Social Welfare and Pensions Act 2013

Recovery of certain benefits and assistance

13. The Principal Act is amended—

(a) in section 4(4)(a), by substituting “342, 343M and 363” for “342 and 363”,

(b) in section 300(2)—

(i) in paragraph (h), by substituting “and insurability),” for “and insurability), and”, and

(ii) by inserting the following after paragraph (h):

“(hh) Part 11B (recovery of certain benefits and assistance) being a question as to whether a benefit, or any part of a benefit, specified in a statement of recoverable benefits is a recoverable benefit within the meaning of that Part, and”,

(c) in section 311 (amended by section 18 of the Social Welfare and Pensions Act 2008 )—

(i) in subsection (1), by substituting “Subject to subsection (4), where any person” for “Where any person”, and

(ii) by inserting the following after subsection (3):

“(4) No appeal may be made under subsection (1) by any person against the decision given by a deciding officer on a question under paragraph (hh) (inserted by section 13(b) of the Social Welfare and Pensions Act 2013) of section 300(2) until the recoverable benefits specified in the statement of recoverable benefits have been paid to the Minister in accordance with section 343R (inserted by section 13(d) of the Social Welfare and Pensions Act 2013).”,

(d) by inserting the following after Part 11A (inserted by section 15 of the Social Welfare and Pensions (Miscellaneous Provisions) Act 2013):

“Part 11B

Recovery of Certain Benefits and Assistance

Interpretation

343L. (1) In this Part—

‘Act of 2003’ means the Personal Injuries Assessment Board Act 2003 ;

‘Board’ means the Personal Injuries Assessment Board;

‘compensation payment’ has the meaning assigned to it by section 343M;

‘compensator’ has the meaning assigned to it by section 343M;

‘court’ means, in relation to a personal injury action, the court in which that action has been brought, being the High Court, Circuit Court or District Court, as the case may be;

‘injured person’ has the meaning assigned to it by section 343M and includes any person acting on his or her behalf or his or her personal representative;

‘personal injury’ includes any disease and any impairment of a person’s physical or mental condition;

‘recoverable benefits’ has the meaning assigned to it by subsection (2);

‘relevant compensation payment’ means any part of a compensation payment that is attributable to loss of earnings or profits of an injured person;

‘specified benefits’ has the meaning assigned to it by section 343O;

‘specified period’ shall be construed in accordance with section 343N;

‘statement of recoverable benefits’ means a statement issued by the Minister under section 343P.

(2) In this Part ‘recoverable benefits’ means—

(a) the specified benefits paid to an injured person as a result of the personal injury up to the date of the issuing of a statement of recoverable benefits, and

(b) any specified benefits that may be paid to the injured person as a result of the personal injury on or after the date referred to in paragraph (a) until the end of the specified period.

Application of Part

343M. (1) Subject to subsection (2), this Part applies where—

(a) a payment (in this Part referred to as a ‘compensation payment’) is made by or on behalf of a person (in this Part referred to as the ‘compensator’) who is, or is alleged to be, liable to any extent in respect of a personal injury, not causing death, suffered by any other person (in this Part referred to as the ‘injured person’),

(b) the injured person has received, is receiving, or may receive, a specified benefit as a result of that personal injury during the specified period, and

(c) the compensation payment is made on or after the commencement of this Part unless that payment is made pursuant to a court order, an order of the Board in accordance with the Act of 2003 or a settlement and that order or settlement is made before the commencement of this Part.

(2) This Part does not apply where compensation payments are made to an injured person—

(a) by the Hepatitis C and HIV Compensation Tribunal,

(b) by a court of competent jurisdiction to compensate certain persons who have contracted Hepatitis C or Human Immunodeficiency Virus within the State from the use of Human Immunoglobulin Anti-D, whole blood or other blood products,

(c) by the Residential Institutions Redress Board,

(d) by the Residential Institutions Statutory Fund Board,

(e) under the provisions of the Health (Repayment Scheme) Act 2006 to a relevant person within the meaning of that Act,

(f) by the Criminal Injuries Compensation Tribunal,

(g) in relation to disability caused by Thalidomide,

(h) in accordance with the Garda Síochána (Compensation) Acts 1941 to 2003, or

(i) by a tribunal, redress board or under a scheme of compensation where that tribunal, scheme or redress board is prescribed under subsection (3).

(3) The Minister may prescribe a compensation tribunal, redress board or scheme of compensation for the purposes of subsection (2) where—

(a) compensation payments by the tribunal, redress board or under the scheme are made from moneys provided by the Oireachtas, or

(b) the tribunal or redress board is performing functions conferred on it by or under an enactment, or

(c) the scheme is administered by the Minister or a Minister of the Government other than the Minister,

and the Minister is satisfied that such prescribing will assist in securing beneficial, effective and efficient use of funds available to that tribunal, redress board or scheme.

(4) This Part applies notwithstanding section 2 of the Civil Liability (Amendment) Act 1964 .

Specified period

343N. The specified period in respect of which specified benefits are recoverable is the period beginning on the date on which the injured person first becomes entitled to a specified benefit as a result of the personal injury and ending on the earliest of the following—

(a) the expiration of the period of 5 years from that date,

(b) the date on which a compensator makes a compensation payment in final discharge of any claim made by or in respect of the injured person as a result of the personal injury, or

(c) the date on which an agreement is made under which agreement an earlier payment is treated as having been made in final discharge of any such claim.

Specified benefits

343O. The specified benefits are:

(a) illness benefit under Chapter 8 of Part 2;

(b) partial capacity benefit under Chapter 8A of Part 2;

(c) injury benefit under section 74;

(d) an increase of disablement pension in accordance with section 77 or 77A, where the person is incapable of work and likely to remain permanently so incapable;

(e) invalidity pension under Chapter 17 of Part 2;

(f) disability allowance under Chapter 10 of Part 3.

Application for statement of recoverable benefits

343P. (1) Subject to subsection (2), a compensator shall apply to the Minister for a statement of recoverable benefits before making any compensation payment to, or in respect of, an injured person.

(2) The Board shall apply to the Minister for a statement of recoverable benefits before issuing an order to pay under section 38 of the Act of 2003.

(3) The Minister shall, within 4 weeks from the date of receipt of an application under subsection (1) or (2), issue a statement of recoverable benefits to the compensator or the Board, as the case may be.

(4) The Minister shall, at the same time as issuing a statement of recoverable benefits to a compensator or the Board under subsection (3), issue a copy of the statement to the injured person.

(5) The Minister may by regulations prescribe—

(a) the information required by him or her relating to the identity of the injured person and benefits received by that person for the purposes of an application for a statement of recoverable benefits, and

(b) the form in which the application shall be made.

Statement of recoverable benefits

343Q. (1) A statement of recoverable benefits shall, in respect of the injured person concerned, specify the amount of recoverable benefits.

(2) A statement of recoverable benefits shall be valid for 3 months from the date that it is issued.

(3) A person to whom a statement of recoverable benefits is issued may request the Minister to furnish particulars of the manner in which the amount of recoverable benefits specified in the statement of recoverable benefits was calculated.

(4) The Minister shall furnish the particulars requested under subsection (3) within 4 weeks of the receipt of such a request.

Obligation to pay recoverable benefits

343R. (1) Subject to subsection (2), a compensator shall pay to the Minister the amount of recoverable benefits specified in the statement of recoverable benefits before making any compensation payment to, or in respect of, an injured person.

(2) Where the recoverable benefits specified in the statement of recoverable benefits exceed the amount of the relevant compensation payment and that relevant compensation payment was the subject of an order of a court or assessment by the Board in accordance with the Act of 2003, the compensator is liable only to the extent of that amount so ordered or assessed.

(3) A compensator who fails to comply with subsection (1) or otherwise fails to pay the amount of recoverable benefits due to the Minister is liable to pay on demand to the Minister that amount of recoverable benefits so due.

Reduction of compensation payment to injured person

343S. (1) A compensator who pays an amount equal to the total amount of the recoverable benefits to the Minister in accordance with section 343R may reduce the relevant compensation payment payable to the injured person by that amount and shall notify the injured person accordingly.

(2) The compensation payment, other than the relevant compensation payment, payable by a compensator to an injured person shall not be reduced by the compensator where the total amount of the recoverable benefits exceeds the amount of the relevant compensation payment payable to an injured person.

Discharge of liability to injured person

343T. Where this Part applies to a claim for a compensation payment by or on behalf of an injured person, that claim, in so far as it relates to a relevant compensation payment, shall be treated as discharged to the extent that the compensator has made a payment to the Minister in respect of that claim in accordance with section 343R.

Refund to compensator where specified benefit not paid

343U. (1) Where a compensator has made a payment to the Minister in accordance with section 343R and any part of that payment includes specified benefits referred to in subsection (2), the Minister shall refund to the compensator the amount of that payment which represents those benefits.

(2) The specified benefits referred to in subsection (1) are those benefits, within the meaning of paragraph (b) of the definition of recoverable benefits, not paid by the Minister to the injured person at the end of the specified period.

Appeal under section 311

343V. (1) This section applies where an appeal is brought under section 311 (amended by section 13 (c) of the Social Welfare and Pensions Act 2013) against a decision given by a deciding officer on a question under paragraph (hh) (inserted by section 13 (b) of the Social Welfare and Pensions Act 2013) of section 300(2).

(2) Where on the determination of an appeal referred to in subsection (1) an appeals officer decides that the amount of recoverable benefits specified in the statement of recoverable benefits exceeds the amount of recoverable benefits due to the Minister, the Minister shall refund the amount of that excess to the compensator.

(3) Where on the determination of an appeal referred to in subsection (1) an appeals officer decides that the amount of recoverable benefits specified in the statement of recoverable benefits is less than the amount of recoverable benefits due to the Minister, the compensator is liable to pay the Minister the difference between the amount paid to the Minister in accordance with section 343R and the amount of recoverable benefits due to the Minister as decided by the appeals officer.

More than one compensator making compensation payment

343W. Where two or more compensators are liable by virtue of this Part for recoverable benefits for the same personal injury, they shall be liable jointly and severally to the Minister in relation to those benefits and Part III of the Civil Liability Act 1961 shall be read as applying to that liability with all necessary modifications.”,

and

(e) by repealing subsections (1) and (2) of section 96, and section 286.