November 13, 2018 11:30
The dispute between the insurers and pharmacists about the fees that charge the latter sees a new player enter the discussion : the insured. These are the courts that allow him to add his voice to the debate.
The applicant Bernard Side has filed an application before the Quebec superior Court that a class action is to compensate policyholders who have been charged fees that are too high, compared to the acts that pharmacists pose for the persons covered by the public plan. Mr. Côté alleges that for the two types of plans, the pharmacists ask the same professional act and book the same order. Why then, in some cases, doubling or tripling the fees for the insured persons of the private ? It is estimated that 4 million us dollars (M$) the amount that may be paid.
The judge Marie-Claude Armstrong has agreed, on the 30th of October last, that the cause be heard. The collective action filed by Mr. smith aims his neighborhood pharmacy, where he buys his drugs, as well as three banners pharmaceutical : Jean Coutu, Pharmaprix and Uniprix.
Why Famili-Prix, Proxim and Brunet are not mentioned in the appeal ? Because Mr. Côté argues that involve all of the banners would have been too complex, one can read in its application instituting proceedings.
Life insurers dumb for the moment
Thecanadian Association of insurance companies of person (CLHIA), which has been campaigning for years to reduce the gap between the fees charged by pharmacists to the private pension schemes and insurance companies, could benefit from the benefits of the judgment if it is to the advantage of Mr. smith. Joined by the Journal of insurance, CLHIA, however, declined to comment.
“We are currently negotiating with theAssociation québécoise des pharmaciens propriétaires (AQPP). We have agreed to a truce in the media during the negotiations. We will therefore not comment except to clarify that we are not involved, for the moment, in this dispute, ” said its assistant vice president of public and governmental affairs, Suzie Pellerin, the Journal of insurance.
A higher rate in the private sector than the public
Bernard Side has filed its application for authorization of a class action in October 2016. He invoked then his inability to get his pharmacist the amount of professional fees billed to enforce its orders.
A year after the filing of its action, the pharmacists were forced by an amendment to the medicines Act to ventilate distinctly their fees for each service rendered, the price paid by the general regime for each drug or supply that it provides as well as the profit margin for the wholesaler, if any.
Despite the entry into force of these provisions, Mr. smith believes that, even after the disclosure of fees imposed by the Act, pharmacies and banners remain faulty, as they charge to consumers with private insurance a higher rate than that of the Plan public at the time of the renewal prescription. He argues that the billing discrepancies constitute unfair treatment and unreasonable members of the group compared the public plan. He also relied on breaches of the Law on consumer protection and the civil Code of Québec.
Finally, it alleges that the defendants, by charging double or triple the same professional act during the renewal of the same prescription for a period of more than a month, act unreasonably, because they would charge three or four times less for the same service to consumers subject to the public plan.
On behalf of all insured persons in the private
The proposed industrial action is undertaken for the benefit of people who are part of the group of insured persons of the private of which Mr. smith himself and for which he offers the following description :
“All persons in Quebec who, since October 25, 2013 until the final judgment, had a drug insurance plan or private employee benefit plan, who have purchased prescription drugs from a pharmacy the defendants that the price shown on the invoice does not disclose the fee for the execution and renewal of order charged by the pharmacist. “
Mr. Côté said that all members of the group suffer the same harm. The practices complained of would be used by all pharmacies, it is alleged. All the insured would therefore be in the same situation and should be able to claim the refund of the professional fees that they have paid in excess of those which have been charged to a consumer insured under the public plan for the enforcement of an order or its renewal(s), argued counsel for Mr. Côté.
The detail of the sums claimed
In terms of monetary damages, Mr. Côté is estimated to 1 283 $ 540 per year, the costs or fees charged unreasonable and unfair by each of the banners identified. In support of this estimate, he formulates the hypothesis that, on average, each of them would have charged approximately $ 10 charge per order in excess of the fee charged to a consumer provided pursuant to RPAM.
On the basis of the information that a pharmacy franchisee of the banner of the Jean Coutu group meets on average 221 300 orders per year, and that 58 % of these orders are attached to the members of the proposed group, it is estimated that each respondent would have charged in too 1 283 $ 540 per year for its professional services. It multiplies by three the amount to cover the period of the three years covered by the action.
It claims and defendants ‘ damage to 3 850 620 $ as well as punitive damages to the tune of $ 25 per person. He argues that the defendants should be punished for excessive billing of their fees since they have had a misconduct, which would justify a condemnation to punitive damages under the Law for the protection of the consumer.
The lawyers of the enterprises covered by the class action challenged the application of the assured under the four main reasons for it. Judge Armstrong rejected their arguments, pointing out that the Court had not at this stage to pronounce on the validity of the conclusions sought by the applicant. It allows, therefore, to exercise a class action against the parties referred to in the name of the group of people who have a prescription drug insurance private said to represent Mr. smith.