Estonia Covid Vaccine NFCS

Introduction 

Estonia created a no fault compensation for covid-19 vaccines on 1 May 2022, effective immediately and covering Covid Vaccines administered from 27 December 2020. 

This scheme was created under national legislation. It is governed by the Medicines Act RT I, 20 June 2022, 75 as amended by the Health Care Provider’s Compulsory Liability Insurance Act RT I, 29 April 2022, 1.  

It is administered by  Estonia Health Insurance Fund (Eesti HaigeKassa), who are an independent public body who organise national health insurance to provide insured people with access to healthcare services. 

The funding for the Covid vaccine compensation awarded under the scheme comes from central government funds. Fundings for compensation from adverse events caused by other vaccines come from a levy of €0.15 per dose. 

 

Vaccines Covered 

This NFCS covers EU approved vaccines, which are used in Estonia. As at March 2023 the covered Covid-19 vaccines are:   

• Pfizer Comirnaty, Pfizer Comirnaty (children);  

• Moderna Spikevax; Moderna Spikevax (children);  

• AstraZeneca Vaxzevria;  

• Janssen;  

• Novavax NUVAXOVID;  

• VLA2001 Valneva 

It includes vaccines approved for emergency use and standard approvals.  

The vaccine must have been given in Estonia.  

 

Injuries Covered 

This NFCS covers both temporary and permanent injuries.  

Under this NFCS only eligible injuries are covered. Eligible injuries are those where:-  

• the person has suffered severe injury which has lasted at least four months, or the person dies; 

• the person’s treatment is documented in the health information system; 

• the State Agency of Medicines has established an association between the vaccination and the subsequent injury caused to the person. 

The scheme specifies that there must be a ‘severe’ injury, but this is not defined and there is no specified disablement threshold in this scheme. 

 

Charges for making a claim 

There is nothing in the statute about whether there is a charge for making a claim under this scheme.  

 

Claimants 

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

• Injured individual 

• Authorised legal representative or guardian of a vaccine recipient who is a child or an adult ward 

• An heir to a deceased vaccine recipient  

All individuals who have been vaccinated in Estonia are able to apply; there is no requirement for the person claiming to hold health insurance in Estonia.  

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

 

Losses covered  

This scheme pays the following:

 

Live vaccine recipient	Dependants of vaccine recipient	Heir of a deceased vaccine recipient
Compensation payments are for general categories and are not broken down into economic and non-economic losses.	No compensation is specifically provided for dependants of the vaccine recipient	Compensation payments are for general categories and are not broken down into economic and non-economic losses.

 

Payments consist of a lump sum payment.  

Funeral expenses do not seem to be specifically provided under this NFCS.  

Compensation under this scheme calculated on an individual basis using tariffs to assist with quantification. The sum insured and the benefits increase annually based on the consumer price index. The rates for 2022 and 2023 are set out below.  

 

Injury Severity	Vaccinated 31/12/2022 or before	Vaccinated 01/01/2023 – 31/12/ 2023
Serious injury of moderate severity	€2 000	€2 390
Serious injury of medium severity	€10 000	€11 940
Serious injury	€25 000	€29 850
Very serious injury	€50 000	€59 700
Extremely serious injury or death	€100 000	€119 400

 

 

Loss of earnings are not paid under this scheme.  

Compensation under this scheme is capped, for 2023 the top value available under the scheme is  €119 400 for extremely serious injury or death.  

There is a minimum claim value under this NFCS, in 2023 this is €2 390 for a serious injury of moderate severity.  

  

Time limits for claims 

The scheme does not set a time limit between vaccination and the adverse event occurring. 

Ordinarily a claim under the scheme must be brought within a year from the occurrence of the insured event. There is an exception for compensation of Covid-19 vaccine injuries. Applications for Covid-19 vaccine injury claims may be submitted retroactively from the beginning of administration thereof (27 December 2020) until 1 May 2023.   

 

Evaluating claims – standard of proof required 

The standard of proof required by the scheme is that on the balance of probabilities the vaccination caused the adverse event/ there is a preponderant probability that the vaccination caused the adverse event/other – specify  

 

Appeals and the right to litigate 

The application is submitted to the Estonian Health Insurance Fund who verify whether the application is potentially eligible for compensation. Claims can be submitted by email, in person, or on paper. Claims which are potentially eligible for compensation are passed to the State Agency of Medicines, who assess whether there is a probable causal link between the vaccine and the reported injury or the death. The State Agency of Medicines report back to the Estonian Health Insurance Fund, who issue a decision to the applicant.  

There is a restricted right to litigate - Compensation awarded through NFCS does not limit the right of the entitled person to submit a civil claim against the manufacturer or distributor of the vaccine to the extent that the Health Insurance Fund has not compensated the damage. Furthermore, the extent of compensation for damages to the entitled person by the Health Insurance Fund is reduced to the extent that the damage has been compensated by the manufacturer of the vaccine. 

 There is an internal appeals process where the NFCS itself reviews the decision.  An application for an internal review must be submitted within 30 days of the delivery of the NFCS decision. There is also an external review process, an appeal can be filed with the administrative court under the Code of Administrative Court Procedure.   

 

Useful information and links  

The scheme does not appear to data on claims & financial performance (claim numbers, payments, claim processing timeframes, administrative costs, etc)  

 

 Link of the scheme website.  

Administrator 

Estonia Health Insurance Fund (Eesti HaigeKassa) 

Scheme information  

Legislation 

The Medicines Act RT I, 20 June 2022, 75  

The Health Care Provider’s Compulsory Liability Insurance Act RT I, 29 April 2022, 1