Acts and Regulations

M-7 - Medical Services Payment Act

Full text
Recovery of costs of entitled services, subrogation, sharing insufficient recovery, release or settlement, liability insurer
10(1)Where, as a result of the negligence or wrongful act of another, a person suffers personal injuries for which he receives entitled services under this Act or the regulations, he
(a) shall have the same right to claim and to recover the cost of the entitled services against the person who was negligent or who did the wrongful act as he would have had if he, himself, had been required to pay for the entitled services, and
(b) if he makes any claim for the personal injuries suffered against the person who was negligent or who did the wrongful act, shall claim and seek to recover the cost of the entitled services.
10(2)Where under subsection (1), a person either acting for himself or on behalf of another person, recovers a sum in respect of entitled services received under this Act or the regulations, he shall as soon as practicable pay such sum recovered to the provincial authority.
10(3)Where, as a result of the negligence or wrongful act of another, a person suffers personal injuries for which he receives entitled services under this Act or the regulations and he does not claim against the person who was negligent or who did the wrongful act, the Crown in right of the Province may maintain an action in the name of the Crown or in the name of the injured person for recovery of the cost of the entitled services.
10(4)Where, as a result of the negligence or wrongful act of another, a person suffers personal injuries for which he receives entitled services under this Act or the regulations and a claim is made against the person who was negligent or who did the wrongful act but the person making the claim, either acting on his own behalf or on behalf of another person, does not
(a) claim for the cost of the entitled services,
(b) if a release is given or the claim is settled, obtain a written approval of the release or settlement in accordance with subsection (9) or (10), or
(c) pay any sum recovered in respect of the entitled services to the provincial authority in accordance with subsection (2),
the Crown in Right of the Province may maintain an action in the name of the Crown against the person making the claim, whether acting on his own behalf or on behalf of another person, for recovery of the cost of the entitled services.
10(5)It shall not be a defence to an action brought by the Crown under subsection (4) that a release has been given, a claim has been settled or a judgment obtained unless
(a) the claim included a claim for the cost of the entitled services, and
(b) if a release is given or the claim is settled, the provincial authority has under subsection (9) or (10) approved the release or settlement.
10(6)Where the provincial authority or a person designated by him approves in writing a release or settlement under subsection (10), the Crown in right of the Province may continue the action or maintain an action in the name of the Crown for recovery of the cost of the entitled services.
Sharing insufficient recovery
10(7)Subject to subsection (10), where, as a result of a claim under this section
(a) the claim is settled or a judgment is obtained, and
(b) insufficient funds are available to provide complete recovery to the injured person for his losses and injuries and to pay the cost of the entitled services,
the injured person and the Crown in right of the Province shall share pro rata in proportion to their respective losses in any recovery in accordance with the terms and conditions prescribed by regulation.
10(8)No person, acting for himself or on behalf of another person, shall, without the approval in writing under subsection (9) or (10) of the provincial authority make a settlement of a claim based upon a cause of action for damages for personal injuries in a case where the injured person has received entitled services under this Act or the regulations unless at the same time he makes a settlement to recover the same pro rata proportion in respect of the cost of the entitled services as the injured person is to recover in respect of his losses and injuries.
10(9)No release or settlement of a claim or judgment based upon a cause of action for damages for personal injuries in a case where the injured person has received entitled services under this Act or the regulations is binding upon the Crown unless the provincial authority or a person designated by him has approved the release or settlement in writing.
10(10)Notwithstanding subsection (9), where a person who makes a claim under subsection (1) has obtained an offer for a settlement whereby the same pro rata proportion of the cost of entitled services would be recovered as the injured person would recover in respect of his losses and injuries but, in the opinion of the provincial authority or a person designated by him, the offer would not provide sufficient recovery in respect of the entitled services, the provincial authority or a person designated by him may approve in writing a release or settlement whereby the person making a claim under subsection (1) makes a settlement of a claim in respect of his injuries or losses without making a settlement in respect of the cost of the entitled services but the written approval is not binding on the Crown in relation to a claim made under subsection (6) in respect of the cost of the entitled services.
10(11)Where a person whose negligent or wrongful act resulted in personal injuries to another is insured by a liability insurer carrying on business in the Province and a claim made in respect of those personal injuries does not include a claim for the cost of the entitled services received by the injured person under this Act or the regulations, the liability insurer shall pay to the provincial authority the cost of the entitled services and payment of that amount to the provincial authority discharges the liability of the insurer to pay the cost of the entitled services in any subsequent claim to the insured person or any person claiming under or on behalf of the insured person.
10(12)Every liability insurer carrying on business in the Province shall provide the provincial authority, when requested to do so, information relating to
(a) a claim made against an insured person by a person who received entitled services under this Act or the regulations, or
(b) the terms and conditions of any settlement entered into by an insured person and a person who received entitled services under this Act or the regulations.
10(13)In an action under this section a certificate signed or purporting to be signed by or on behalf of the provincial authority shall be accepted by all courts
(a) as conclusive proof
(i) that the person named in the certificate has received entitled services,
(ii) that the amount recorded in the certificate is the cost of the entitled services received by the person named in the certificate, and
(iii) of the office, authority and signature of the person signing or purporting to sign the certificate, without proof of his appointment, authority or signature, and
(b) as prima facie proof that the entitled services were received in respect of the personal injuries suffered.
10(14)This section applies except where the personal injuries occurred as a result of the use or operation of a motor vehicle registered in the Province.
1968, c.85, s.10; 1975, c.35, s.2; 1985, c.15, s.3; 1986, c.53, s.2; 1988, c.22, s.4; 1992, c.82, s.2; 2023, c.17, s.152
Recovery of costs of entitled services, subrogation, sharing insufficient recovery, release or settlement, liability insurer
10(1)Where, as a result of the negligence or wrongful act of another, a person suffers personal injuries for which he receives entitled services under this Act or the regulations, he
(a) shall have the same right to claim and to recover the cost of the entitled services against the person who was negligent or who did the wrongful act as he would have had if he, himself, had been required to pay for the entitled services, and
(b) if he makes any claim for the personal injuries suffered against the person who was negligent or who did the wrongful act, shall claim and seek to recover the cost of the entitled services.
10(2)Where under subsection (1), a person either acting for himself or on behalf of another person, recovers a sum in respect of entitled services received under this Act or the regulations, he shall as soon as practicable pay such sum recovered to the provincial authority.
10(3)Where, as a result of the negligence or wrongful act of another, a person suffers personal injuries for which he receives entitled services under this Act or the regulations and he does not claim against the person who was negligent or who did the wrongful act, Her Majesty the Queen in right of the Province may maintain an action in her own name or in the name of the injured person for recovery of the cost of the entitled services.
10(4)Where, as a result of the negligence or wrongful act of another, a person suffers personal injuries for which he receives entitled services under this Act or the regulations and a claim is made against the person who was negligent or who did the wrongful act but the person making the claim, either acting on his own behalf or on behalf of another person, does not
(a) claim for the cost of the entitled services,
(b) if a release is given or the claim is settled, obtain a written approval of the release or settlement in accordance with subsection (9) or (10), or
(c) pay any sum recovered in respect of the entitled services to the provincial authority in accordance with subsection (2),
Her Majesty the Queen in Right of the Province may maintain an action in her own name against the person making the claim, whether acting on his own behalf or on behalf of another person, for recovery of the cost of the entitled services.
10(5)It shall not be a defence to an action brought by Her Majesty under subsection (4) that a release has been given, a claim has been settled or a judgment obtained unless
(a) the claim included a claim for the cost of the entitled services, and
(b) if a release is given or the claim is settled, the provincial authority has under subsection (9) or (10) approved the release or settlement.
10(6)Where the provincial authority or a person designated by him approves in writing a release or settlement under subsection (10), Her Majesty the Queen in right of the Province may continue the action or maintain an action in her own name for recovery of the cost of the entitled services.
Sharing insufficient recovery
10(7)Subject to subsection (10), where, as a result of a claim under this section
(a) the claim is settled or a judgment is obtained, and
(b) insufficient funds are available to provide complete recovery to the injured person for his losses and injuries and to pay the cost of the entitled services,
the injured person and Her Majesty the Queen in right of the Province shall share pro rata in proportion to their respective losses in any recovery in accordance with the terms and conditions prescribed by regulation.
10(8)No person, acting for himself or on behalf of another person, shall, without the approval in writing under subsection (9) or (10) of the provincial authority make a settlement of a claim based upon a cause of action for damages for personal injuries in a case where the injured person has received entitled services under this Act or the regulations unless at the same time he makes a settlement to recover the same pro rata proportion in respect of the cost of the entitled services as the injured person is to recover in respect of his losses and injuries.
10(9)No release or settlement of a claim or judgment based upon a cause of action for damages for personal injuries in a case where the injured person has received entitled services under this Act or the regulations is binding upon Her Majesty unless the provincial authority or a person designated by him has approved the release or settlement in writing.
10(10)Notwithstanding subsection (9), where a person who makes a claim under subsection (1) has obtained an offer for a settlement whereby the same pro rata proportion of the cost of entitled services would be recovered as the injured person would recover in respect of his losses and injuries but, in the opinion of the provincial authority or a person designated by him, the offer would not provide sufficient recovery in respect of the entitled services, the provincial authority or a person designated by him may approve in writing a release or settlement whereby the person making a claim under subsection (1) makes a settlement of a claim in respect of his injuries or losses without making a settlement in respect of the cost of the entitled services but the written approval is not binding on Her Majesty in relation to a claim made under subsection (6) in respect of the cost of the entitled services.
10(11)Where a person whose negligent or wrongful act resulted in personal injuries to another is insured by a liability insurer carrying on business in the Province and a claim made in respect of those personal injuries does not include a claim for the cost of the entitled services received by the injured person under this Act or the regulations, the liability insurer shall pay to the provincial authority the cost of the entitled services and payment of that amount to the provincial authority discharges the liability of the insurer to pay the cost of the entitled services in any subsequent claim to the insured person or any person claiming under or on behalf of the insured person.
10(12)Every liability insurer carrying on business in the Province shall provide the provincial authority, when requested to do so, information relating to
(a) a claim made against an insured person by a person who received entitled services under this Act or the regulations, or
(b) the terms and conditions of any settlement entered into by an insured person and a person who received entitled services under this Act or the regulations.
10(13)In an action under this section a certificate signed or purporting to be signed by or on behalf of the provincial authority shall be accepted by all courts
(a) as conclusive proof
(i) that the person named in the certificate has received entitled services,
(ii) that the amount recorded in the certificate is the cost of the entitled services received by the person named in the certificate, and
(iii) of the office, authority and signature of the person signing or purporting to sign the certificate, without proof of his appointment, authority or signature, and
(b) as prima facie proof that the entitled services were received in respect of the personal injuries suffered.
10(14)This section applies except where the personal injuries occurred as a result of the use or operation of a motor vehicle registered in the Province.
1968, c.85, s.10; 1975, c.35, s.2; 1985, c.15, s.3; 1986, c.53, s.2; 1988, c.22, s.4; 1992, c.82, s.2