REPUBLIC OF LATVIA CABINET OF MINISTERS

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1 Valid from: Published: Vēstnesis, , no. 32 Published: ZIŅOTĀJS, , no. 6 REPUBLIC OF LATVIA CABINET OF MINISTERS Riga Regulations No. 92 Regulations Regarding the Amount and Procedure for the Compensation of the State Budget and Local Government Budget Expenses, Providing Medical Treatment, Rehabilitation, Technical Aids and Pension and Allowance Payments Amendments: Regulations of the Cabinet of Ministers of 30 June, 2009 no. 662 (L.V., July 4, no. 104) Regulations of the Cabinet of Ministers of 3 November, no (L.V., November 10, no. 178) Regulations of the Cabinet of Ministers of 10 December 2013, No (L.V., 20 December 2013., no.250) (Protocol No. 6, 30) Issued in accordance with The Law on the compulsory third party liability insurance for inland motor vehicle owners Section 24, Paragraph three I. General Provisions 1. The Regulations shall determine the amount of and the procedure, according to which the insurer or the association "Latvian Motor Insurers Bureau (hereinafter in the text - Motor Insurers Bureau) shall indemnify for the State budget and the local government budget expenses that have been incurred in providing a suffered person s medical treatment, rehabilitation, technical aids and pension and allowance payments. 2. The Insurer or the Motor Insurers' Bureau shall pay out the insurance indemnity in the following cases and in the following amount: 2.1. if the state budget cash is spent on providing a suffered parson s medical treatment and rehabilitation up to EUR ; 2.2. if the state budget cash is spent on a suffered person s pensions and allowances, as well as on the paying out of the pensions and allowances regarding the death of a suffered person up to EUR ; 2.3. if the state budget cash is spent on a suffered person's social or professional rehabilitation - up to EUR ; 2.4. if the state budget cash is spent on the purchase of the technical aids and on their adjustment according to a suffered person s needs - up to EUR ; 2.5. if the state budget cash is spent on a suffered person s an employee of the system of the Ministry of the Interior or an employee of the Department of Imprisonment Places of the Ministry of Justice with a special official title medical treatment or rehabilitation, spending

2 the State budget cash of the Health and Sport Center of the Ministry of the Interior up to EUR ; 2.6. if the local government budget is spent on a suffered person s medical treatment, rehabilitation, on the purchase or lease of the technical aids or on a suffered person s allowances - up to EUR June 2009, No. 662 and by the Regulations of the Cabinet of Ministers of 10 December 2013, No. 1436) 3. If the amount of the insurance indemnity to be paid out exceeds the limit of liability for the losses caused to a person, the insurer or the Motor Insurers' Bureau shall indemnify for the state budget or the local government budget expenses according to the succession regarding the receipt of the insurance indemnity payment applications (hereinafter - application), not exceeding the insurer's liability limits, stipulated by the Section 15 of the Law on the compulsory third party liability insurance for inland motor vehicle owners. 4. The State budget cash which in accordance with the Sub-clause 2.1 of these regulations is spent on a suffered person s medical treatment and medical rehabilitation, shall be indemnified by the insurer or by the Motor Insurers' Bureau to the State budget according to the National Health Service s application and the documents attached to it. (with the amendments, which are made by the Regulations of the Cabinet of Ministers of 3 November 2009, No and by the Regulations of the Cabinet of Ministers of 10 December 2013, No. 1436) 5. The State budget cash, which in accordance with the Sub-clause 2.2 of these regulations is spent on the payment of the suffered persons pensions and allowances or on the pension and allowance payments regarding the death of the suffered person, as well as for the provision of these pensions and allowances payments, shall be indemnified by the insurer or the Motor Insurers' Bureau to the State budget according to the State Social Insurance Agency s application and the documents attached to it. 6. The State budget cash which in accordance with the sub-clause 2.3. of these regulations, is spent on a suffered person s social or professional rehabilitation provision, shall be indemnified by the insurer or by the Motor Insurers' Bureau to the State budget according to the Social Integration State Agency s application. June 7. If the injuries, resulting from the road traffic accident, entailed the suffered person s disability, the state budget cash, which according to the sub-clause 2.4 of these regulations, is spent on the adjustment of the motor vehicle, owned by the suffered person, or of the credit institution s or leasing company's motor vehicle, held by the suffered person (if the suffered person in the Road Traffic Safety Department s State Register of Vehicles and Vehicle Drivers is specified as the holder of the corresponding motor vehicle), according to a person s functional injuries (hereinafter in the text the adjustment of the motor vehicle), shall be indemnified by the insurer or by the Motor Insurers' Bureau to the State budget according to the Social Integration State Agency s application. June 8. The State budget cash which in accordance with the sub-clause 2.4. of these regulations, is spent on the purchase of the technical aids for a suffered person s needs, shall be indemnified by the insurer or by the Motor Insurers' Bureau to the State budget according to State Limited Liability company National rehabilitation center Vaivari (hereinafter referred to in the text as the - rehabilitation center) application and the documents attached to it. June

3 9. The Sate budget cash which according to the sub-clause 2.5. of these regulations, is spent on the suffered persons the employees of the system of the Ministry of the Interior or the employees of the Department of Imprisonment Places of the Ministry of Justice with a special official title medical treatment or medical rehabilitation, which is paid up by the Health and Sport Center of the Ministry of the Interior, using the state budget cash, granted to it, shall be paid by the insurer or by the Motor Insurers' Bureau to the State budget according to the Health and Sport Center of the Ministry of the Interior application and the documents attached to it. (with the amendments, which are made by the Regulations of the Cabinet of Ministers of 10 December 2013, No. 1436) 10. The local government budget cash which is spent according to the sub-clause 2.6. of these regulations and which is not paid from the state budget, shall be indemnified by the insurer or by the Motor Insurers' Bureau based on the city (district) council or a parish council (or its executive body) application and the documents attached to it. 11. The indemnification amount regarding the state budget and local government budget expenses shall be calculated by the insurer or by the Motor Insurers' Bureau, based on the state institutions or self-government institutions applications and their accompanying documents. 12. The applications and the accompanying documents regarding the claim of the insurance indemnity shall be considered by the insurer or by the Motor Insurers' Bureau according to the order of their submission. The decision on the indemnification of the state budget and local government budget expenses shall be made by the insurer or by the Motor Insurers' Bureau in accordance with the Section 39 of the Law on the compulsory third party liability insurance for inland motor vehicle owners. Having made the decision, and having paid the indemnity to the state budget or to the local government budget, the insurer or the Motor Insurers' Bureau shall notify the claimant of the insurance indemnity, specifying the suffered person s name, surname and personal identity number, as well as the amount of the insurance indemnity paid to the state budget or to the local government budget. 13. The right to raise a claim against the insurer or the Motor Insurers' Bureau shall terminate according to the Section 38 of the Law on the compulsory third party liability insurance for inland motor vehicle owners. 14. The Insurer or the Motor Insurers' Bureau shall pay out the insurance indemnity, observing the term/time period, stipulated by the Section 40 of the Law on the compulsory third party liability insurance for inland motor vehicle owners. 15. The Information center of the Ministry of the Interior shall provide the information to the National Health Service, to the State Social Insurance Agency, to the Health and Sport Center, to the Social Integration State Agency and to the rehabilitation center regarding the road traffic accidents in which the persons have suffered, in accordance with the normative enactments regarding the Volume, Forms and Procedure for the Input, Exchange and Use of Data required for the Operation of Information System of Compulsory Third Party Liability Insurance for Owners of Inland Motor Vehicles. (according to the wording/revision of the Regulations of the Cabinet of Ministers of 30 June 2009, No. 662 with the amendments, which are made by the Regulations of the Cabinet of Ministers of 3 November 2009, No and by the Regulations of the Cabinet of Ministers of 10 December 2013, No. 1436) At the request of the local government, the State police within a month shall free of charge issue a reference regarding the road traffic accident in which the persons have suffered (Annex 1). (according to the wording/revision of the Regulations of the Cabinet of Ministers of 30 June

4 II. The Procedure for the Claiming and Indemnification of the Expenses Regarding the Medical Treatment 16. Regaining the State budget cash, mentioned in the sub-clause 2.1. of these regulations, the National Health Service represents the other state administration institutions or medical institutions which receive money from the state budget for rendering medical services or the institutions which services are paid from the state budget. (with the amendments, which are made by the Regulations of the Cabinet of Ministers of 3 November 2009, No and by the Regulations of the Cabinet of Ministers of 10 December 2013, No. 1436) 17. The insurer or the Motor Insurers' Bureau shall indemnify to the National Health Service as to the third party (according to the Law on the compulsory third party liability insurance for inland motor vehicle owners) or to a representative of the institution all the state budget cash spent on the suffered person s medical treatment or rehabilitation. (with the amendments, which are made by the Regulations of the Cabinet of Ministers of 3 November 2009, No and by the Regulations of the Cabinet of Ministers of 10 December 2013, No. 1436) 18. (Deleted according to the Regulations of the Cabinet of Ministers of 30 June 2009, No. 662) 19. Within a month after the receipt of the documents, mentioned in the Clause 20 of these regulations, the National Health Service or the Health and Sport Center shall submit to the insurer or to the Motor Insurers' Bureau an application. The application shall include: the name, surname and the personal identity number of the suffered person; information regarding the emergency first medical aid rendered; medical treatment or rehabilitation institution in which the suffered person has been medically treated or received rehabilitation services; sum of money spent on the suffered person s medical treatment or rehabilitation; information on the road traffic accident; the National Health Service account details of the State basic budget; the Health and Sport Center income account details of the State basic budget. (with the amendments, which are made by the Regulations of the Cabinet of Ministers of 3 November 2009, No and by the Regulations of the Cabinet of Ministers of 10 December 2013, No. 1436) 20. The National Health Service and the Health and Sport Center shall attach the following documents to the application specified in the Clause 19 of these regulations: the print-out from the information system of the compulsory third party liability insurance for inland motor vehicle owners regarding the road traffic accident; the documents of the courts, prosecutor s offices and investigating bodies or the documents regarding the emergency first medical aid, rendered to a person, suffered in the road traffic accident; the information on the suffered person - basic diagnosis, manipulations and operations, as well as rehabilitation services rendered; calculation of the cash spent on the suffered person s medical treatment or medical rehabilitation. (with the amendments, which are made by the Regulations of the Cabinet of Ministers of 30 June 2009, No. 662 and with the amendments, which are made by the Regulations of the Cabinet of Ministers of 3 November 2009, No and by the Regulations of the Cabinet of Ministers of 10 December 2013, No. 1436) 21. In order the insurer or the Motor Insurers' Bureau can indemnify for the local government budget s cash, mentioned in the sub-clause 2.6. of these regulations and spent on the suffered person s medical treatment, the self-government shall, within one month

5 after the receipt of the documents, mentioned in the clause 22 of these regulations, submit to the insurer or to the Motor Insurers' Bureau the application. The application shall include: the name, surname of the suffered person, the personal identity number and declared information on the road traffic accident; information on the paid services, rendered to the suffered person and the substantiation of the service rendering; the institution, which has received the payment for the expenses, necessary to the suffered person; the copies of the documents, confirming the service rendering and payments; budget account details of the corresponding local government. 22. The self-government shall attach the following documents to the application, mentioned in the Clause 21 of these Regulations: the reference on the road traffic accident in which the persons have suffered; the documents of the courts, prosecutor s offices and investigating bodies or the the reference on the medical treatment of the person suffered in the road traffic accident. III. The Claiming for Indemnification and the Procedure for Indemnification of the Cash Spent on the Provision of the Pension and Allowance Payments 23. Concerning each event, the State Social Insurance Agency shall, once per half-year, submit to the insurer or to the Motor Insurers' Bureau the application regarding the cash spent during the reporting period on the provision of the pension and allowance payments, mentioned in the sub-clause 2.2. of these regulations. The application shall include: the name, surname of the suffered person, the personal identity number and declared amount of the granted (re-calculated) pension or allowance (before the imposition of the income tax) and the date from which the pension or allowances is granted; decision on the granting (re-calculation) of pension or allowance, specifying its number and date of taking; the amount of cash spent on the provision of the pension or allowance payments; the deceased person's name, surname, personal identity number and declared place of residence, if the pension or allowance is granted regarding the loss (death) of the breadwinner; the account details of the corresponding special budget of the state social insurance or the income account details of the state basic budget. June 24. The State Social Insurance Agency shall attach the following documents to the application, mentioned in the Clause 23 of the regulations: the print-out from the information system of the compulsory third party liability insurance for inland motor vehicle owners regarding the road traffic accident; the documents of the courts, prosecutor s offices and investigating bodies or the the copy of the decision, mentioned in the sub-clause of these regulations; the copy of the sick-leave certificate B, if the sickness allowance is granted to the suffered person. June

6 25. In order the insurer or the Motor Insurers' Bureau can indemnify for the local government budget s cash, which according to the sub-clause 2.6. of these regulations is spent on the suffered person s allowances, the self-government shall, within one month after the receipt of the documents, mentioned in the clause 26 of these regulations, submit to the insurer or to the Motor Insurers' Bureau the application. The application shall include: the name, surname of the suffered person, the personal identity number and declared amount of the allowance granted and the date, from which the allowance is granted; the number of the decision concerning the granting of allowance and the date, on which this decision has been taken; the deceased person's name, surname, personal identity number and declared place of residence, if the allowance is granted regarding the death of the breadwinner; account details of the corresponding local government budget. 26. The local government shall attach the following documents to the application concerning a certain person, mentioned in the Clause 25 of these regulations: the reference on the road traffic accident in which the persons have suffered; the documents of the courts, prosecutor s offices and investigating bodies or the IV. The Claiming for Indemnification and the Procedure for Indemnification of the Expenses Regarding Technical Aids, Social and Professional Rehabilitation 27. In order the insurer or the Motor Insurers' Bureau can indemnify for the state budget s cash, mentioned in the sub-clause 2.3. of these regulations and spent on the rendering of the social rehabilitation and professional rehabilitation services, the Social Integration State Agency shall, within one month after the end of the social rehabilitation service rendering, but in case the professional rehabilitation services are rendered, - once per half a year regarding each service -, submit to the insurer or to the Motor Insurers' Bureau the application. The application shall include: the name, surname of the suffered person, the personal identity number and declared information on the road traffic accident; the rehabilitation institution where a suffered person received rehabilitation services; sum of cash spent on a person s rehabilitation regarding the social rehabilitation course or the professional rehabilitation program or its part during the reporting period; income account details of the State basic budget. June 28. The Social Integration State Agency shall attach the following documents to the application, mentioned in the clause 27 of these regulations: the print-out from the information system of the compulsory third party liability insurance for inland motor vehicle owners regarding the road traffic accident; the documents of the courts, prosecutor s offices and investigating bodies or the calculation of the cash spent on the suffered person rehabilitation and on the rendered rehabilitation services; the copy of the opinion of the suffered person s family doctor (doctor in charge) regarding the necessity of the social rehabilitation services, in which it is specified that functional disturbances have resulted from the injuries caused in the road traffic accident; the copy of the reference of the State Medical Commission for the Assessment of Health Condition and Working Ability regarding the necessity of the professional rehabilitation services, in which it is specified that disability has resulted from the injuries caused in the road traffic accident.

7 (according to the wording/revision of the Regulations of the Cabinet of Ministers of 30 June In order the insurer or the Motor Insurers' Bureau can indemnify for the state budget s cash, mentioned in the sub-clause 2.4. of these regulations and spent on the adjustment of the motor vehicle, mentioned in the clause 7 of these regulations, the Social Integration State Agency shall, within one month after the end of the corresponding service rendering, submit to the insurer or to the Motor Insurers' Bureau the application. The application shall include: the name, surname of the suffered person, the personal identity number and declared information on the road traffic accident; the number of the decision concerning adjustment of the motor vehicle and the date, on which this decision has been taken; sum of cash spent on the motor vehicle adjustment; income account details of the State basic budget. (according to the wording/revision of the Regulations of the Cabinet of Ministers of 30 June The Social Integration State Agency shall attach the following documents to the application, mentioned in the clause of these regulations: the print-out from the information system of the compulsory third party liability insurance for inland motor vehicle owners regarding the road traffic accident; the documents of the courts, prosecutor s offices and investigating bodies or the calculation of the cash spent on the adjustment of the motor vehicle; the copy of the decision, mentioned in the sub-clause of these regulations; the copy of the opinion of the State Medical Commission for the Assessment of Health Condition and Working Ability regarding the necessity of the motor vehicle s adjustment, in which it is specified that disability has resulted from the injuries caused in the road traffic accident. (according to the wording/revision of the Regulations of the Cabinet of Ministers of 30 June 29. In order the insurer or the Motor Insurers' Bureau can indemnify for the state budget s cash, mentioned in the sub-clause 2.4. of these regulations, after the granting of the corresponding technical aid, the rehabilitation center shall submit to the insurer or to the Motor Insurers' Bureau the application. The application shall include: the name, surname of the suffered person, the personal identity number and declared the place and date on which the technical aid was handed over; the type and price of the technical aid; income account details of the State basic budget. (according to the wording/revision of the Regulations of the Cabinet of Ministers of 30 June 30. The rehabilitation center shall attach the following documents to the application, mentioned in the clause 29 of these regulations: for receipt of the technical aid: a copy of the opinion of the suffered person's doctor in charge is necessary or a copy of the medical card of an in-patient according to the normative enactments regulating the record-keeping procedure of the medical and registration documentation of medical institutions; the print-out from the information system of the compulsory third party liability insurance for inland motor vehicle owners regarding the road traffic accident; the documents of the courts, prosecutor s offices and investigating bodies or the documents of their officials regarding the correspondent road traffic accident (if any). (according to the wording/revision of the Regulations of the Cabinet of Ministers of 30 June

8 31. In order the insurer or the Motor Insurers' Bureau can indemnify for the local government cash, mentioned in the sub-clause 2.6. of these regulations and spent on the rendering of the social rehabilitation and professional rehabilitation services, the selfgovernment shall, within one month after receipt of the documents, mentioned in the clause 32 of these regulations, submit, regarding each case, to the insurer or to the Motor Insurers' Bureau the application. The application shall include: the name, surname of the suffered person, the personal identity number and declared the date of the road traffic accident; the rehabilitation institution, where the suffered person received rehabilitation services; amount of cash, spent on rehabilitation; budget account details of the corresponding local government. 32. The local self-government shall attach the following documents to the application, mentioned in the clause 31 of these regulations: the reference on the road traffic accident in which the persons have suffered; the documents of the courts, prosecutor s offices and investigating bodies or the documents of their officials regarding the correspondent road traffic accident (if any) calculation of the cash spent on the suffered person s rehabilitation and on the rehabilitation services rendered. 33. In order the insurer or the Motor Insurers' Bureau can indemnify for the local government cash, mentioned in the sub-clause 2.6. of these regulations and spent on the purchase or rent of the technical aids, the self-government shall, within one month after receipt of the documents, mentioned in the clause 34 of these regulations, submit, regarding each case, to the insurer or to the Motor Insurers' Bureau the application. The application shall include: the name, surname of the suffered person, the personal identity number and declared the place, date of handing over and terms of use of the technical aids, as well as the fees for their using (regarding rent of technical aids); type and price of technical aids; adjustment expenses of a car, owned by a person, if the medical indications are prescribed for a I or II group disabled person regarding purchase a specially adjusted car and regarding receiving of allowance; budget account details of the corresponding local government. 34. The local self-government shall attach the following documents to the application, mentioned in the clause 33 of these regulations: the copy, submitted by a suffered person, of a patient s medical card of an in-patient or out-patient medical institution, substantiating the technical aid necessity; the reference on the road traffic accident in which the persons have suffered; the documents of the courts, prosecutor s offices and investigating bodies or the documents of their officials regarding the correspondent road traffic accident (if any). V. Final Provisions (Section according to the wording/revision of the Regulations of the Cabinet of Ministers of 30 June 35. Till the 31 st of August, 2009, the rehabilitation center s duties, mentioned in the clauses 8., 15., 29., and 30 of these regulations, shall be performed by the state agency Technical aid center. Prime Minister A. Kalvitis

9 Minister of Health G.Berziņš

10 Annex 1 to the the Regulations of the Cabinet of Ministers of 31 January 2006, No. 92

11 Minister of Health G.Berzins (Annex 2 shall be deleted according to the Regulations of the Cabinet of Ministers of 30 June