Suing the at-fault driver after ACAA has treated you

It is the subrogation machinery of Article 7 of Act 111-2020. ACAA compensates the injured person without asking who was at fault; in exchange, where there is a responsible third party, the Act lets it step into your rights to pursue them and recover what it spent. That right of the Administration is interwoven with yours, and from that come the deadlines, temporary bars and certifications this guide describes.

It applies to the injured person — or their beneficiaries in death cases — where the injury, illness, disability or death giving a right to compensation under the Act arose in circumstances making a third party liable, and the Administration was obliged to compensate in any form or provide treatment. It also reaches the defendant, the person liable to satisfy an extrajudicial claim, and their insurer, who are barred from paying without the Administration’s certification.

• Waiting for ninety (90) days to pass from the date the Administration’s resolution became firm and executory before suing or settling against the responsible third party.Verified against the official source
• Notifying the Administration with a copy of the filed complaint, including in its caption or in one of its allegations the case number of your ACAA claim.Verified against the official source
• Obtaining, both as plaintiff and as defendant, an Administration certification that no debt exists before payment of the judgment is satisfied.Verified against the official source
• Notifying the Administration in writing before paying, where what exists is an extrajudicial claim against the driver, the registered titleholder or their insurers.Verified against the official source

• A copy of the filed complaint, with the ACAA case number visible in the caption or in an allegation.
• The Administration’s certification that no debt exists, which plaintiff and defendant must obtain before the judgment is paid.
• The Administration’s resolution in your case, with the date it became firm and executory: the ninety days and the year hang from that date.

1. 1

   Step 1: The day the clock starts

   Everything hangs from one date: the day the Administration’s resolution in your case became firm and executory. Not the accident date, not the discharge date, not the date of the last payment. From then, the Act says the injured person or their beneficiaries may claim and obtain damages from the responsible third party within the following year. Keep the resolution and the record of when it became firm: without that date you cannot compute any of the deadlines that follow.

2. 2

   Step 2: Ninety days in which ACAA decides first

   The Administration steps into your rights and may bring proceedings against the third party in your name, within the ninety days following the decision becoming firm and executory. If it does, it must notify you in writing within five business days of starting the action, and you are a party to any proceeding it brings. Anything recovered above the expenses incurred in the case is handed to you or the beneficiaries entitled to it.

3. 3

   Step 3: And ninety days in which you cannot move

   This is the part that surprises. The Act says, in its own words, that neither the injured person nor their beneficiaries may sue or settle any cause of action they have against the third party responsible for the damage, until after ninety days have passed from the date the Administration’s resolution became firm and executory. It is a temporary bar, not a waiver: after ninety days you regain the initiative. But if you sign an agreement inside that window, the Act runs it over.

4. 4

   Step 4: If ACAA does not sue, you are free

   The next subparagraph is the most favourable to the injured person in the whole article: if the Administration fails to sue the responsible third party, the injured person or their beneficiaries are completely free to bring that suit for their own benefit, without being obliged to reimburse the Administration for the expenses incurred in the case. That is: if ACAA did not use its ninety-day window, what you recover is yours and you do not owe it the treatment.

5. 5

   Step 5: The certification without which nothing is paid

   When the court awards damages under negligence liability, the defendant and also the plaintiff, before payment of the judgment is satisfied, must obtain an Administration certification that no debt exists in relation to the services provided. If the Administration is entitled to reimbursement, payment must issue separately: one cheque to the Administration and another to the injured person, each for its respective amount. And if whoever is obliged to pay the judgment pays without regard to the Administration’s interests, it is entitled to be indemnified for the loss by the plaintiff, the defendant or the interested party.

6. 6

   Step 6: The extrajudicial settlement that becomes void

   Outside court the rule is harsher still. If the injured person files an extrajudicial claim against the driver, the registered titleholder or their insurers and they grant compensation for bodily injury, the claimant and their insurer are obliged to notify the Administration in writing before paying. The Administration investigates whether it is entitled to reimbursement, and the person obliged to pay and their insurer are barred from paying until the Administration remits a certification that no debt exists. If they pay without the prior certification, any extrajudicial settlement between the parties is void; further, the Administration may go to the Court of First Instance to challenge the payment and, if it does, is entitled to compensation equal to double the amount of the benefits it paid.

7. 7

   Step 7: The complaint copy with the case number

   The Administration is entitled to intervene before the Court of First Instance in every case seeking negligence damages for injuries for which benefits were provided under this Act. So that it can, the court will require the plaintiff to notify it with a copy of the filed complaint, and that complaint must include in its caption or in one of its allegations the case number of the claim before the Administration. The Act is explicit about the consequence: non-compliance is sufficient cause for the action to be dismissed, without prejudice, after the court grants a discretionary term never shorter than thirty calendar days.

8. 8

   Step 8: Three years for ACAA to appear

   The article closes with a deadline that runs against the Administration, not against you: in every case where it is notified, the Administration shall appear in the suit to exercise its rights, and if it does not appear within three years its cause of action is deemed withdrawn with prejudice and the court shall enter judgment to that effect. Notifying it properly, then, is not only your obligation: it is also what starts its clock.

The suit against the responsible third party goes to the Court of First Instance. The no-debt certification is requested from the Automobile Accident Compensation Administration. The Act refers the terms and conditions for issuing that certification to an Administration regulation; we did not read that regulation and do not describe here where or how the request is filed.

• Signing a settlement with the insurer inside the ninety days: the Act strips it of legal effect.
• Collecting an extrajudicial settlement without ACAA’s no-debt certification: the agreement is void.
• Filing the complaint without the ACAA case number in the caption or an allegation.
• Not serving ACAA with a copy of the complaint: sufficient cause for dismissal without prejudice.
• Counting the year from the accident date rather than from when the ACAA resolution became firm.
• Believing you must repay ACAA what it spent even where it did not sue within its ninety days.
• Accepting a single cheque where ACAA is entitled to reimbursement: the Act requires separate payments.

These are the government pages this guide is based on.

• Administración de Compensaciones por Accidentes de Automóviles (ACAA)

  ACAA

  docs.pr.gov

• Automobile Accident Compensation Administration

  acaa

  www.acaa.pr.gov