delivered the opinion of the court:
On October 28, 1986, the City of Chicago, Anthony Wilczak and Arnold Cisco (the City) filed a third-party complaint for contribution against Dr. Michael Jerva, alleging negligence in his treatment of the plaintiff in the underlying action. Three days later, Penn Trailers Truck and Bodies Corporation and Irving Nuger (Penn Trailers), named defendants in the same underlying suit, also filed a third-party complaint for contribution against Dr. Jerva. Jerva thereafter filed a motion to dismiss the third-party complaints, which the trial court granted. The trial court found that because the third-party actions were filed more than four years after the alleged acts of negligence occurred, they were barred by the statute of repose contained in section 13 — 212(a) of the Illinois Code of Civil Procedure (Ill. Rev. Stat. 1987, ch. 110, par. 13 — 212(a)). The City and Penn Trailers appealed, contending that an action for contribution is timely if it is filed during the pendency of the underlying direct action. The appellate court affirmed the trial court’s dismissal of the third-party complaints. (180 Ill. App. 3d 441.) We allowed the City’s and Penn Trailer’s petitions for leave to appeal (107 Ill. 2d R. 315(a)), and consolidated the matters for oral argument and disposition. In addition, we granted the Illinois Trial Lawyers Association leave to submit a brief as amicus curiae.
On December 29, 1983, Vincent Hayes brought an action in the circuit court of Cook County against the City, Michael Jerva and Penn Trailers, among others, for injuries allegedly sustained by him on January 1, 1982, while he was being transported in a police “Squadrol” and while undergoing medical treatment for those injuries later that day. After filing the suit, Hayes died and Brenda Hayes, administrator of his estate, was substituted as plaintiff. On January 29, 1985, pursuant to the stipulation of Brenda Hayes and Michael Jerva (for reasons that do not appear in the record), the trial court dismissed Dr. Jerva from the cause with prejudice. On August 6, 1986, Brenda Hayes filed an amended complaint against the City and Penn Trailers, among others. Dr. Jerva was not named a defendant in the amended complaint.
On October 28, 1986, the City filed a third-party complaint for contribution against Dr. Jerva (the defendant), alleging acts of negligence arising out of the defendant’s treatment and care of Vincent Hayes on January 1, 1982. Penn Trailers also filed a third-party complaint for contribution against the defendant based on the same alleged acts of negligence. On September 25, 1987, Jerva filed a motion to dismiss the third-party complaints filed by the City and Penn Trailers. In his motion to dismiss the third-party complaints, the defendant alleged, among other things, that because the City’s and Penn Trailer’s third-party complaints were filed more than four years after the alleged acts of negligence occurred, the actions were barred by the statute of repose contained in section 13 — 212(a) of the Illinois Code of Civil Procedure (hereafter the medical malpractice statute of repose) (Ill. Rev. Stat. 1987, ch. 110, par. 13 — 212(a)). The provision provides in relevant part:
“Except as provided in Section 13 — 215 of this Act, no action for damages for injury or death against any physician, dentist, registered nurse or hospital duly licensed under the laws of this State, whether based upon tort, or breach of contract, or otherwise, arising out of patient care shall be brought *** more than four years after the date on which occurred the act or omission or occurrence alleged in such action to have been the cause of such injury or death.”
Citing as authority the appellate court’s decision in Hartford Fire Insurance Co. v. Architectural Management, Inc. (1987), 158 Ill. App. 3d 515, which held that a similar statute of repose for actions against certain persons for construction-related activities governed third-party actions for contribution, the trial court granted defendant’s motion to dismiss the third-party complaints on March 8, 1988. In addition, the trial court concluded that there was no just reason to delay the enforcement or appeal of the order pursuant to Supreme Court Rule 304(a) (107 Ill. 2d R. 304(a)).
The City and Penn Trailers (the plaintiffs) appealed, contending that the medical malpractice statute of repose does not govern an action for contribution. Instead, the plaintiffs argued, an action for contribution is timely if it is filed during the pendency of the underlying direct action. The appellate court disagreed and affirmed the trial court’s dismissal of the third-party complaints. The appellate court concluded that a plain reading of the disputed provision demonstrated that it applied to all medical malpractice actions against physicians regardless of the claim. The appellate court determined that “a contribution action is just a ‘different way’ of bringing an action *** for injury or death against a physician.” (180 Ill. App. 3d at 444.) The appellate court then determined that the specific period of repose in the medical malpractice statute controlled over the general statute of limitations found in the Contribution Act. 180 Ill. App. 3d at 447.
The plaintiffs raise here their argument below that the four-year period of repose set forth in section 13— 212 does not apply to contribution actions. In addition, the plaintiffs contend that even if the language in section 13 — 212 encompasses actions for contribution, the medical malpractice statute of repose is superseded by the rule, established by this court in Laue v. Leifheit (1984), 105 Ill. 2d 191, that an action for contribution can be brought anytime during the pendency of the underlying action.
The plaintiffs initially point to the condition in the statute of repose that “no action for damages for injury or death against any physician *** whether based upon tort, or breach of contract, or otherwise, arising out of patient care” can be brought after the running of the repose period. (Ill. Rev. Stat. 1987, ch. 110, par. 13— 212(a).) The plaintiffs argue that the phrase “action for damages” in the disputed provision refers only to an action at law for damages and not to an equitable apportionment of the damages among those who proximately caused the original plaintiffs injury. Therefore, the plaintiffs contend, the term “otherwise” in the provision relates only to various, but unenumerated, theories for recovery of damages for a plaintiff’s injury or death. Citing this court’s opinion in Doyle v. Rhodes (1984), 101 Ill. 2d 1, 14, the plaintiffs then submit that a contribution action is not an “action for damages” but is instead a separate and independent action in equity, designed to insure that all joint tortfeasors bear their fair share of the damages awarded in the underlying direct action.
Defendant counters that the term “action” in the disputed provision should be given its plain and ordinary meaning. Defendant offers an excerpt from Black’s Law Dictionary defining the term to include “all the formal proceedings in a court of justice attendant upon the demand of a right made by one person of another in such court, including an adjudication upon the right and its enforcement or denial by the court.” (Black’s Law Dictionary 26 (5th ed. 1979).) Defendant then contends that the phrase “no action for damages” is met here because the plaintiffs’ actions for contribution are for the recovery or credit of damages directly caused by defendant’s alleged malpractice “arising out of patient care.”
When interpreting a disputed provision, courts should ascertain and give effect to the true intent and meaning of the legislature, considering first the statutory language. (In re Marriage of Logston (1984), 103 Ill. 2d 266, 277.) Unambiguous terms, when not specifically defined, must be given their plain and ordinary meaning. (See, e.g., People v. Moore (1978), 69 Ill. 2d 520, 523.) Moreover, courts should not insert words into legislative enactments when the statute otherwise presents a co: gent and justifiable legislative scheme. (See Hagen v. City of Rock Island (1959), 18 Ill. 2d 174, 179.) A plain reading of the disputed provision leads us to conclude that the General Assembly did not intend to define an “action for damages” in the medical malpractice statute of repose as an “action at law for damages.” We believe that the medical malpractice statute of repose bars any action after the period of repose seeking damages against a physician or other enumerated health-care provider for injury or death arising out of patient care, whether at law or in equity.
Because we find that the statute of repose is not limited to actions at law, we need not address the plaintiffs’ argument that this court’s decision in Doyle v. Rhodes, 101 Ill. 2d at 1, established the principle that an action for contribution is a suit in equity.
Nevertheless, we must still determine whether an “action for damages,” as provided in the medical malpractice statute of repose, includes a third-party action for contribution or, as the plaintiffs contend, is limited to only a direct action by the injured party. The plaintiffs assert that their third-party actions against the defendant are not for recovery of the damages sustained by the original plaintiff, but instead are actions seeking the enforcement of an equitable duty to share liability among the parties responsible for the original plaintiff’s injury in proportion to their relative fault. (See Doyle v. Rhodes (1984), 101 Ill. 2d 1, 14.) In support of their contention, the plaintiffs point out that an action for contribution can be based on a theory of recovery other than that asserted by a plaintiff in his direct action.
We believe that the plaintiffs’ interpretation of the medical malpractice statute of repose unduly limits its scope and misapprehends the purpose behind its enactment. It is true, as the plaintiffs observe, that an action for contribution need not be predicated on the same theory of recovery as that asserted by the plaintiff in the underlying action. (See, e.g., Hall v. Archer-Daniels-Midland Co. (1988), 122 Ill. 2d 448, 450, 461; J.I. Case Co. v. MeCartin-McAuliffe Plumbing & Heating, Inc. (1987), 118 Ill. 2d 447, 451-52, 462; Doyle, 101 Ill. 2d at 14.) Nevertheless, “the basis for a contributor’s obligation rests on his liability in tort to the injured party” (J.I. Case, 118 Ill. 2d at 462), even if the plaintiff in the direct action did not assert the theory of liability on which the third-party action relies. The action for contribution apportions the damages among the parties responsible for the original plaintiff’s injury, and the contributor is obligated for the damages directly created by the contributor’s negligent actions. The third-party plaintiff, therefore, is seeking from the third-party defendant those damages proximately caused by the negligent acts of the third-party defendant which the third-party plaintiff may be obligated to pay in the underlying suit. This leads us to conclude that an action for contribution is an “action for damages” under the medical malpractice statute of repose.
The purpose behind the General Assembly’s enactment of the medical malpractice statute of repose further supports our interpretation of the disputed provision. As previously discussed by this court (see, e.g., Anderson v. Wagner (1979), 79 Ill. 2d 295), when the General Assembly limited the time period in which a party could bring a suit for medical malpractice, it was faced with what it perceived as a medical malpractice insurance crisis. “The crisis resulted from the increasing reluctance of insurance companies to write medical malpractice insurance policies and the dramatic rise in premiums demanded by those companies which continued to issue policies. The difficulty in obtaining insurance at reasonable rates forced many health-care providers to curtail or cease to render their services. The legislative response to this crisis sought to reduce the cost of medical malpractice insurance and to insure its continued availability to the providers of health care.” (Anderson, 79 Ill. 2d at 301.) The legislature therefore enacted, among other provisions, an outside time limit of five years, later amended to four, in which an action could be brought against physicians and hospitals for actions arising out of patient care (Pub. Act 79 — 960, eff. Nov. 11, 1975; Ill. Rev. Stat. 1975, ch. 83, par. 22.1). (Mega v. Holy Cross Hospital (1986), 111 Ill. 2d 416, 427.) This definite period in which an action could be filed was viewed as necessary to prevent extended exposure of physicians and other hospital personnel to potential liability for their care and treatment of patients, thereby increasing an insurance company’s ability to predict future liabilities. (See Anderson, 79 Ill. 2d at 307.) This increased ability to predict liability was meant to assist in reducing health-care malpractice insurance premiums.
Because a suit for contribution against the insured for damages arising out of patient care exposes insurance companies to the same liability as if the patient were to have brought a direct action against the insured, we believe that the term “or otherwise” in the medical malpractice statute of repose includes actions for contribution against a physician for injuries arising out of patient care. We find wanting the plaintiffs’ claim that the word “otherwise” does not include actions for contribution because such actions did not exist in Illinois until this court’s 1978 decision in Skinner v. Reed-Prentice Division Package Machinery Co. (1977), 70 Ill. 2d 1, three years after the General Assembly initially enacted the medical malpractice statute of repose. The inclusion of the term “or otherwise” following more restrictive language in the statute seems to us to indicate that the legislature intended the term to be all-inclusive. We believe that the term demonstrates the General Assembly’s desire at the time it originally enacted the statute to limit a physician’s exposure to liability for damages for injury or death arising out of patient care under all theories of liability, whether then existing or not.
Plaintiffs next contend that the statute of limitations governing actions for contribution supersedes the medical malpractice statute of repose. Amicus curiae, citing the rule that a specific statutory provision relating to a specific subject prevails over a conflicting general provision (see Sierra Club v. Kenney (1981), 88 Ill. 2d 110, 126), asserts that section 13 — 204 of the Illinois Code of Civil Procedure (Ill. Rev. Stat. 1987, ch. 110, par. 13— 204) governs the action here. Section 13 — 204 provides that “[n]o action for contribution among joint tortfeasors shall be commenced with respect to any payment made in excess of a party’s pro rata share more than 2 years after the party seeking contribution has made such payment towards discharge of his or her liability.”
We find amicus curiae’s reliance on section 13 — 204 of the Illinois Code of Civil Procedure misplaced. Section 5 of “An Act in relation to contribution among joint tortfeasors” (Ill. Rev. Stat. 1987, ch. 70, pars. 301 to 305) (Contribution Act), rather than section 13 — 204 of the Illinois Code of Civil Procedure, applies to actions for contribution when a direct action is pending. Section 5 states that “[a] cause of action for contribution among joint tortfeasors may be asserted by a separate action before or after payment, by counterclaim or by third-party complaint in a pending action.” (Ill. Rev. Stat. 1987, ch. 70, par. 305.) In Laue v. Leifheit (1984), 105 Ill. 2d 191, this court held that a claim for contribution must be asserted, by counterclaim or third-party complaint, during the pendency of the underlying action, if one should exist. 105 Ill. 2d at 196.
The plaintiffs argue that the requirement stated in Laue was met here and that the Laue holding governs all actions for contribution, including actions for contribution arising from the contributor’s medical malpractice. We do not believe that Laue is dispositive of the issue at bar. Laue only established a procedural requirement that actions for contribution must be filed during the pendency of the underlying direct action. (Laue, 105 Ill. 2d at 196.) The decision does not hold that all actions for contribution brought within the time an underlying suit is pending are timely filed. The medical malpractice statute of repose, on the other hand, “is intended to terminate the possibility of liability after a period of time.” Mega, 111 Ill. 2d at 422.
Plaintiffs next argue that public policy precludes application of the medical malpractice statute of repose to actions for contribution. We disagree. Absent application of the medical malpractice statute of repose to actions for contribution, insurance companies would once again face an indefinite exposure to liability. Such a result would substantially thwart the legislative goal of reducing insurance premiums for health-care providers. Cf Stephens v. McBride (1983), 97 Ill. 2d 515 (application of the notice provision in the Local Governmental and Governmental Employees Tort Immunity Act to a case for contribution “would be of questionable value”).
Plaintiffs finally note that application of the repose period to actions for contribution effectively abolishes contribution actions in all cases where the underlying action is filed close to or on the last day of the four-year repose period. We are mindful of Dean Prosser’s words, cited by this court in Skinner, 70 Ill. 2d at 13, that “ ‘[t]here is obvious lack of sense and justice in a rule which permits the entire burden of a loss, for which two defendants were equally, unintentionally responsible, to be shouldered onto one alone, according to the accident of a successful levy of execution, the existence of liability insurance, the plaintiff’s whim or spite, or his collusion with the other wrongdoer, while the latter goes scot free.’ Prosser, Torts sec. 50, at 307 (4th ed. 1971).” Nevertheless, the General Assembly perceived the medical malpractice insurance crisis as so grave that it limited to four years a patient’s right to bring an action against certain health-care providers for damages arising out of patient care. For that reason, we find it difficult to believe that the General Assembly did not also intend to bar a culpable party’s claim for contribution if not filed within the same statutory four-year period allowed an innocent plaintiff.
Because we believe that the City’s and Penn Trailer’s actions for contribution against Dr. Jerva were time-barred by the medical malpractice statute of repose, we affirm the appellate court’s and trial court’s judgments dismissing their third-party complaints.
Judgments affirmed.