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Big Changes to ICBC Injury Claims

The 2019 changes to ICBC benefits not only affect car accidents after April 1, 2019 but also all accidents before April 1, 2019. These changes affect claims in different ways. Ask your ICBC adjuster to explain in writing how the changes to ICBC affect your claim for ICBC benefits. Take time to read and understand these changes.

Injured in a car accident after April 1, 2019? Learn how ICBC limits paying your healthcare costs and compensation for loss of enjoyment of life. But what if I am not at fault for the car accident? The changes still apply to your claim. The changes apply to passengers, infants, and all innocent drivers, cyclists and pedestrians. Increased ICBC payouts on disability benefits will also help guilty and innocent drivers. However, Innocent drivers with private insurance cannot require ICBC to repay their disability plan.

2019 Changes to ICBC Injury Claims create strict new deadlines when making a claim. As a result, your medical expenses will not be paid unless submitted to ICBC within 60 days of treatment. Completing ICBC forms are required by doctors and therapists. To get ICBC benefits, you may be examined by a “registered care advisor”. The result, if you don’t follow the treatment recommendations ICBC could label your serious injury as minor.

Before explaining the key changes to ICBC benefits let’s first understand what types of ICBC benefits can be claimed.

ICBC Benefits and New Limits

There are two types of injury benefits ICBC provides: mandatory and permissive. First, ICBC must pay mandatory benefits as such doctor visits and physiotherapy. Second, ICBC may pay permissive benefits such as attendant care and home renovations if it promotes rehabilitation.

ICBC benefits have doubled according to ICBC. But, have they? Health care benefits are limited and capped, not doubled. The guilty driver’s insurance with ICBC does not fully cover your healthcare after a car accident. You get no reimbursement from ICBC above the limits. This applies whether you have private insurance to cover the additional cost, or not.

What are the ICBC limits on health care costs? The health care services with fee limits and pre-authorized treatments are: acupuncture, chiropractic, counselling, kinesiology, massage therapy, physiotherapy, psychology. The following is the 2019/2020 Health Care Services, Fees Limits and Pre-authorized Treatments Table 1:

ICBC disability benefits will increase from $300 per week to $740 per week for accidents after April 1, 2019 for time off work. Homemaking benefits increase to $280 per week from $145. These benefits are fully deductible from your claim against the guilty driver, whether you make an ICBC claim or not. You must exhaust your other benefits and advance loans before ICBC pays disability benefits.

ICBC Limits on Pain and Suffering

Did the ICBC adjuster tell you ICBC may label you minor injury and cap your pain and suffering to $5,500? Well, it’s true.

If you suffer a serious injury you must prove your injury is serious under the legislation and regulations or ICBC will label it minor injury. This applies to all car accidents, pedestrian accidents, bike accidents, hit and runs and the like after April 1, 2019 .

You are entitled to a maximum of $5,500 for all your pain and suffering, if you agree your injury is minor. However, You’re not subject to the minor injury cap if you have proven your injury is serious.

ICBC Registered Care Advisors

A new category of professional created to help ICBC evaluate your claim, the Registered Care Advisor. Ask your family doctor to explain this referral. This referral must be made by your family doctor within 90 days of the accident.

Once the referral is made, the registered care advisor (RCA) should examine you within 15 days. Your treating physician remains the primary care provider.

The registered care advisor writes a report to the referring physician within 10 days of the examination. This report may form the basis for denying your serious injury as minor under the Minor Injury Regulations.

A registered care advisor must be an independent assessor, not hired by ICBC or your lawyer. The RCA must have no financial interest in the treatment.

60 Day Time Limit to Submit Receipts

Important advisory: ICBC will not pay for any healthcare cost submitted after 60 days of the expense. For ICBC benefits, submit your health care invoices to your ICBC adjuster right away. Make sure you get a copy of the medical expense receipt after the appointment. Send receipts to ICBC within 60 days for the care expenses. This applies to accidents after April 1, 2019.

You only have 60 days after your treatment to submit your receipts to the ICBC adjuster. Send your receipts and invoices for medical care to ICBC within 60 days.

The Future of ICBC Injury Benefits

Unfortunately, the changes to ICBC in 2019 do not lead to increased benefits for the treatment and medical support. There are also additional changes which prevent your private insurance company from getting ICBC reimbursement. These are significant changes and generally negatively impact innocent victims. These changes are however not discussed in this article.

If you have a serious injury defined as minor by ICBC, the government has set up a state run tribunal. Access to Supreme Court judges have been curtailed for determination of minor injury. If it sounds unfair, we agree, but it currently is the law.

The Minor Injury Laws have re-defined serious injuries as minor injury for auto victims. Expect therefore to be treated differently if you are defined as a minor injury. This scheme is meant to save money on insurance premiums, but does it promote the quality of life and equality the citizens expect in British Columbia? Tell your MLA what you think, but for now, it is the law.

Reporting Your ICBC Injury Claim

Tags: ICBC adjusters, ICBC benefits, ICBC limits on healthcare costs

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