Clinical Negligence and Personal Injury Claims - Healthcare Trust
In the event that your group scheme funds any treatment costs attributable to the fault or negligence of a Third Party (including accident, illness, clinical negligence), the scheme trustees through the administrators have the contractual right to recover all medical expenses in the event that your litigation/claim is successful.

It is an implicit term of the scheme that if we fund any treatment costs you agree to comply with the Claims Co-operation Procedure set out below.

Claims Co-operation Procedure

If you need to make a claim which may have been caused by some other person or organisation, you must let us know straightaway. This also applies in the event that this information becomes apparent at a later date.

In the event that you subsequently make a claim against the Third Party, it is important that you understand that it is your personal duty to include in your claim any such medical expenses claimed through the scheme and repay these to us from any settlement of your personal injury claim. If you do not do this then we have the right to recover in full from you the medical costs we have paid and withhold payment of any further medical expenses claims until you do comply with this Claims Co-operation Procedure. We will provide you with a Form of Instruction which you are required to complete and send back to us in order to help with this process.

By making a claim for medical expenses you agree that you will:

  • Pursue your personal injury claim against the Third Party at your own expense and hold the group scheme trustees and administrators harmless from any adverse costs orders;
  • Tell your solicitor immediately that you are in a healthcare scheme for your admissible medical expenses;
  • Include all your medical expenses which you have claimed or may claim under your group scheme in your personal injury claim;
  • Instruct your solicitor to provide every assistance to us and upon request by the administrators, disclose copies of any expert reports or other legal documents concerning your personal injury claim.
  • Ensure that you and your solicitor do not prejudice our rights to recover medical expenses paid, or due to be paid under your group scheme (including any potential future medical costs);
  • Instruct your solicitor not to agree any final settlement of your claim or waive our right to recover from the third party any medical expenses paid out by us without consulting us first and our agreeing to this;
  • Instruct your solicitor to repay promptly your medical expenses directly to us from any settlement of your claim (with interest if this is applicable);
  • In the event that your solicitor or the Third Party pays you direct, that you agree to repay promptly your medical expenses directly to us from any settlement of your claim (with interest if this is applicable);
  • Agree that the administrators and the scheme trustees reserve the contractual right to take over any legal action against the Third Party should it choose to do so in order to recover its costs and that you will provide us with all reasonable assistance in this regard.

Legal help and advice

You may already have a solicitor who can advise you. If not, you can normally obtain free advice without any obligation from specialist solicitors who will be pleased to explain your rights.