Norway Covid Vaccine NFCS
Introduction
Norway had an existing no-fault compensation scheme for vaccines, which was incorporated into the Norwegian medicines compensation arrangements in 2004 by Act 430 of 10 June 2003. Covid-19 vaccines were incorporated from 21 December 2020.
This scheme was created under national legislation under the Act Relating to Compensation for Patient Injuries, etc (Patient Injury Act) Act 53 of 15 June 2001.
It is administered by norsk pasientskade-erstatning NPE (the patient insurer in Norway), who are a government agency under the Norwegian Ministry of Health and Care Services.
The funding for the scheme comes from Levies.
Vaccines Covered
Approved vaccines administered in Norway are covered by this NFCS. This covers EU approved vaccines, both vaccines approved for emergency use and standard approvals.
Injuries Covered
This NFCS covers both temporary and permanent injuries.
Under this NFCS any injury is potentially covered.
Charges for making a claim
There is no charge for making a claim under this scheme.
There is no upfront charge for making a claim under this scheme. There is provision for a deductible added to the Patient Injury Act by Act No. 78 of 29 June 2007, but no deductible appears to have been set.
Claimants
Under this scheme the following categories of individuals are permitted to make a claim.
- Vaccine recipient/their representative
- Estate of vaccine recipient
- Survivor of a deceased vaccine recipient
Under this scheme the claimant is allowed to nominate a legal representative to make their claim. In some circumstances funding for legal representation is provided by the scheme, but this is not automatic. There is provision for payment of legal fees for those who lack capacity, don't speak Norwegian, etc, but payment of legal representation fees is not standard. A patient ombudsman and/or a Health Care Professional can also help fill in forms.
Losses covered
This scheme pays the following
| Live Vaccine Recipient | Dependants of Vaccine Recipient | Estate of Deceased Vaccine Recipient |
| Both eligible economic and non-economic losses are compensated | Only eligible economic losses are compensated | Only eligible economic losses are compensated |
All payments in this scheme are secondary to other sources of compensation such as a social security payments and benefits. The following payments categories are available.
Live Vaccine recipients
This NFCS generally only compensates economic losses. The exception to this is the payment of permanent injury compensation.
- Permanent injury compensation. This is available in cases of permanent (10+ years) and significant (over 15% disablement) injury. Permanent injury compensation is awarded for the loss of quality of life, irrespective of whether the affected individual has suffered a financial loss. The quantification of permanent injury compensation is based on the rate of medical disability, the patient's age at the time of the injury and the National Insurance Base Rate.
- Loss of earnings. This covers both past lost earnings and future loss of earnings. Quantification is individual comparing pre-injury income levels with post-injury earnings; the resulting difference is the loss to be covered. This is a net loss calculation so benefits as a result of the injury will be deduced from the compensation. Travel expenses, trade union dues and pension contributions and other cost involved with employment will also be taken into consideration. Compensation for net future losses will normally be restricted to pension age. It may also be appropriate to award compensation for loss in pension amount.
- Household work. If the claimant has been rendered incapable of carrying out normal household chores compensation will be provided to cover the cost of having this work done. The amount of compensation payable will depend on the extent of the injury, the residential situation, the family situation etc. There is an expectation on claimants to adjust to the new situation and, for example, redistribute household chores.
- Expenses. Reasonable and necessary expenses incurred as a consequence of the injury will be covered. This can include expenses incurred in connection with medical treatment, medication, physiotherapy and transport which will not be provided by other sources. In some cases, the cost home modifications and of everyday care may also be eligible. This includes both incurred expenses and predicted future expenses.
Deceased Vaccine Recipients.
- Funeral expenses. Normal funeral expenses and other reasonable expenses in connection with the death will be covered.
- Loss of maintenance. Lost maintenance, covering the loss of the deceased's financial contribution to the family and domestic input in the form of work and care during a transitional period. Any benefit receivable such as funeral benefit, widow's/widower's pension and children's pension will be deducted from the compensation. Any widow or widower has a duty to make adjustments in order to gradually become able to pay for their own sustenance. This means that the compensation award is payable for a restricted period of time.
Payments consist of a lump sum payment.
Funeral expenses are available under this NFCS.
Compensation under this scheme calculated on an individual basis.
Loss of earnings are paid under this scheme. They are quantified on an individual basis.
Compensation under this scheme is not capped.
There is no minimum claim value under this NFCS. Ordinarily there is a 10,000NOK minimum claim value, but this requirement has been removed for covid vaccine injury claims.
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 three years of becoming aware of the injury.
Evaluating claims – standard of proof required
NPE are responsible for both patient injury claims and pharmaceutical claims. Interestingly claims for covid vaccine injury use the patient injury claim form rather than the drug injury form. Claims are handled by a claims manager, who gathers the required medical evidence, seeks advice from an independent expert if required and then determines the claim. Successful claims are then quantified. The standard of proof required by the scheme is specified in Section 3 of the Patient Injury Act
‘In the case of compensation resulting from injury under recommended or mandatory vaccinations pursuant to Act No. 5 of 1994 August 55 relating to protection against communicable diseases, the right to compensation under section 2 first paragraph (d) shall apply unless the person responsible proves that one or more other causes are more likely.’
This is a reversal of the burden of proof.
Should new evidence come to light a claim can always be reopened.
Appeals and the right to litigate
There is a restricted right to litigate. Section 4 of the Patient Injury Act states
‘The Act does not prevent claims for compensation from being asserted against parties other than the Norwegian System of Patient Injury Compensation. However, claims that may be brought pursuant to this Act may not be brought against the state, regional health authorities, health trusts, county authorities and municipalities. Recourse can only be claimed against the person who has caused the damage intentionally or who has failed to pay a subsidy under section 8.’
In effect there is a requirement to use the NFCS rather than going to court.
If a claimant is unhappy with the outcome of the NFCS decision they can an appeal against the decision. This is both an internal appeals process and an external appeals process. The appeal must be sent to NPE for consideration within three weeks of the decision date. If NPE do not find grounds for reversing the decision the appeal will be sent on to the Patient Injury Compensation Board (PSN). The PSN are a separate public body. If the refusal to pay compensation is upheld by the PSN the case can then be litigated in the courts.
Useful information and links
The scheme produces an annual report including data on claims & financial performance (claim numbers, payments, claim processing timeframes, administrative costs, etc)
Scheme website.
Legislation
Act Relating to Compensation for Patient Injuries, etc (Patient Injury Act) Act 53 of 15 June 2001.
Act relating to damages (Indemnity Act) Act 26 of 13 June 1969