June 2017
Since claims sought by the National Health Insurance provider by way of subrogation should include circumstances where the automobile liability insured (victimizer) is at no fault, there is no issue of calculating the amount which may be claimed by way of subrogation based on the accident liability percentage of the victimizer after insurance benefits are paid(Taiwan)
2017.3.27
Sophia Tsai
The Ministry of Justice issued the Fa-Lu-10603500320 Circular of March 27 to respond by pointing out that Article 95, Paragraph 1, Subparagraph 1 of the National Health Insurance Act provides: "
In case of an insured accident in which the insured may claim damages from a third party, the insurer of this Insurance may exercise the right of claim by way of subrogation pursuant to the following provisions after paying the insurance benefits: (1) in case of a car traffic accident: the claim may be asserted against the insurer of the compulsory automobile liability insurer..."For purposes of the special provisions concerning recovery by the National Health Insurance provider by way of subrogation, the so-called "right to claim damages from a third party" should be deemed to cover the circumstances where the compulsory automobile liability insured (victimizer) is not at fault. Therefore, after the National Health Insurance provider provides insurance benefits, there is no issue of calculating the amount which may be claimed by way of subrogation based on the accident liability percentage of the victimizer.
This Circular further explains that although the Compulsory Automobile Liability Insurance Act adopts a legislative model of "liability insurance," still when a victim is injured or deceased as a result of a car accident, the claimant is always entitled to claiming insurance from the insurer pursuant to such law, regardless of whether the victimizer is at fault. In addition, except when the victim or any other claimant is subject to any circumstance set forth in Article 28, Paragraph 1 of such law, the insurer does not consider if the victim is at fault upon payment of the insurance benefits. Even in case of a car accident, if the accident is attributable to the spouse or any parent, relative, blood relative within the fourth degree of consanguinity or in-law within the third degree of consanguinity, the insurer has no right to claim damages by way of subrogation except when such occurrence was caused deliberately. To wit, the insurance payment liability assumed by an automobile liability insurer under such law is greater than the damages liability which shall be assumed by the insured (i.e., the victimizer) under the Civil Code and is different from the design of ordinary liability insurance. In addition, Article 32 of such law also specifically provides that insurance payout by an insurer pursuant to such law shall be deemed part of the damages assumed by the insured.
Sophia Tsai
The Ministry of Justice issued the Fa-Lu-10603500320 Circular of March 27 to respond by pointing out that Article 95, Paragraph 1, Subparagraph 1 of the National Health Insurance Act provides: "
In case of an insured accident in which the insured may claim damages from a third party, the insurer of this Insurance may exercise the right of claim by way of subrogation pursuant to the following provisions after paying the insurance benefits: (1) in case of a car traffic accident: the claim may be asserted against the insurer of the compulsory automobile liability insurer..."For purposes of the special provisions concerning recovery by the National Health Insurance provider by way of subrogation, the so-called "right to claim damages from a third party" should be deemed to cover the circumstances where the compulsory automobile liability insured (victimizer) is not at fault. Therefore, after the National Health Insurance provider provides insurance benefits, there is no issue of calculating the amount which may be claimed by way of subrogation based on the accident liability percentage of the victimizer.
This Circular further explains that although the Compulsory Automobile Liability Insurance Act adopts a legislative model of "liability insurance," still when a victim is injured or deceased as a result of a car accident, the claimant is always entitled to claiming insurance from the insurer pursuant to such law, regardless of whether the victimizer is at fault. In addition, except when the victim or any other claimant is subject to any circumstance set forth in Article 28, Paragraph 1 of such law, the insurer does not consider if the victim is at fault upon payment of the insurance benefits. Even in case of a car accident, if the accident is attributable to the spouse or any parent, relative, blood relative within the fourth degree of consanguinity or in-law within the third degree of consanguinity, the insurer has no right to claim damages by way of subrogation except when such occurrence was caused deliberately. To wit, the insurance payment liability assumed by an automobile liability insurer under such law is greater than the damages liability which shall be assumed by the insured (i.e., the victimizer) under the Civil Code and is different from the design of ordinary liability insurance. In addition, Article 32 of such law also specifically provides that insurance payout by an insurer pursuant to such law shall be deemed part of the damages assumed by the insured.
