What you need to know about making a bodily injury claim for seeking compensation and working with a personal injury lawyer.
I’ve been injured in a motor vehicle accident—do I have to provide a statement in person at ICBC?
No, you don’t have to make your statement in person. You do need to provide ICBC with a written report of the accident no later than 30 days from the date of the accident, but you can do this online. Your statement does not need to describe every detail of your accident or include any details you are unsure of.
If you are pursuing either a Part 7 claim or a tort claim, ICBC may ask you for a more detailed statement, as well as your medical history—including information about any relevant pre-existing injuries or disabilities. However you do not need to include this information in your statement to ICBC.
The requirement to provide ICBC with a statement as described above is different than the requirement to give ICBC notice of the accident. You must notify ICBC promptly. Unless there are extenuating circumstances, we recommend contacting ICBC’s “Dial-A-Claim” as soon as you are able—certainly within 24 hours of the accident.
What are Part 7 Benefits?
ICBC Part 7 benefits are often called “accident benefits”or “No Fault Benefits.” These are benefits that may be available to any party in an accident—regardless of who is at fault.
- Medical and rehabilitative benefits;
- Disability benefits for employed persons;
- Homemaker benefits; and
- Death benefits.
To receive these benefits you must be insured under Part 7 regulation, which is to say you are either:
- An owner of an ICBC insured vehicle
- A member of the vehicle owner’s household;
- A resident of BC who has been properly issued a valid driver’s license and members of that persons household;
- An occupant of a vehicle licensed in BC;
- An occupant of a vehicle not required to be licensed in BC, but is operated by a person properly issued a valid BC driver’s license;
- A cyclist or pedestrian who collides with an ICBC insured vehicle; or
- A resident of BC who is entitled to bring an action as a result of a hit-and-run or accident with an underinsured motorist.
What is a tort claim?
A tort is an injury claim. In the case of motor vehicle accidents, the most common tort is negligence.
Anyone injured in a motor vehicle accident can make a tort claim, provided they can prove that someone else was at least partially at fault. To receive any compensation, the injured party must also prove that he or she suffered damages as a result of the accident.
Damages may include:
- Pain and suffering (also called loss of enjoyment of life);
- Cost of future care;
- Out of pocket expenses;
- Past wage loss; and
- Loss of future earning capacity
You must file a tort claim within the two-year limitation period.
Who qualifies for No Fault Benefits?
To qualify for No Fault Benefits, you must be considered an “insured” by the standards of the Regulations to the Insurance (Vehicle) Act. An insured is defined as:
- an owner of a vehicle;
- a member of a vehicle owner’s household;
- an occupant of a vehicle licensed in British Columbia or an occupant of a vehicle not required to be licensed in British Columbia but driven by someone who possesses a valid BC driver’s licence;
- a cyclist or pedestrian who collides with a vehicle described in an owner’s certificate;
- a resident of British Columbia who is entitled to bring an action for injury or death as a result of an uninsured motorist or a hit-and-run accident;
- the personal representative of a deceased insured; or
- a resident of British Columbia who holds a valid driver’s licence and members of his or her household.
If I am at fault for a motor vehicle accident, am I entitled to any compensation?
Under Part 7 of the Regulations to the Insurance (Vehicle) Act, certain No Fault Benefits are available to individuals involved in a motor vehicle accident regardless of who is liable for the accident.
You may be entitled to compensation for temporary total disability and rehabilitation costs—even in an accident for which you are responsible.
Keep in mind that ICBC’s contractual obligations to provide you with compensation as part of your No Fault Benefits are separate from any compensation you may be entitled to against the “at fault” party responsible for your injuries.
How do I claim No Fault Benefits?
To claim No Fault Benefits, you must:
- promptly give ICBC notice of the accident;
- give ICBC with a written report or statement of the accident no later than 30 days from the date of the accident; and
- give ICBC a completed Application for Benefits (known as a CL 22) within 90 days of the accident.
If I have extended health coverage, do I still qualify for No Fault Benefits?
No Fault Benefits are secondary benefits. You must first submit expenses to any extended health plan from which you may receive coverage.The balance of any expenses that are not covered by the extended health plan can be submitted to ICBC for reimbursement.
What kinds of No Fault Benefits are available to me?
In general, there are three types of No Fault Benefits:
- Medical and Rehabilitative benefits;
- Disability benefits (i.e. wage loss); and
- Death benefits.
What kinds of medical and rehabilitative benefits are available to me?
ICBC is required by law—documented in the Regulations to the Insurance (Vehicle) Act—to pay “all reasonable expenses the insured incurred as a result of the injury for necessary medical, surgical, dental, hospital, ambulance, professional nursing services, physical therapy, chiropractic treatment, occupational therapy, speech therapy, or for a prosthesis or orthosis.”
However, with respect to massage therapy and physiotherapy, ICBC’s coverage is limited to:
- no more than twelve physiotherapy treatments, unless a medical practitioner certifies in writing that more treatment is necessary; and
- no more than twelve massage therapy treatments in the first eight weeks after the accident.
In order to claim medical and rehabilitative benefits, you must obtain a note from your family physician recommending the treatment and show this note to your ICBC adjuster.
Other forms of injury treatment not be covered by MSP (such as psychological counselling) are generally considered discretionary and may also be funded by ICBC if recommended by a primary care professional like a family physician.
What kinds of disability benefits are available to me?
If you were employed at the time of the accident and your injuries prevent you from doing your job within twenty days of the date of the accident, ICBC will pay you the lesser of:
- $300.00 per week; or
- 75% of your average gross weekly earnings in the twelve months immediately preceding the date of the accident.
To qualify for these disability benefits, you must either:
- be employed or actively working at the time of the accident; or
- be employed or actively working for any six months during the twelve months immediately preceding the date of the accident.
To claim these disability benefits, you must obtain a note from your family physician, confirming that you are totally disabled from your employment as a result of the accident. You must also give the adjuster reasonably sufficient documentation confirming your employment (i.e.: record of employment, pay stubs, tax returns, etc.).
No disability benefits are payable for the first seven days after the date of the accident. Once payable, benefits will be paid for either the duration of your disability from employment, or for 104 weeks—whichever is the shorter period.
Because No Fault Benefits are considered to be “secondary benefits”, you must apply for employment insurance, or any short-term disability benefits to which you may have access. This includes disability plans that may be available to you through your employment or through a spouse’s employment.
Do I qualify for disability benefits if I was not working at the time of the accident?
If you were a “homemaker” at the time of the accident, and your injuries disable you from performing most of your household tasks within twenty days of the date of the accident, you are entitled to receive compensation from ICBC. This is to cover reasonable expenses incurred to hire a person to perform the chores you are incapable of performing—up to a maximum of $145 per week. These benefits are not payable when the chores are instead performed by a member of your household.
No benefits are payable for the first seven days after the date of the accident. If you remain disabled at the end of 104 weeks, the benefits will continue for the duration of the disability or until you turn 65, whichever is the shorter period.
What kind of death benefits are available to the family of a deceased individual?
The following death benefits are available:
- Burial and funeral expenses up to a maximum of $2,500 per insured;
- Lump sum payments to the surviving spouse, dependant child, or dependant parent, based on the age and status of the deceased (ranging from $500 for a deceased dependant child less than five years of age to $5,000 for a deceased head of household); and
- Supplemental survivor benefits including $1,000 to each survivor (other than the first survivor) and $145 to the first survivor and $35 per week to each other survivor, for a period of 104 weeks after the death of the deceased insured.