1. Recovery of certain Benefits & Assistance (RBA) Scheme
Christy Grogan/Kevin Warren

2. Agenda Introductions & Overview RBA - The Legislation RBA – The Scheme
RBA – Current challenges
Q & A

3. 1. Overview: Policy Objectives
The policy objectives are:
to ensure that welfare benefits paid by the DSP are recovered from compensators in personal injuries cases
to avoid double compensation
to ensure that general damages are protected and not reduced by the offsetting arrangements

4. 1. Overview: Principles
There is a fundamental principle that a person should not be compensated twice over in respect of the same accident, injury or disease.
In line with recommendations of the Law Reform Commission and in line with the practice in the UK (and other jurisdictions), it is intended that the principle be upheld but that the State should no longer be liable for the costs involved.

5. 2. Legislation
Prior to enactment, damages in personal injuries cases were reduced in accordance with
S. 96 and S. 286 of the Principal Act
S.96 provided for reductions in damages against the loss of earnings element of an award in respect of Injury Benefit and Disablement Benefit only.
S.286 provided for reductions in damages in the case of non fatal road traffic accidents in respect of Disability Benefit(Now renamed Illness Benefit) and Invalidity Pension.
There was no provision in the legislation for recovery of benefits to the Minister and the benefit of any reduction fell to the compensator

6. 2. Social Welfare and Pensions Act 2013 Social welfare (Miscellaneous Provisions) Act 2015
The SWPA 2013 S.13 and SW(MP) Act 2015
Amend S.300 of the Principal Act to provide that a deciding officer is empowered to make a decision on whether a benefit or any part of a benefit specified in a statement or revised statement of recoverable benefits is a recoverable benefit within the meaning of Part 11B.
and
Amend S.311 to provide that no Appeal can be made against a decision given by a deciding officer on whether a benefit is a recoverable benefit unless the recoverable benefit specified in the relevant statement is paid to the Minister
Repeals appropriate sections of S.96 and S. 286

7. 2. RBA - The Legislation
S. 343L provides the definitions used for Part 11B.
S. 343M provides for the recovery of benefits where,
A compensation payment is made by a compensator to an injured person in respect of a non fatal personal injury.
The injured person has received, is receiving or may receive a specified benefit within a specified period.
The compensation payment is made on or after the 1st August unless the payment is pursuant to a court order or injuries board assessment or a settlement finalised before that date
The compensation payment is not one of those listed in 343M(2) e.g. Hep C HIV compensation
S. 343M(4) provides that the part applies notwithstanding S.(2) of the Civil Liability (Amendment) Act 1964

8. 2. RBA - The Legislation S. 343N provides that the specified period is
5 years from the date the injured person first becomes entitled to a specified benefit to the date of settlement, whichever date is earliest.
S. 343O identifies the specified benefits as
Illness Benefit, Partial Capacity Benefit, Injury Benefit, Disablement Pension (increases in respect of Unemployability Supplement and constant care allowance) , Invalidity Pension and Disability Allowance
S. 343P. Provides that
The compensator must apply for a statement before making a payment to the injured person
The injuries board must apply for a statement before issuing an order to pay
The Minister must issue a statement within 4 weeks of date of receipt of request
A copy of the statement must issue to the injured person
The Minister can make regulations specifying the information required to establish the identity of the injured person and the form of the application

9. 2. RBA - The Legislation S. 343PA provides that
A statement or revised statement can be issued to a compensator without application
A revised statement may issue where a decision is made by a deciding officer or an appeals officer to award or vary a specified benefit to an injured person
A copy of the statement or revised statement must issue to the injured person
Regulations may be introduced prescribing the information to be provided by a compensator or injured person to establish the identity of the injured person and the benefits received by that person for the purposes of issuing a statement or revised statement.

10. RBA - The Legislation . 343Q provides that
The statement will be valid for 12 months from the date of issue ( or until a decision or revised decision issues ) in the case of nil statements and statements where recoverable benefits are identified and have ceased at the time of statement issue
In any other case the statement will be valid for 3 months from issue date or or until a decision or revised decision issues.
The person may request particulars in relation to calculated amount (should not be required as full information provided on statement)
S. 343R provides that
The compensator must pay the Minister the amount of the recoverable benefit specified in the relevant statement immediately before making a payment to the injured person.
Where the compensation award is the subject of an assessment of the injuries board or a court order and the recoverable amount exceeds the relevant compensation payment the compensators liability to repay the recoverable benefit is capped at the amount of the relevant compensation payment i.e. the loss of earnings award .

11. 2. RBA - The Legislation S. 343S provides that
Where a compensator has paid the recoverable benefit in accordance with 343R that they may offset this against the relevant compensation payment only and must inform the injured person .
Where the total amount of recoverable benefits exceeds the relevant compensation payment the compensation payment other than the relevant compensation payment payable to the injured person cannot be reduced or offset. General damages are therefore protected.
343T provides that
Where a compensator makes a payment to an injured person in respect of a claim, the claim insofar as it relates to a relevant compensation payment is treated as discharged to the extent that a payment is made to the Minister in accordance with 343R

12. 2. RBA - The Legislation S.343U provides that
Where the compensator has made a payment to the Minister in accordance with S.343R the Minister can refund any amounts relating to specified benefits included in the statement but not paid to the injured person at the end of the specified period (possible but not probable)
S.343V provides that
Following an appeal amounts may be refunded to the compensator where the appeals officer makes a decision that the recoverable benefit paid to the Minister exceeds the recoverable benefit due.
S.343 W provides that
Where there is more than one compensator they are liable jointly and severally. S.343X provides for transitional arrangements

13. 3. RBA Scheme: Scheme introduced in Budget 2014
Project team set up – December 2013
Launched 1st August 2014
Engagement with interested parties (post budget):
Injuries Board
State Claims Agency
Motor Insurance Bureau
Insurance Ireland
The Law Society
ODPC etc.

14. 3. Scheme: continued
Set up new section – staff ( approx 30), accommodation, BOMi (in house computer system) etc.
Operational guidelines drawn up – on website
Press advertisement to launch the scheme
Application form (RBA01) and recovery form (RBA20) for compensators on website -

15. 3. The Scheme – continued High-Level Compensator Workflow
A valid RBA Statement is required when a compensator is finalising a compensation case.
Statements will be provided within 4 weeks of receipt of properly completed request.
In general Statement valid for 3 months from the date of the statement

16. 3. RBA - Scheme Processes
Communications – post, fax
Statement Requests
Additional Details
Renewal Requests
Triage – mandatory fields, type of decision etc.
Decision/statement issue x 2 (1 x compensator and 1 x injured party/injured party representative)
Reviews
Appeals
Quality Control
Reporting – MIS
Payment Reconciliation

17. 3. What Compensators/agents can expect from DSP-RBA Team…
Prompt handling of all RBA Statement Requests
Correctly calculated RBA Statements
Courtesy at all times
Partnership approach to all activity undertaken
On-going refinement of RBA processes to improve interface between DSP & Compensators
Open communication with the Insurance Industry/ Stakeholders at all times

18. 3. What DSP expects from Compensators AND AGENTS …
Provision of accurate information on RBA Statement requests and additional information as required
Courtesy at all times
Partnership approach to all activity undertaken
Timely requests for RBA Statements
Timely payment of agreed RBA monies
Accurate dissemination of RBA Scheme information with insurance industry stakeholders

19. 3. RBA Scheme – Volumes (since scheme commenced to end may 2017)
Statement Requests
179,500
Decisions issued
86,800
Nil amount recoverable (75%)
65,100
Recoverable amount (25%)
21,700
Amount received since scheme commenced
€60.3m

20. 4. RBA - CURRENT challenges
28 days to issue a decision
Settlement issues – statement value V PIAB/Court settlements

21. Q&A
Questions ?