As discussed before, when you are involved in a car accident in B.C., you may have as many as three distinct legal claims: a claim for Part 7 benefits, a claim for vehicle damage, and a tort claim against a negligent driver. By default, those latter two claims are only available if someone else was at fault in causing the accident.
But ICBC Part 7 benefits are the no-fault portion of B.C. auto insurance. That is, they are available regardless of who was at fault for the accident. You can be eligible to receive them if someone else was at fault, if you were at fault, or—in cases involving inevitable accidents—even if nobody was at fault.
ICBC Part 7 benefits include the following:
- Disability (lost earnings) benefits
- Medical and rehabilitation benefits
- Funeral and death benefits.
This post takes a closer look at ICBC Part 7 medical benefits. Under Regulation 88 (1), ICBC is required to pay for all “reasonable” and “necessary” medical expenses. ICBC is required to pay for the following treatment types (subject to the maximum amount in brackets for a standard treatment).
- Acupuncture ($88)
- Chiropractic ($53)
- Counselling ($120)
- Kinesiology ($78)
- Massage Therapy ($80)
- Physiotherapy ($79)
- Psychology ($195)
- Occupational Therapy ($112 per hour)
- Dental, hospital, ambulance, professional nursing services, speech therapy, prostheses and orthoses ($ limits as prescribed by the Medical Services Commission).
The allowable amounts for the items noted in the first eight bullets above adjust on April 1st every year, pursuant to a formula linked to the Consumer Price Index (CPI). Higher amounts are permitted for assessments and reports, but the treatment costs are limited, as outlined above.
In addition to the limitations on cost, ICBC Regulations limit the number of treatments a person is entitled to. Other than the pre-approved treatments provided within the first 12 weeks, ICBC can deny funding for treatment. The reason being, if you require more treatment than the maximum pre-approved allowance or require treatment more than 12 weeks after an accident, the treatment is deemed “not a necessary healthcare service” unless ICBC’s medical advisor or the claimant’s physician “certifies to ICBC in writing that, in the opinion of the medical advisor or physician, the treatment is necessary for the insured.” In other words, the Part 7 benefit plan assumes that with minimal early treatment, you should be fine and well on your way to complete recovery. In practice, however, that is simply not how claimants recover from injuries.
Part 7 provides for up to $300,000 to pay for medical and rehabilitation expenses. While this amount is more than enough for most claims, when an individual suffers very severe injuries, the Part 7 fund may not be enough. Talk to the personal injury lawyers at Hoogbruin & Company to make sure that your rights are protected.