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Understanding OHIP Subrogated Claims

Man in hospital

Ontario’s publicly funded healthcare system provides support to millions of Ontario residents. If you have been injured as a result of the negligence and fault of another party, you will probably receive some OHIP funded healthcare treatment. If you then commence litigation against the at fault party for compensation for your injuries, the Ministry of Health and Long-Term Care is entitled to recoup the expenses they spent on your injuries, except in motor vehicle collision cases.

This is what is called a subrogated claim – the Ministry requires you to step into their shoes to recover payment for your health-related treatment that was caused by the at fault party.

The Ministry’s right to recover these expenses is pursuant to the Health Insurance Act, R.S.O. 1990, c. H.6, and the regulations enacted under this Act, as well as the Long-Term Care Homes Act, 2007 S.O. 2007, c. 8.

You have an obligation as the injured party to protect the Ministry’s right to recover its expenses and to advance a claim on its behalf.

Often, the Ministry is repaid after a settlement is achieved, and its account can be subject to negotiation depending on the net amount of settlement you receive and what your ongoing care needs are.

It is important to consult with a lawyer once you are injured as a result of someone’s negligence to ensure that all your obligations and rights are followed and protected.

To consult with a lawyer please contact our team at JEWELL RADIMISIS JORGE LL.P for a free initial consultation at 1 (855) 546-2525.

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