In a certain sense, you could consider maintenance and cure like a modern-day health maintenance organization (HMO),
except that the patient-the seaman- does not pay a premium, and the shipowner (or the shipowner’s insurer) serves as the HMO.
In short, a seaman is entitled ro have the shipowner pay the seaman’s medical expenses incurred by reason of the seaman’s injury-or illness-that manifests itself on board, including,
for example, cancer or appendicitis or some other affiiction unrelated ro the seaman’s work environment.
In other words, the shipowner has ro pay the seaman’s medica l bills even if the shipowner had no role in causing the condition needing medical treatment.
This entitlement is based on the relationship between the seaman and the vessel.
Therefore, any provision of a contract with the seaman that attempts ro deprive the seaman of the benefits of maintenance and cure will not be enforced.
Certain union contracts, however, are allowed ro shape some of the benefits.
At this poinr, it is worth noting a comparison between maintenance and cure and workers’ comp.
You’ll reca ll that a shoreside employee is entitled ro workers’ comp for any injury incurred on the job,
even if the employer had no fault in the injury.
(This is known as “strict liability.”) But maintenance and cure is even more expansive.
The shipowner, like the shoreside employer, is liable for on-the-job injuries without regard ro the employer’s fault, but the shipowner is,
in addition, liable for medical care for illnesses of the seaman, even those arising independently of the workplace.
For example, take a form of cancer or a heart condition that manifests itself during the course of employment.
The shipowner would be liable under maintenance and cure, but a shoreside employee could not collect benefits under workers’ compensation. Maintenance and cure is also more expansive in terms of geography.
A shoreside employer is liable for injuries incurred “on the job” (as opposed ro “at home,” or “on the rown,” for example),
but the shipowner is liable for maintenance and cure for illnesses and injuries that occur at any point that the seaman is subject ro recall to duty on board the ship.
As long as the seaman has nor severed the employment relationship with the vessel,
he or she would be entirled to maintenance and cure benefits even for incidents that occur while on shore leave, or even at home,
as long as he or she is still subject to recall to work. Indeed,
in one famous (or infamous) case, a seaman was ruled entirled to maintenance and cure benefits for an injury he incurred while making his escape from a bordello.
Even the negligence or fault of the seaman in creating the injury or illness will not, for the most part,
defeat the right to collect maintenance and cure.
This is at odds with rhe rule in most other forms oflegal recovery for injury or illness,
but it does mean that an intoxicated seaman (on shore leave, fo r example) may not necessarily thereby lose the rights to benefits.
There are a few sorts of conduct on the part of the seaman that can result in the rightful denial of maintenance and cure benefits.
One is when the injury is wholly attributable to his/her own misconduct- typically venereal disease or intoxication.
Another is when the seaman misrepresents his/her medical condition to rhe shipowner,
and the need for medical treatment relates to rhe falsehood.
Bur these are rare exceptions, and, in general, the law favo rs the position of the seaman.
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