Filed: Mar. 05, 2018
Latest Update: Mar. 05, 2018
Summary: RULING ON PRIVATE HEALTH CARE INSURANCE OFFSET 1 NORA BETH DORSEY , Chief Special Master . During a telephonic status conference, counsel for the parties discussed the need for a ruling concerning how 15(g) and (h) of the National Childhood Vaccine Injury Compensation Program (the "Vaccine Act" or "Program") 2 pertain to the present case. Petitioner informed the court that her health insurance carrier recently issued a letter indicating that it would likely assert a lien related to th
Summary: RULING ON PRIVATE HEALTH CARE INSURANCE OFFSET 1 NORA BETH DORSEY , Chief Special Master . During a telephonic status conference, counsel for the parties discussed the need for a ruling concerning how 15(g) and (h) of the National Childhood Vaccine Injury Compensation Program (the "Vaccine Act" or "Program") 2 pertain to the present case. Petitioner informed the court that her health insurance carrier recently issued a letter indicating that it would likely assert a lien related to thi..
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RULING ON PRIVATE HEALTH CARE INSURANCE OFFSET1
NORA BETH DORSEY, Chief Special Master.
During a telephonic status conference, counsel for the parties discussed the need for a ruling concerning how §§ 15(g) and (h) of the National Childhood Vaccine Injury Compensation Program (the "Vaccine Act" or "Program")2 pertain to the present case. Petitioner informed the court that her health insurance carrier recently issued a letter indicating that it would likely assert a lien related to this case. Thus, petitioner seeks to clarify whether her health care insurer is entitled to reimbursement of benefits that it has paid if petitioner recovers monies in this case.
Under the Vaccine Program, a petitioner may recover actual and projected unreimbursable expenses, lost wages, and pain and suffering, and an award of $250,000 if the injury resulted in a death. § 15(a); see also Gram v. Sec'y of Health & Human Servs., No. 15-305V, 2015 WL 7166087 (Fed. Cl. Spec. Mstr. Sept. 29, 2015); Helman v. Sec'y of Health & Human Servs., No. 10-813V, 2014 WL 3589564, at *1 (Fed. Cl. Spec. Mstr. June 24, 2014) (citing Bruesewitz v. Wyeth, LLC, 131 S.Ct. 1068, 2074 (2011).
Pursuant to § 15(g), the Vaccine Act is a secondary payer to any insurance policy. § 15(g); see also Gram, Helman. Any award under the Vaccine Act must be offset by payments made or expected to be paid under an insurance policy. See § 15(g), Gram, and Helman. Furthermore, § 15(h) prohibits a health insurance policy from making payment of benefits under a policy secondary to the payment of compensation under the Vaccine Program.
Thus, the undersigned rules that pursuant to the Vaccine Act, petitioner's insurer would not be reimbursed for payments made for petitioner's treatment in connection with the injury, sickness, accident, or condition which has been alleged, should petitioner recover any monies in this matter.
IT IS SO ORDERED.
