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OHIP Subrogation

. Erickson & Partners v. Ontario (Health and Long-Term Care)

In Erickson & Partners v. Ontario (Health and Long-Term Care) (Ont CA, 2015) the Court of Appeal considered the application of the statutory requirement that plaintiffs in personal injury cases must advance subrogated claims on behalf of OHIP for insured services, and the manner of calculation of OHIP's portion thereunder (including the treatment of legal costs) [see S.39, General Reg, Health Insurance Act]:
[1] Under the Ontario Health Insurance Act,[1] any person who commences an action to recover damages arising out of the negligence or other wrongful act of a third party must include a claim on behalf of the Ontario Health Insurance Plan (the “Plan”) for the cost of any insured medical services provided to the insured person in respect of the injury or disability suffered. Section 39(6) of the General Regulation made under the Act[2] (the “Regulation”) prescribes the portion of the costs of the insured person’s action which the Plan must bear. At issue on this appeal is the proper interpretation of that section.
The case is useful reading for anyone involved in such a subrogated claim case.


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