In the event that WPA funds any treatment costs attributable to the fault or negligence of a Third
Party (including accident, illness or clinical negligence), WPA has a right in law to recover all such
medical expenses from the Third Party.
It is a term of your health insurance that if WPA funds any treatment costs for which you make a
personal injury or clinical negligence claim you agree to comply with the Claims Co-operation
Procedure set out below.
It is important that you understand the legal implications of the Claims Co-operation Procedure.
If you are in any doubt as to what it means then you must contact us or take independent legal advice as soon as possible.
Claims Co-Operation Procedure
If you make a claim under your health insurance for treatment which may have been caused by a Third
Party, you must let us know straightaway. This also applies in the event that it later transpires that a
Third Party is at fault.
If you subsequently make a personal injury or clinical negligence claim against the Third Party,
it is important that you understand that it is your personal duty to include in your claim any medical costs
claimed from WPA. You must repay to WPA from any settlement of your personal injury or clinical negligence claim such medical costs.
If you do not do this then we have the right to recover in full from you the medical costs we have paid,
together with interest and any legal costs we incur in recovering such monies. In addition we may withhold
payment of any further claims for which you have claimed or wish to claim for 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.
By making a claim for your medical costs you agree that:
In pursuing your personal injury or clinical negligence claim against a Third Party you
understand that this is at your own expense. In addition you will indemnify WPA against any
adverse cost orders;
Inform your solicitor at the outset that you are insured by WPA for your admissible medical costs;
Include all medical costs which you have claimed or may claim from WPA as a head of damages
in your personal injury or clinical negligence claim;
Instruct your solicitor to liaise with and provide every assistance to WPA. Upon request by
WPA, disclose copies of any expert reports or other legal documents concerning your personal
Ensure that you and your solicitor do not prejudice WPA’s right to recover medical costs paid,
or due to be paid under the terms of your insurance (including any potential future medical
Instruct your solicitor not to compromise or agree any final settlement of your claim or waive
our right to recover from the third party any medical costs without expressly consulting with
us first and obtaining our written agreement;
Instruct your solicitor to repay promptly your medical costs directly to WPA from any
settlement of your claim (with interest if this is applicable); and
In the event that your solicitor or the Third Party pays you any settlement directly agree to
repay promptly your medical costs directly to WPA from any settlement of your claim. If you
do not do so we will seek recovery directly from you together with interest and our legal costs.
Please note WPA reserves its right of subrogation to take over any legal action in your name against
the Third Party should we choose to do so in order to recover medical costs WPA has incurred on your behalf.
In this event you must provide WPA with all reasonable assistance.