Canada - Quebec Covid Vaccine NFCS

Introduction

Quebec was the only part of Canada which had an existing no-fault vaccine compensation scheme at the start of the covid pandemic. This scheme started in November 1987 and covid vaccines were covered from 22 April 2021. (Details on the Canadian Scheme for covid vaccines for all of Canada except Quebec which was announced on 8 December 2020 can be found here.)

The Quebec scheme is a statutory scheme under Chapter VII, Division III, Sections 70-78 of the Public Health Act 2001 and the regulation under the Public Health Act in effect since August 2003, division II sections 4-28.

It is administered by the Institut National de Sante Publique du Quebec (INSPQ), who are a public body. The funding for the scheme comes from the Quebec State government.

Vaccines Covered

This NFCS covers covid vaccine administered in Quebec under the Quebec Immunization Program. To date these have been nationally approved (Health Canada approved) vaccines approved for emergency use and standard approvals.

Injuries Covered

This NFCS covers serious permanent physical or mental injury, or death. Under this NFCS any type injury is potentially covered.  

Charges for making a claim

There is no charge for making a claim under this scheme.

Eligible Claimants

Under this scheme the following categories of individuals are permitted to make a claim.

  • Live vaccine recipient/their authorised representative
  • Beneficiaries of a vaccine recipient/their authorised representative
  • The estate/representative of a deceased vaccine recipient

Under this scheme the claimant is allowed to nominate a legal representative to make their claim. Funding for legal representation is not provided by the scheme.

Losses covered

This scheme pays the following

Live vaccine recipient Dependants of vaccine recipient Estate of deceased vaccine recipient 
Both eligible economic and eligible non-economic losses are compensated Both eligible economic and eligible non-economic losses are compensated Both eligible economic and eligible non-economic losses are compensated

The following categories benefits and reimbursements are available.

  • Income replacement
  • Bodily injury
  • Personal assistance benefits
  • Death benefits, including funeral expenses
  • Reimbursement of eligible economic losses such as medical expenses,
  • Rehabilitation costs

Benefits and reimbursements are quantified according to the Automobile Insurance Act. Payments consist of a mixture of periodic payments and a lump sum payment. Periodic payments are indexed to take into account cost of living increases.

Funeral expenses are available under this NFCS.

Compensation for non-economic losses under this scheme are calculated on an individual basis using tariffs/guidelines set out in the Automobile Insurance Act to assist with quantification. There is a top cap of $175,000 Canadian dollars.

Compensation for economic losses are individualised and claimants are expected to provide receipts/documents required for reimbursement.

Loss of earnings/income replacement are paid under this scheme. They are quantified on an individual basis but with a top cap which is updated annually.

There is no de minimis threshold for claims to this NFCS.

Time limits for claims

The scheme does not set a time limit between vaccination and the adverse event occurring. A claim under the scheme must be brought within 3 years of the vaccination, or death for claims for death benefits. If an injury starts gradually the 3 years starts from the date the injury first became apparent or the date when a likely causal relationship with the vaccine is established.

The claimant’s medical situation must be stable before an assessment can take place to determine if the injury is permanent. It may take some time for the medical situation to stabilise.

Evaluating claims – standard of proof required

INSPQ collect all the relevant medical records (with the claimant’s permissions). Claims are reviewed by a three-person expert panel. The panel are all medical professionals. One of the panel is appointed by the claimant, a second by the minister and the third (who chairs the panel and writes the report) is appointed by the other two panel members. The standard of proof required by the scheme is that on the balance of probabilities there is a likely causal relationship between the injury and the vaccine. This requires a majority decision by the three person panel.

If causality is established the panel undertake an assessment of the degree of injury according to the Schedule of Injuries of the Societe de l’assurance automobile du Quebec (SAAQ). The Minister considers the recommendations in the report from the panel and a written decision to compensate or not is made. SAAQ quantifies the compensation as per the Automobile Insurance Act and makes the payment.

Appeals and the right to litigate

The right to litigate is not affected by use of the scheme - A claimant has a free choice to use the scheme or to litigate. If an individual successfully litigates after they have used the scheme they have to pay back any payments the scheme has awarded them from their court-awarded damages.

There is an external process. If a claimant is dissatisfied with either the decision of the Minster or the quantification of their claim they can appeal to the Tribunal Administratif du Quebec within 60 days of the date of notification of the scheme decision. The appellant must pay their own costs.  There is also the choice to litigate.

Useful information and links

The scheme publishes data on claims & financial performance (claim numbers, payments, claim processing timeframes, administrative costs, etc)

Vaccine Injury Compensation Program | Gouvernement du Québec (quebec.ca)

 

S-2.2 - Public Health Act (gouv.qc.ca)

S-2.2, r. 1 - Regulation under the Public Health Act (gouv.qc.ca)

A-25 - Automobile Insurance Act (gouv.qc.ca)

 

 

 

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