Getting the Most Out of Your ICBC Part 7 Benefits
When British Columbia committed to a no-fault auto insurance model in the early 1970s, the government created the Insurance Corporation of British Columbia (ICBC) as the mandatory insurer for every motorist in the province. The basic coverage for medical, rehabilitation and wage loss benefits is collectively known as Part 7 benefits. Additional coverage can be purchased to work around the benefit limits that apply under the basic coverage, but in theory at least, the ICBC Part 7 benefits are to be paid without regard to negligence or fault in each injury accident case.
Protecting Your Right to Medical Treatment and Rehabilitation Services
Medical and rehabilitation benefits are to be paid for all "reasonable" and "necessary" costs up to $150,000 under the basic coverage. As you can imagine, what is reasonable and what is necessary in the view of an ICBC adjuster can often come into dispute. If you're concerned about the adequacy of the medical treatment and rehabilitative services that you or a family member is receiving after a motor vehicle accident, contact Murphy Battista for a free consultation about your right to full payment.
In claims involving serious injuries suffered in motor vehicle accidents, the basic limit of $150,000 will probably fall short of what you need for weeks or months in hospital, additional time in a convalescent centre or nursing home, and follow-up treatment or additional surgery. Our lawyers know how to effectuate the provisions of the ICBC regulations that can cover additional treatment needs. More frequently, we are called upon to convince ICBC that its adjusters have understated an accident victim's needs or have arbitrarily limited benefits on the basis of doubtful assumptions.
Be aware that ICBC has significantly greater discretion for the payment of rehabilitation services than it does for medical treatment. The lawyers at Murphy Battista have decades of experience with the proof of claims over an adjuster's objection based on our ability to present a strong case for the necessity of a particular rehabilitative service.
Understanding Wage Benefits Under ICBC Regulations
If a covered injury prevents you from working, getting timely access to wage benefits under the ICBC system can be difficult. There is a seven-day waiting period before you become eligible, and other qualifications must also be met. The key issue in a claim for lost wages is whether the injury resulted in a Total Temporary Disability, or TTD.
The legal standard for determining disability is not whether you are entirely incapacitated from working — instead, it's whether you are unable to perform "any substantial requirement" of your ordinary job. The lawyers at Murphy Battista know how to develop and present proof of TTD rights whenever the ICBC adjuster resists payment of benefits for lost wages on the basis of disability.
Part 7 wage benefits are calculated at 75 percent of average weekly earnings, with a maximum of $300 per week under the basic coverage. Persons with higher incomes can buy optional additional coverage to protect higher wages or salaries. Those covered under private or group disability plans must exhaust those benefits before the TTD benefits are payable. TTD benefits can also supplement private wage protection, provided that the total amount received does not exceed 75 percent of average weekly earnings based on the previous 52 weeks.
Questions About British Columbia No-Fault Benefits? Call 866-315-5694
Many other detailed provisions of the ICBC Part 7 regulations apply to different aspects of an injured person's claims for medical treatment, rehabilitation services and lost wages. Coordinating these benefits with private insurance plans can also raise complex questions. For dependable advice about the full range of your rights to ICBC Part 7 benefits, contact Murphy Battista for a free consultation.
