Peru Covid Vaccine NFCS

Introduction

Peru created a no-fault compensation for COVID-19 vaccines in 2021 through the passing of the Decreto de Urgencia No. 031-2021 on 10 March 2021. The scheme is further regulated by the Decreto Supremo No. 012-2021-SA of 21 April 2021.

The scheme is administered by the Ministry of Health (Ministerio de Salud, or ‘MINSA’). The Decreto de Urgencia No. 031-2021 provides that a specialised Committee, the Comité Asesor Nacional de los Efectos Supuestamente Atribuidos a la Vacunación o Inmunización del Ministerio de Salud (‘Comité Asesor de ESAVI’, where ESAVI stands for ‘Effect Supposedly Attributed to Vaccination or Immunization’) is tasked with the production of the final report determining the existence of a causal link between any of the COVID-19 vaccines acquired by the Ministry of Health and alleged serious adverse events (Decreto de Urgencia No. 031-2021, Article 3.2).

The funding for the scheme comes from central government.

It should be noted that the Decreto de Urgencia No. 031-2021 was valid until 31 July 2022.

 

Vaccines Covered

This NFCS covers vaccines against COVID-19 acquired by the Ministry of Health and administered within the Peruvian territory.

It is not specified whether this scheme includes both vaccines approved for emergency use and standard approvals.

 

Injuries Covered

This NFCS only covers permanent injuries.

Under this NFCS only eligible injuries are covered. Eligible injuries are alleged severe adverse reactions resulting from a covered COVID-19 vaccination causing a total permanent disability, a permanent partial severe disability, or death. (see Decreto Supremo No. 012-2021-SA, Article 3.

 

Charges for making a claim

There is no charge for making a claim under this scheme (see Decreto de Urgencia No. 031-2021, Article 6)

 

Claimants

This scheme provides for an ex officio procedure, which is started by public and private health service providers who have to immediately notify the Direcciones de Redes Integradas de Salud (local agencies of the Ministry of Health), Direcciones Regionales de Salud (regional health directorates), and the Gerencias Regionales de Salud (regional health management bodies) of the occurrence of a case of possible severe adverse reaction to a COVID-19 vaccination acquired by the Ministry of Health.

Under this scheme the following categories of individuals are entitled to compensation:

•  A vaccinated person who has suffered a possible serious adverse reaction following vaccination;
• The legal heirs of a vaccinated person.

 

Losses covered

This scheme pays the following:

 

Live vaccine recipient	Dependants of vaccine recipient	Legal heirs 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.	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 are not specifically provided under this NFCS.

Compensation under this scheme calculated on an individual basis using tariffs/guidelines to assist with quantification and is based on 100% of the Remuneración Vidal Minima (‘RVM’), that is the legal minimum wage, at the time of the NFCS decision, in the amount specified by the Decreto Supremo No. 012-2021-SA, Article 9:

•  35 times the RMV in the event of death;
• Up to 25 times the RMV in case of severe permanent total disablement;
• Up to 15 times the RMV in cases of severe permanent partial disablement.

Loss of earnings are not paid under this scheme.

Compensation under this scheme does not have an explicit cap, but the maximum quantum that can be awarded seems to be 35 times the RMV in the event of death of the vaccinated person.

There is no specified minimum claim value under this NFCS.

A person who has been found to have suffered an eligible injury also has the right to continuity of the coverage by the relevant public IAFA Health Insurance Fund Administrator Institution, or by the private IAFA according to the current regulatory framework. People who do not have health insurance are immediately enrolled in the Comprehensive Health Insurance (SIS) – see Decreto de Urgencia No. 031-2021, Article 3.4(a).

 

Time limits for claims

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

There are no specific time limits for people eligible for compensation to file claims, as this NFCS sets out an ex officio compensation procedure. However, Article 4 of the Decreto Supremo No. 012-2021-SA provides that public and private health service providers have to immediately notify the appropriate administrative health bodies (see ‘Claimants’ section above) of the occurrence of a possible case of serious adverse reaction following a covered COVID-19 vaccination for NFCS proceedings to be commenced.

 

Evaluating claims – standard of proof required

The decision on causality between serious adverse events and covered COVID-19 vaccinations is made by the Comité Asesor de ESAVI based on the published scientific evidence (Decreto de Urgencia 031-2021, Article 3.2).

The decision on compensation quantum for eligible disabling injury found to be causally linked to vaccination is made through subsequent evaluations in the NFCS procedure involving other administrative bodies, with the Comité Nacional de Ponderaciones being the entity responsible for determining the amount to be paid to the vaccinated person – for further detail on these stages of the compensation procedure see Decreto Supremo No. 012-2021-SA, Articles 6, 7 and 8.

 

Appeals and the right to litigate

There is a restricted right to litigate - a final report ('informe final') from the relevant NFCS authority (the Comité Asesor de ESAVI) is required before starting court proceedings. A second-instance administrative decision on the compensation quantum is required before starting litigation to challenge the amount of compensation awarded. See Decreto de Urgencia 031-2021, Articles 3.3 and 3.5.

There is an optional internal NFCS review process to challenge the compensation amount decision made by the Comité Nacional de Ponderaciones. There is also an external review process where NFCS decisions can be challenged through administrative court litigation.

 

Useful information and links

It is not known whether this scheme produces an annual report including data on claims & financial performance (claim numbers, payments, claim processing timeframes, administrative costs, etc).

 

Links to legislation:

Decreto de Urgencia No. 031-2021 on 10 March 2021: https://cdn.www.gob.pe/uploads/document/file/1956167/Decreto%20Supremo%20N%C2%B0%20031-2021%20y%20Exposicio%CC%81n%20de%20motivos.pdf.pdf

Decreto Supremo No. 012-2021-SA of 21 April 2021: https://cdn.www.gob.pe/uploads/document/file/1850579/Decreto%20Supremo%20N%C2%B0%20012-2021-SA.pdf