When you are injured in a motor vehicle collision, getting ICBC to cover medical expenses and lost income “up front” can go a long way to promoting a speedy recovery, and reducing stress about financial exposure.

There are two different types of claims that an injured party (a driver, passenger, cyclist or pedestrian) can make after a car accident in British Columbia.  The first claim is the tort claim against the driver at fault for the collision.  This is the commonly known claim that covers all losses when the claim is settled.

The second claim is for medical rehabilitation benefits, and wage replacement benefits.  This second category of benefits is available under Part 7 of the Revised Regulation under the Insurance (Vehicle) Act, and are often referred to as “Part 7 benefits”, “no fault benefits”, or “accident benefits”.  As an injured party, you are entitled to Part 7 benefits regardless of who was at fault for the accident.  Most importantly, they are payable “on the fly”, long before the rest of the claim is settled.

Various Part 7 benefits can be mandatory or discretionary, and only the mandatory ones can be enforced.  To access these benefits, you must report to ICBC that you have been involved in a collision as soon as possible (this is usually done through ICBC’s Dial-A-Claim service).  Within 30 days of the collision, you must provide a written statement detailing the accident, and within 90 days, you must submit a proof of claim form.

If you can demonstrate that you have been injured as a result of a collision, ICBC must pay for all reasonable expenses you incur for necessary medical, surgical, hospital, ambulance or professional nursing services, or for necessary physical therapy, chiropractic treatment, occupational therapy or speech therapy or for prosthesis or orthosis.

To show that you have been injured, ICBC needs objective proof of your injury.  Examples of objective proof include broken bones, cuts and bruises, muscle spasms, and reduced range of motion. They are symptoms a medical practitioner can detect independently of your subjective complaints (ie. “my neck hurts”).  Accordingly, ICBC often requests a practitioner’s note, report or clinical records.

Once you have shown that you have been injured, ICBC will pay for treatments such as physiotherapy, chiropractic treatments, massage treatments and acupuncture.   The recommendation that you undergo a particular type of treatment must come from your medical practitioner and it must be “reasonable and necessary”.   On receiving a recommendation for treatment, ICBC must either fund the treatment or retain another medical expert to examine you and to show that the treatment is not necessary.

While ICBC limits payment to a certain amount of treatments (ie. 12 physiotherapy visits), if your medical practitioner (preferably a doctor) recommends further treatments, generally ICBC must continue to fund those treatments.  This written recommendation could again be a note, or a report depending on the duration of the treatment.

Ensuring that your doctor is communicating effectively with ICBC can be time consuming and frustrating, particularly when you are trying to focus on your recovery.  Retaining a lawyer soon after the collision can be to your advantage, as an experienced personal injury lawyer should work closely with your doctor to ensure that your treatments are being covered by ICBC, and that all options for treatment are being canvassed in order to maximize your chances for early rehabilitation.

Wage replacement benefits are also payable, provided that you are completely disabled from working in the time immediately after the accident.  The benefit amount is 75% of your income, up to $300 per week.  You can earn small amounts of income as the healing progresses, while still preserving your entitlement.  This encourages a return to work as quickly as possible, without jeopardizing your entitlement if your medical condition deteriorates later.

Part 7 benefits are a helpful source of coverage, which are designed to encourage quicker recovery, and prevent a tort claimant from being “starved” into a premature settlement.  ICBC is often reluctant to provide these benefits, and that’s where a lawyer can help.