Payment of Medical Expenses in Traffic Accidents

In today's Turkey, one of the biggest problems brought about by the increasing population is undoubtedly traffic accidents. The steadily rising number of traffic accidents has undoubtedly become a matter of legal concern. Therefore, one of the most frequently asked questions is which compensation items can be claimed in the event of a traffic accident and from whom these items can be claimed. In today's article, we will try to answer these questions and, as seen in the title, we will explain how compensation for healthcare services, which are specifically regulated in the Highway Traffic Law, can be claimed.

According to the Highway Traffic Law No. 6047, in accidents arising from the operation of a motor vehicle, the owner of the motor vehicle and the enterprise to which it belongs are jointly and severally liable. Furthermore, those operating motor vehicles are obligated to obtain Compulsory Financial Liability Insurance in accordance with Article 91 of the Highway Traffic Law. The items of receivables covered by Compulsory Financial Liability Insurance are as follows:

• Material Damages: Damages to the economic assets of a third party, including the decrease in the value of the vehicle
• Permanent Disability: The item of damage that a third party can claim due to the disability sustained in their body as a result of the accident, which will last for the rest of their lives
• Medical Expenses: The costs of treatment incurred by a third party as a result of the accident
• Loss of Support Compensation: This is a type of compensation that can be claimed by those who have lost a person's support as a result of the death of a third party in an accident

When an accident occurs as a result of the operation of a motor vehicle, the injured third party may claim the items listed above from the insurance company of the motor vehicle that caused the damage, under the Compulsory Motor Vehicle Insurance (ZMSS) coverage.

Healthcare costs, also known as treatment expenses, are specifically regulated in Article 98 of the Highway Traffic Law. Healthcare costs refer to all treatment expenses incurred to restore the physical integrity of a person injured in an accident. How these damages will be covered is clearly explained in Article 98 of the Highway Traffic Law. Accordingly, the healthcare costs provided by all healthcare institutions specified in the law due to treatment resulting from a traffic accident will be covered by the Social Security Institution (SGK). This means that even if the treatment is performed in hospitals that do not have an agreement with the SGK, the healthcare costs will be covered by the SGK. Before the amendment to Article 98 in 2011, the driver, operator, and insurance company covered by the Compulsory Motor Vehicle Insurance (ZMSS) were jointly responsible for these healthcare costs. However, with the amendment in 2011, responsibility was transferred to the SGK. Furthermore, a temporary provision stipulated that healthcare costs for accidents that occurred before 2011 would also be covered by the SGK.

However, as mentioned above, the Social Security Institution (SGK) is only responsible for documented treatment expenses, not all treatment costs. In other words, caregiver expenses and other treatment costs are not covered by SGK. Therefore, the responsibility of the vehicle owner, driver, and insurance company for treatment expenses is not completely eliminated; their responsibility continues, at least for treatment expenses not covered by SGK.