Updated on 1 October 2026: text revised and sources added.
After a road or workplace accident, the public hospital provides the care the victim needs. Who bears that cost depends on who is legally or contractually responsible, and it is not always the SNS. Even so, some patients have received bills they should not have, so it is worth knowing how this works.
Why does this happen?
Where a party is legally or contractually responsible for the costs (for example, the insurer of whoever caused a road accident), SNS institutions can claim the cost of the care provided directly from it (Decree-Law 218/99 of 15 June). In road accidents covered by valid compulsory insurance, the law allows certain costs to be claimed from the vehicle’s insurer even before liability for the accident has been established. Each insurer is responsible for the people carried in the insured vehicle, except the driver. An identified SNS user does not become liable simply for having been in an accident: their own care is, as a rule, covered by the SNS where there is no other responsible party. Even so, the Health Regulatory Authority (ERS) has examined a case of improper charging at a hospital unit in Faro and ruled that identified SNS users should not be charged in these situations. If you receive a bill of this kind, you should assess whether it applies to your case and, if appropriate, contest it.
Who is exposed?
- A responsible driver without valid compulsory third-party liability insurance: may be liable for the costs relating to victims and passengers and for any other damage legally attributable to them. The Motor Guarantee Fund (Fundo de Garantia Automóvel) may also step in and then seek reimbursement from the party responsible.
- Employers without valid workplace accident insurance, or with insufficient cover, who are liable for the costs.
- People not identified as SNS users, for example foreigners without a user number.
Their own healthcare, if they are an identified SNS user, is covered by the SNS.
In practice, holding valid compulsory insurance and cover suited to your situation is the simplest way to avoid surprises.
What insurance covers, and what it does not
Compulsory motor third-party liability insurance protects third parties and the people carried in the vehicle, within the legal limits, but it does not cover the driver’s own bodily injury. Optional cover, such as personal accident insurance or driver protection, exists for that and should be assessed case by case. Workplace accident insurance, which is compulsory for those who employ workers and for the self-employed, covers the costs of work-related accidents under the terms of the policy.
Personal accident insurance follows the same logic: everyday mishaps (a fall at home, a sports injury) can also lead to expenses that are worth having covered in advance, rather than risking paying them out of your own pocket.
What you can do now
You don’t need to wait for an accident to find out whether you are well protected. A simple review of your current policies (car, workplace accidents, personal accidents) is enough to spot any gaps in cover and fix them before they become a real problem. If you receive a hospital bill after an accident, check whether it applies to your case before paying it and, if in doubt, talk to me.
If you would like to understand your own situation, with no obligation, I am available for a conversation, by WhatsApp, email, phone or video call and, depending on availability, in person in the Algarve.
Sources
- Health Regulatory Authority (ERS), deliberation ERS/001/2025: ERS document (in Portuguese).
- Decree-Law 218/99 of 15 June (recovery of costs by SNS institutions; in Portuguese).