, or dental (if your teeth got knocked out, for instance) or whatever, those charges generally get applied to workers comp, or the other party’s auto insurance, or whomever before you can bill any extended health care plan you may have.
If you injure yourself just being a boob, charges of that type are either covered by an extended health care plan you have through your employer, or privately, or you pay for it yourself. If you have low income or are a senior, many of the charges would be covered by the government.
In Australia you still need liability coverage. For cars, 3rd party injury insurance is usually included in the registration fee (or in some states, separate but required in order to register a car). Workers compensation insurance is compulsory for businesses. I think general business insurance typically includes a public liability component. House insurance policies generally include coverage for injury to 3rd parties in your home.
** Please note that regular homeowner’s insurance does NOT cover the peril of flood. To have flood insurance you must purchase a separate policy from the National Flood Insurance Program. You can usually do this through your regular agent, but if no agent in your area sells it, the NFIP does offer a Write-Your-Own policy. **
Here in Canada, I think the general answer to the OP’s question is no, insurance companies don’t try to find a third party to sue, because they don’t have to make any payments for any medical care covered by the medicare plan. That’s because the injured party doesn’t have to pay anything, and so has no medical expenses to claim against the insurer.
For instance, if I trip and fall on my neighbour’s icy sidewalk and have to have my broken leg fixed up at the hospital, that medical cost is covered by the public health system. Since i’ve not paid any money to the doctor or the hospital, I don’t have any loss, and can’t claim against any insurance I may have.
However, it’s just the medical costs that are covered. I can still sue my neighbour for the pain and suffering I’ve endured from the slip and fall, and if I’ve had to stay home from work and lost salary, I might be able to claim that as well. If found liable, my neighbour would make a claim against his house insurance company.
And note as well that in Canada, not everything is covered by medicare, which is broadly defined as stuff provided by a medical doctor. Most dentistry is not covered, and physio-therapy may not be. So if I have a slip and fall on my neighbour’s sidewalk, and lose a couple of teeth, and need physio-therapy for the strain it caused to my back, that’s not covered by medicare. If I claim against my neighbour, his insurance may ultimately foot the bill.
I live in Australia and my employer pays for my workers comp insurance, I pay for my privater cover as well as my government provided cover though a 1.5% tax on my income. I can choose to go whichever way I like and they are for the most part self funded.
Not here. In the UK you simply go to the doctor or hospital and get fixed. I’ve had a week long stay in hospital following a couple of visits to a clinic and a bunch of x-rays. Money/cost was not mentioned at any point.
Not in Sweden either. The entire concept of health insurance is foreign, and is a fringe benefit that some employers offer their employees to provide expedient health care at a private health institution.
But to be concise, the state pays for most of my healthcare and not a private third party, and the state doesn’t care how I incurred my injury or who is responsible (criminal liability is of course another and irrelevant matter).
Perhaps if you wanted to sue the other party for pain, distress, loss of earnings etc. Then yes, you may go down the legal route for that but I’m not aware of the NHS trying to recoup costs for treatment given. (ETA - yep, what Northern Piper said)
There are still ambulance-chasing lawyers in the UK (their TV ads parodied absolutely brilliantly by Armstrong and Miller here), but health costs are a minor feature of the compensation settlements they seek. And certainly, since the NHS isn’t built on an insurance paradigm, it doesn’t to my knowledge seek recompense or liability in any way. Society, by almost total consent, pays it to prevent disease and make people better, and that’s what it does. Simples.
First place, you cannot say, “In Canada…” because each province has its own scheme. This is mandated by and partly subsidized by the federal government (and god help any federal party, no matter how conservative, that would propose getting rid of it) but, subject to certain rules, it is run by the provinces.
Seven years ago, I slipped on ice and broke my ankle. I went to hospital, they x-rayed it, had me spend several days in bed letting the swelling go down, operated and put in a plate and then I went home, all just by showing my Quebec medicare card. Several months later, I got a form from the health insurance board wanting to know the details of the accident, whether any third party could be made to pay for damages. In fact, it was the city of Montreal, which had closed the sidewalk on a major street (Park Ave. along the park, if you know the city), four lanes of traffic in each direction and not given the poor pedestrian any alternative (except go back a block and cross to the other side). So I ventured across a snow and ice covered field with those consequences. Anyway, I explained all this and I have no idea if they pursued it. I wish they did. Maybe the city would pay more attention. Till about 10 years you could sue the city, but they have taken that right away.
I’ll second this - you have no health insurance company, it’s one big (provincial) health authority. If you have additional damages not covered (the physiotherapy example) you may be able to sue, but generally not. I had employment benefit coverage for additional items - ambulance rides (not covered), TV rental in the hospital, dental care, etc. but in these, rarely is any single payout big enough to be worth getting lawyers involved and I have never heard of those insurance companies suing to recover. I have never heard of the provincial health authorities suing to recover from the owners of icy sidewalks, I don’t think that sort of recovery of costs is part of their mandate. Icy sidewalks are a bylaw issue. Even if you are a moron emulating the Jackass movies, the government pays to patch you up no questions asked.
Workers Compensation is a separate government program in Canada, where generally the provincial WC covers any medical costs incurred by a work injury. In return, the employer cannot be sued since WC covers medical expenses, physiotherapy, and even provides pensions for permanent injuries. SO your doctor may ask if the injury happened at work, in which case he bills WC instead of the provincial health care.
Some provinces even have government car insurance. In some cases this is cheaper, in other cases more expensive. From what I recall (assume it’s still this way) they also paid physiotherapy and other related costs over accidents. In provinces without this, the private auto insurance companies for the involved parties settle it among themselves and may occasionally end up in court.
So yes, there’s a lot less bureacracy and hounding of the victim compared to mercenary for-profit insurance at least in regard to finding blame. A lot more lawyers are out of work. So sad.
Just to clarify - but auto insurance companies do not pay your medical bills; they would be on the hook for on-going not covered items like extended physiotherapy and chiropractor visits for whiplash, etc.
The NHS can make charges for ambulance and hospital treatment from a party who has made a compensation payment. The charges are fixed and don’t depend on the actual treatment or costs incurred and can only be claimed if compentation has been paid.
IANAL and have no idea how this actually works but I remember some years ago the charges were so pathetic it wasn’t worth the hospital’s time trying to claim them. I think the system was changed to make recovery easier (and widen the scope to cover all cases where compnsation is paid - not jut road trafific accidents - about five years ago but not sure if the changes worked.
ETA Should have said, I suppose the logic is that if some party is making some form of compensation payment they must have been at fault and, if there is some one to blame, why should the taxpayer foot the bill.
This all makes sense to me, if there is someone at fault then of course they’d be liable for things other than the basic medical care. Lost work time, pain and suffering, etc. But it’s up to you to pursue that, the state isn’t hounding anyone.
Sometimes I forget there are still things not covered, like ambulance rides or physical therapy. Good to know if an injury is caused by someone’s negligence there’s potentially recourse for the patient to not be on the hook for those costs.
The amount of time my insurance spends trying not to pay for my medical care, if I went to the wrong hospital in and emergency, or if they can find anyone else to put the blame on is ridiculous. It seems like such a colossal waste of time and energy and that’s all money taken away from providing health care.
Yeah, in Canada probably does not happen in a way described but something else does.
When my friend’s wife got pregnant they found that there is this probability that the baby will be born with long term disability due to some test that came back. Health ministry officials paid the visit several times trying to argue for a woman to abort but my friend and his wife decided to proceed. They are still bitter about it b/c in the midst of realizing what’s possibly going on with a fetus they had to deal with quite offensive approach these guys from Ministry took.
But the healthcare is not free in socialized medicine countries. Sure, nobody is billed, but somebody (the government) still pays for it. It would be in the governments best interest to bill liable third parties, no? The concept of socialized healthcare creates an entitlement of having medical care paid for, not an entitlement of freeing me from civil liability when I injure others. How is it that it seems the former became the latter?
Ambulance rides and physiotherapy are free in the UK. So is emergency dental treatment. The only medical costs you might incur would be cosmetic dental treatment and any prescriptions issued outside hospital, the latter costing up to a max of £100 a year.
You are liable to the person you injure for all other costs of the injury, such as the other person’s personal losses: pain and suffering; compensation for lost income (which in a serious injury could be life-long); cost of future care not covered by the medicare plan (e.g. - special living accommodations for a person rendered paraplegic by your negligence).
It’s just that since the individual who is injured has not paid anything directly for the medical care, that is not a loss to the individual, and the injured individual therefore has no claim against you.
As for the cost to the government, well, it’s a government program. Governments don’t bill drivers for the wear and tear on the roads caused by their driving, nor for police services, nor for fire services, and so on. We all pay in by taxes, and we all benefit from it at appropriate times, just like those other government services.