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Certificates of NHS charges | |
138 Applications for certificates of NHS charges | |
(1) Before a person makes a compensation payment in consequence of any injury | |
suffered by an injured person, he may apply for a certificate to the Secretary of | |
State, the Scottish Ministers or both, according to whether he believes the | 5 |
relevant NHS charges payable by him (if any) would be due to the Secretary of | |
State, the Scottish Ministers or both. | |
(2) If the Secretary of State receives or the Scottish Ministers receive an application | |
under subsection (1), he or they must arrange for a certificate to be issued as | |
soon as is reasonably practicable (subject to section 139). | 10 |
(3) A certificate may provide that it is to remain in force— | |
(a) until a specified date, | |
(b) until the occurrence of a specified event, or | |
(c) indefinitely. | |
(4) A person may apply under subsection (1) for a fresh certificate from time to | 15 |
time. | |
(5) Subsection (2) does not require the Secretary of State or the Scottish Ministers | |
to arrange for a fresh certificate to be issued to a person applying under | |
subsection (4) if, when the application is received, a certificate issued to the | |
applicant in respect of the injured person is still in force; but the Secretary of | 20 |
State or the Scottish Ministers (as the case may be) may arrange for a fresh | |
certificate to be issued so as to have effect on the expiry of the current | |
certificate. | |
(6) If a certificate expires, the Secretary of State or the Scottish Ministers (as the | |
case may be) may arrange for a fresh certificate to be issued without an | 25 |
application having to be made. | |
(7) In the circumstances mentioned in subsection (8), a person who has made a | |
compensation payment in consequence of an injury suffered by an injured | |
person must apply for a certificate to the Secretary of State, the Scottish | |
Ministers or both, according to whether he believes the relevant NHS charges | 30 |
payable by him (if any) would be due to the Secretary of State, the Scottish | |
Ministers or both. | |
(8) The circumstances are that— | |
(a) at the time the payment is made by the person— | |
(i) no certificate has been issued to him in respect of the injured | 35 |
person, or | |
(ii) if such a certificate has been issued to him, it is no longer in | |
force, and | |
(b) no application for a certificate has been made by him during the | |
prescribed period ending immediately before the day on which the | 40 |
compensation payment is made. | |
(9) An application for a certificate must be made in the prescribed manner and, in | |
the case of an application under subsection (7), within the prescribed period. | |
(10) On receiving an application under subsection (7), the Secretary of State or the | |
Scottish Ministers must arrange for a certificate to be issued as soon as is | 45 |
reasonably practicable (subject to section 139). | |
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(11) In this section and section 139, “relevant NHS charges” has the meaning given | |
in section 137(7). | |
139 Section 138: supplementary | |
(1) Subsection (2) applies if— | |
(a) an application is made under subsection (1) or (7) of section 138 to the | 5 |
Secretary of State or the Scottish Ministers, and | |
(b) it appears to the Secretary of State or the Scottish Ministers that the | |
relevant NHS charges payable by the applicant (if any) would be due | |
to the Scottish Ministers or the Secretary of State (respectively) instead. | |
(2) The Secretary of State or the Scottish Ministers (as the case may be) must refer | 10 |
the application to the Scottish Ministers or the Secretary of State (respectively), | |
and the application is to be treated, for the purposes of this Part, as having been | |
made to the Scottish Ministers or the Secretary of State (as the case may be). | |
(3) Subsection (4) applies if— | |
(a) an application is made under subsection (1) or (7) of section 138 to the | 15 |
Secretary of State or the Scottish Ministers, and | |
(b) it appears to the Secretary of State or the Scottish Ministers that the | |
relevant NHS charges payable by the applicant (if any) would be due | |
in part to him or them and in part to the Scottish Ministers or the | |
Secretary of State (respectively). | 20 |
(4) The Secretary of State or the Scottish Ministers (as the case may be) must refer | |
the application to the Scottish Ministers or the Secretary of State (respectively) | |
in so far as the application relates to relevant NHS charges due to them or him, | |
and the application is to be treated, for the purposes of this Part, as having been | |
made to the Secretary of State in so far as it relates to relevant NHS charges due | 25 |
to him under subsection (2) of section 137 and to the Scottish Ministers in so far | |
as it relates to relevant NHS charges due to them under that subsection. | |
(5) A certificate may be issued under section 138 jointly by the Secretary of State | |
and the Scottish Ministers specifying— | |
(a) an amount (or amounts) for which a person is liable under subsection | 30 |
(2) of section 137 to the Secretary of State, and | |
(b) an amount (or amounts) for which that person is liable under that | |
subsection to the Scottish Ministers, | |
in respect of the same injured person in consequence of the same injury. | |
(6) In the case of a certificate issued under section 138 specifying an amount (or | 35 |
amounts) as mentioned in paragraphs (a) and (b) of subsection (5), references | |
in the following provisions of this Part to a certificate are to be taken as being | |
to the certificate in so far as it relates to the liability to the Secretary of State or | |
in so far as it relates to the liability to the Scottish Ministers (as the case may | |
require). | 40 |
140 Information contained in certificates | |
(1) A certificate must specify the amount (or amounts) for which the person to | |
whom it is issued is liable under section 137(2). | |
(2) The amount (or amounts) to be specified is (or are) to be that (or those) set out | |
in, or determined in accordance with, regulations, reduced if applicable in | 45 |
accordance with subsection (3). | |
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(3) If a certificate relates to a claim made by or on behalf of an injured person— | |
(a) in respect of which a court in England, Wales or Scotland has ordered | |
a reduction of damages in accordance with section 1 of the Law Reform | |
(Contributory Negligence) Act 1945 (c. 28), | |
(b) in respect of which an officer of a court in England or Wales has entered | 5 |
or sealed an agreed judgement or order which specifies— | |
(i) that the damages are to be reduced to reflect the injured | |
person’s share in the responsibility for the injury in question, | |
and | |
(ii) the amount or proportion by which they are to be so reduced, or | 10 |
(c) in the case of which the parties to any resulting action before a court in | |
Scotland have executed a joint minute which specifies— | |
(i) that the action has been settled extra-judicially, and | |
(ii) the matters mentioned in paragraph (b)(i) and (ii), | |
the amount (or amounts) specified in the certificate is (or are) to be that (or | 15 |
those) which would be so specified apart from this subsection, reduced by the | |
same proportion as the reduction of damages. | |
(4) If a certificate relates to an injured person who has not received NHS treatment | |
at a health service hospital or been provided with NHS ambulance services in | |
respect, or as a result, of the injury, it must indicate that no amount is payable | 20 |
to the Secretary of State or the Scottish Ministers (as the case may be) by | |
reference to that certificate. | |
(5) Regulations under subsection (2) may, in particular, provide— | |
(a) that the amount, or the aggregate amount, specified in a certificate is | |
not to exceed a prescribed sum, | 25 |
(b) for different amounts to be specified in respect of different | |
circumstances or areas, | |
(c) for cases in which an injured person receives treatment at two or more | |
health service hospitals, | |
(d) for cases in which an injured person receives treatment at one or more | 30 |
health service hospitals and is provided with NHS ambulance services, | |
(e) for cases in which liability under section 137(2) is to be apportioned | |
between two or more persons making compensation payments to or in | |
respect of the same injured person in consequence of the same injury, | |
(f) for cases in which a fresh certificate is issued or a certificate is revoked | 35 |
as a result of a review under section 143 or an appeal under section 144 | |
or 146, | |
(g) for the amount specified in a certificate issued by the Secretary of State | |
or the Scottish Ministers to be adjusted to take into account any amount | |
for which the person to whom the certificate is issued is liable under | 40 |
section 137(2), in respect of the same injured person in consequence of | |
the same injury, in accordance with a certificate issued by the Scottish | |
Ministers or the Secretary of State (respectively), | |
(h) for any matter requiring determination under or in consequence of the | |
regulations to be determined by the Secretary of State or the Scottish | 45 |
Ministers (as the case may require), | |
and in the case of paragraph (e) may make such provision by modifying this | |
Part. | |
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(6) Any reference in subsection (5)(a) or (b) to any amount (or amounts) specified | |
in a certificate are to the amount (or amounts) which would be so specified | |
apart from subsection (3). | |
(7) Regulations under subsection (2) which provide for cases mentioned in | |
subsection (5)(e) may (among other things) provide in the case of each | 5 |
compensator for— | |
(a) determining, or re-determining, the amount for which he is liable | |
under section 137(2), | |
(b) giving credit for amounts already paid, and | |
(c) the payment by any person of any balance or the recovery from any | 10 |
person of any excess. | |
(8) Regulations under subsection (2) which provide for cases mentioned in | |
subsection (5)(f) may (among other things) provide in the case of any | |
compensator for the matters mentioned in paragraphs (b) and (c) of subsection | |
(7). | 15 |
(9) A person to whom a certificate is issued is entitled to such particulars of the | |
manner in which any amount (or amounts) specified in the certificate has (or | |
have) been determined as may be prescribed, if he applies to the Secretary of | |
State or the Scottish Ministers (as the case may require) for those particulars. | |
(10) Regulations under subsection (2) may be made so as to apply to any certificate | 20 |
issued after the time the regulations come into force, other than one relating to | |
a compensation payment made before that time. | |
Recovery of NHS charges | |
141 Payment of NHS charges | |
(1) If the certificate by reference to which an amount payable under section 137(2) | 25 |
is determined is issued before the settlement date, that amount must be paid | |
before the end of the period of 14 days beginning with the settlement date. | |
(2) If the certificate by reference to which an amount payable under section 137(2) | |
is determined is issued on or after the settlement date, that amount must be | |
paid before the end of the period of 14 days beginning with the day on which | 30 |
the certificate is issued. | |
(3) “Settlement date” means the date on which the compensation payment is | |
made. | |
(4) This section is subject to section 142(2). | |
142 Recovery of NHS charges | 35 |
(1) This section applies if a person has made a compensation payment and | |
either— | |
(a) subsection (7) of section 138 applies but he has not applied for a | |
certificate as required by that subsection, or | |
(b) he has not made payment, in full, of any amount due under section | 40 |
137(2) by the end of the period allowed under section 141. | |
(2) The Secretary of State, the Scottish Ministers or both, according to the | |
circumstances of the case, may— | |
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(a) in a case within subsection (1)(a), issue the person who made the | |
compensation payment with a certificate, and | |
(b) in a case within subsection (1)(b), issue him with a copy of the certificate | |
or (if more than one has been issued) the most recent one, | |
and, in either case, issue him with a demand that payment of any amount due | 5 |
under section 137(2) be made immediately. | |
(3) Subsections (5) and (6) of section 139 apply to certificates issued under | |
subsection (2) above as they apply to certificates issued under section 138. | |
(4) A demand issued under subsection (2) may be issued jointly by the Secretary | |
of State and the Scottish Ministers specifying— | 10 |
(a) an amount due under subsection (2) of section 137 to the Secretary of | |
State, and | |
(b) an amount due under that subsection to the Scottish Ministers, | |
in respect of the same injured person in consequence of the same injury. | |
(5) In the case of a demand specifying amounts as mentioned in subsection (4)(a) | 15 |
and (b), references in the following provisions of this section to a demand are | |
to be taken as being (as the case may require) to— | |
(a) the demand in so far as it relates to any amount due to the Secretary of | |
State, or | |
(b) the demand in so far as it relates to any amount due to the Scottish | 20 |
Ministers, | |
and related expressions are to be read accordingly. | |
(6) The Secretary of State or the Scottish Ministers may recover the amount for | |
which a demand for payment is made under subsection (2) from the person | |
who made the compensation payment. | 25 |
(7) If the person who made the compensation payment resides or carries on | |
business in England or Wales and a county court so orders, the amount | |
demanded is recoverable by execution issued from the county court or | |
otherwise as if it were payable under an order of that court. | |
(8) If the person who made the compensation payment resides or carries on | 30 |
business in Scotland, the demand may be enforced as if it were an extract | |
registered decree arbitral bearing a warrant for execution issued by the sheriff | |
court of any sheriffdom in Scotland. | |
(9) A document which states that it is a record of the amount recoverable under | |
subsection (6) is conclusive evidence that the amount is so recoverable if it is | 35 |
signed by a person authorised to do so by the Secretary of State or the Scottish | |
Ministers (as the case may be). | |
(10) For the purposes of subsection (9), a document purporting to be signed by a | |
person authorised to do so by the Secretary of State or the Scottish Ministers (as | |
the case may be) is to be treated as so signed unless the contrary is proved. | 40 |
Review and appeal | |
143 Review of certificates | |
(1) The Secretary of State or the Scottish Ministers must review a certificate issued | |
by him or them if the certificate relates to a claim made by or on behalf of an | |
injured person— | 45 |
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(a) in respect of which, after the certificate is issued, a court in England, | |
Wales or Scotland orders a reduction of damages in accordance with | |
section 1 of the Law Reform (Contributory Negligence) Act 1945 (c. 28), | |
(b) in respect of which, after the certificate is issued, an officer of a court in | |
England or Wales enters or seals an agreed judgement or order which | 5 |
specifies— | |
(i) that the damages are to be reduced to reflect the injured | |
person’s share in the responsibility for the injury in question, | |
and | |
(ii) the amount or proportion by which they are to be so reduced, or | 10 |
(c) in the case of which, after the certificate is issued, the parties to any | |
resulting action before a court in Scotland execute a joint minute which | |
specifies— | |
(i) that the action has been settled extra-judicially, and | |
(ii) the matters mentioned in paragraph (b)(i) and (ii), | 15 |
and notification of the order, judgement or minute has been given to the | |
Secretary of State or the Scottish Ministers (as the case may be) in the | |
prescribed manner. | |
(2) If— | |
(a) the Secretary of State and the Scottish Ministers have issued certificates | 20 |
to a person specifying an amount (or amounts) for which that person is | |
liable under section 137(2) in respect of the same injured person in | |
consequence of the same injury, and | |
(b) either the Secretary of State or the Scottish Ministers subsequently | |
adjusts or adjust the amount (or amounts) specified in the certificate | 25 |
issued by him or them on a review of, or an appeal against, that | |
certificate, | |
the other must review the certificate issued by him or them (as the case may be) | |
if he is or they are satisfied that it is necessary or expedient to make | |
consequential adjustments to that certificate. | 30 |
(3) The Secretary of State or the Scottish Ministers may review a certificate issued | |
by him or them— | |
(a) either within the prescribed period or in prescribed cases or | |
circumstances, and | |
(b) either on application made for the purpose or on his or their initiative. | 35 |
(4) On a review under this section, the Secretary of State or the Scottish Ministers | |
may— | |
(a) confirm the certificate, | |
(b) issue a fresh certificate containing such variations as he considers or | |
they consider appropriate, or | 40 |
(c) revoke the certificate. | |
(5) Subsections (5) and (6) of section 139 apply to certificates issued under | |
subsection (4)(b) above as they apply to certificates issued under section 138. | |
144 Appeal against a certificate | |
(1) An appeal against a certificate may be made by the person to whom the | 45 |
certificate was issued on one or more of the following grounds— | |
(a) that an amount (or amounts) specified in the certificate is (or are) | |
incorrect, | |
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(b) that an amount (or amounts) so specified takes (or take) into account— | |
(i) treatment which is not NHS treatment received by the injured | |
person, in respect of his injury, at a health service hospital, | |
(ii) ambulance services which are not NHS ambulance services | |
provided to the injured person as a result of his injury, or | 5 |
(iii) treatment as mentioned in sub-paragraph (i) and ambulance | |
services as mentioned in sub-paragraph (ii), | |
(c) that the payment on the basis of which the certificate was issued is not | |
a compensation payment. | |
(2) No appeal may be made until— | 10 |
(a) the claim against the person to whom the certificate was issued, which | |
gives rise to the compensation payment, has been finally disposed of, | |
and | |
(b) payment of the amount (or amounts) specified in the certificate has | |
been made to the Secretary of State or the Scottish Ministers (as the case | 15 |
may be). | |
(3) For the purposes of subsection (2)(a), if an award of damages in respect of a | |
claim has been made under or by virtue of— | |
(a) section 32A(2)(a) of the Supreme Court Act 1981 (c. 54), | |
(b) section 12(2)(a) of the Administration of Justice Act 1982 (c. 53), or | 20 |
(c) section 51(2)(a) of the County Courts Act 1984 (c. 28), | |
(orders for provisional damages in personal injury cases), the claim is to be | |
treated as having been finally disposed of. | |
(4) Regulations may make provision— | |
(a) as to the manner in which, and the time within which, an appeal may | 25 |
be made, | |
(b) as to the procedure to be followed if an appeal is made, | |
(c) as to the circumstances in which appeals may be consolidated | |
(including the consolidation of an appeal against a certificate issued by | |
the Secretary of State with an appeal against a certificate issued by the | 30 |
the Scottish Ministers), and | |
(d) for the purpose of enabling an appeal to be treated as an application for | |
a review under section 143. | |
145 Appeal tribunals | |
(1) The Secretary of State or the Scottish Ministers must refer an appeal to an | 35 |
appeal tribunal constituted under Chapter 1 of Part 1 of the Social Security Act | |
1998 (c. 14). | |
(2) In determining an appeal, the tribunal must take into account any decision of | |
a court relating to the same, or any similar, issue arising in connection with the | |
injury in question. | 40 |
(3) On an appeal, the tribunal may— | |
(a) confirm the amount or amounts specified in the certificate, | |
(b) specify any variations which are to be made on the issue of a fresh | |
certificate under subsection (4), or | |
(c) declare that the certificate is to be revoked. | 45 |
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