Disputes with ICBC (12:VI): Difference between revisions

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{{REVIEWED LSLAP | date= August 2, 2022}}
{{REVIEWED LSLAP | date= August 6, 2024}}
{{LSLAP Manual TOC|expanded = ICBC}}
{{LSLAP Manual TOC|expanded = ICBC}}
{{LSLAP 12 New System Notice}}
{{LSLAP 12 New System Notice}}


If you have an issue with the outcome of your claim or with how it was decided, there are processes available to dispute your claim. Different procedures apply to different types of claim disputes. The following outlines the remedies for some common types of disputes that may arise with ICBC. '''''This section should be used with caution, as at the time of writing certain parts of the ICBC dispute process''''' (minor injury disputes, and liability and damages disputes) '''''were under review at the BC Court of Appeal.'''''
If you have an issue with the outcome of your claim or with how it was decided, there are processes available to dispute your claim. Different procedures apply to different types of claim disputes. The following outlines the remedies for some common types of disputes that may arise. '''This section should be used with caution as certain parts of the ICBC dispute process have been the subject of litigation in BC and may continue to be reviewed'''.


==A. Minor Injury Determination Disputes==
==A. Minor Injury Determination Disputes==
If your injury is classified as a minor injury, this places a cap on the amount on non-pecuniary damages that you can access (''IVA'', s 103(2)). Minor injury has a specific legal meaning, and is defined in s 101(1) of the ''IVA'' as: “a physical or mental injury, whether or not chronic, that
Non-pecuniary damages are capped for minor injuries (''IVA'', s 103(2)). Minor injury has a specific legal meaning, and is defined in s 101(1) of the ''IVA'' as: “a physical or mental injury, whether or not chronic, that
:(a) subject to subsection (2), does not result in a serious impairment [(defined in s 101(1) of the ''IVA'')] or a permanent serious disfigurement [(defined in s 101(1) of the ''IVA'')] of the claimant, and
:(a) Subject to subsection (2), does not result in a serious impairment [(defined in s 101(1) of the ''IVA'')] or a permanent serious disfigurement [(defined in s 101(1) of the ''IVA'')] of the claimant, and
:(b) is one of the following:
:(b) Is one of the following:
::(i) an abrasion, a contusion, a laceration, a sprain or a strain;
::(i) An abrasion, a contusion, a laceration, a sprain or a strain;
::(ii) a pain syndrome;
::(ii) A pain syndrome;
::(iii) a psychological or psychiatric condition;
::(iii) A psychological or psychiatric condition;
::(iv) a prescribed injury or an injury in a prescribed type or class of injury;[(defined in s 1(1) of the ''Minor Injury Regulation'')]
::(iv) A prescribed injury or an injury in a prescribed type or class of injury;[(defined in s 1(1) of the ''Minor Injury Regulation'')].
   
   
Minor injury classifications may be disputed either internally, by speaking with your claim representative and their manager, or by making an application to the Civil Resolution Tribunal (CRT) to adjudicate on the matter. Note that ICBC does not make further information publicly available about the process or deadlines for disputing a determination internally.
Minor injury classifications may be disputed either internally, by speaking with your claim representative and their manager, or by making an application to the Civil Resolution Tribunal (CRT) to adjudicate on the matter. Note that ICBC does not make further information publicly available about the process or deadlines for disputing a determination internally.


The CRT is an independent administrative tribunal, authorized by the Civil Resolution Tribunal Act to adjudicate on minor injury determination, among other matters. The CRT process does not involve legal representation, and use of the CRT to resolve these disputes is meant to cut legal costs for all parties, although certain parties who require assistance can apply to have a helper or advocate to assist them in the tribunal process. For more details on the CRT, see Chapter 20 of the LSLAP Manual on the CRT and its procedures: https://www.lslap.bc.ca/manual.html
The CRT is an independent administrative tribunal, authorized by the Civil Resolution Tribunal Act to adjudicate on minor injury determination, among other matters. The CRT process does not involve legal representation, although certain parties who require assistance can apply to have a helper or advocate to assist them in the tribunal process. For more details on the CRT, see the LSLAP Manual on the CRT and its procedures.


'''Note:''' As of June 2022, the BC Court of Appeal has upheld the CRT’s authority to adjudicate on minor injury determinations as being constitutional (''Trial Lawyers Association of British Columbia v. British Columbia (Attorney General)'', 2022 BCCA 163 (CanLII)). This case may ultimately be brought before the Supreme Court of Canada in the future, but as of now the CRT has jurisdiction on minor injury determinations below $50,000.
'''Note:''' As of June 2022, the BC Court of Appeal has upheld the CRT’s authority to adjudicate on minor injury determinations as being constitutional (See [https://www.canlii.org/en/bc/bcca/doc/2022/2022bcca163/2022bcca163.html?autocompleteStr=Trial%20Lawyers%20Association%20of%20British%20Columbia%20v.%20British%20Columbia%20(Attorney%20General)%2C%202022%20BCCA%20163&autocompletePos=1&resultId=53077f2097974176ad581364b0c538df&searchId=2024-08-06T14:34:21:087/6d0f24375a154da1b76b3fb5abdec406 ''Trial Lawyers Association of British Columbia v. British Columbia (Attorney General)'', 2022 BCCA 163 (CanLII)]). The Supreme Court of Canada denied the application for leave to appeal in [https://www.canlii.org/en/ca/scc-l/doc/2022/2022canlii121522/2022canlii121522.html?autocompleteStr=Trial%20Lawyers%20Association%20of%20British%20Columbia%2C%20et%20al.%20v.%20Attorney%20General%20of%20British%20Columbia%2C%20et%20al.%2C%202022%20CanLII%20121522%20(SCC)&autocompletePos=1&resultId=3066786b08974ebb94f30d795dab0520&searchId=2024-08-06T14:37:22:176/4c1382948b5a4090a7c0e6cc10be2ae4 ''Trial Lawyers Association of British Columbia, et al. v. Attorney General of British Columbia, et al.'', 2022 CanLII 121522 (SCC)]. Thus, the CRT has jurisdiction on minor injury determinations below $50,000.


==B. Liability And Damages Disputes==
==B. Liability And Damages Disputes==
Following an accident claim, ICBC will compile information from various sources to determine liability. Per ICBC’s website, this internal process includes gathering information from other drivers, witnesses, or police reports, as well as conducting comparisons with similar accidents, or determining if there are any Motor Vehicle Act violations. Generally, this process results in a finding of partial, full or no fault in relation to the accident (i.e. the insured’s degree of liability).  
Following an accident claim, ICBC will compile information from various sources to determine liability. Per ICBC’s website, this internal process includes gathering information from other drivers, witnesses, or police reports, as well as conducting comparisons with similar accidents, or determining if there are any Motor Vehicle Act violations.  


Disputes about a finding of liability can be made internally through ICBC’s Claims Assessment Review process, in which an independent arbitrator reviews the liability decision. Per the ICBC website, an insured has ''60 days'' after the initial decision within which to submit a Claims Assessment Review application, although ICBC may change this internal deadline, so it is always best to confirm the deadline as soon as possible.
In circumstances where a person is found to be more than 25% responsible for an accident, it is often worth it to dispute a questionable liability feeling, because often times being more than 25% responsible for an accident will result in an increase in insurance premiums.


Disputes about liability or damage assessments can also be disputed in certain circumstances by making an application to the CRT to adjudicate on the matter. The CRT has jurisdiction over liability and damages in cases where an accident occurred in BC, and was, “caused by a vehicle or the use or operation of a vehicle as a result of which a person suffers bodily injury” (''IVA'', s 101) and where the total damage amount is less than or equal to $50,000 (note that this damage cap to fall within CRT jurisdiction is, “including loss or damage to property related to the accident but excluding interest and any expenses referred to under section 49” of the ''CRT Act'') (''CRT Act'', s 133(1)(c)).
The first step is for the insured to speak with the claims representative on their file to ensure that no information was missed when the claim was filed or when the assessment was made. The second step is to request a secondary review by emailing responsibility.review@icbc.com (please note that this email address may change; please refer to ICBC’s website for an update to date contact). This must be done within 90 days of receiving the initial notification of responsibility. The secondary reviewer will contact the insured to discuss their claim and provide them, in writing, a detailed responsibility assessment.


'''Note:''' See previous note about CRT above.
If an insured is not satisfied with the detailed responsibility assessment, they can then proceed to file a dispute with the CRT. As per the ICBC website, the deadline to file in most cases is 90 days after the date on the insured’s detailed responsibility assessment. The CRT has jurisdiction over liability and damages in cases where an accident occurred in BC, and was “caused by a vehicle or the use or operation of a vehicle as a result of which a person suffers bodily injury” (''IVA'', s 101) and where the total damage amount is less than or equal to $50,000 (note that this damage cap to fall within CRT jurisdiction is, “including loss or damage to property related to the accident but excluding interest and any expenses referred to under section 49” of the ''CRT Act'') (''CRT Act'', s 133(1)(c)).


==C. Disputing Denied Benefits (in relation to Parts 1 AND 10 of the IVA)==
An insured may also elect to dispute a responsibility assessment in Small Claims Court or BC Supreme Court. However, these processes tend to be slower and take longer than the CRT.


Disputes in relation to denied accident benefits can be handled by making an application to the CRT to adjudicate on the matter. This applies to benefits denied under Part 1 or Part 10 of the ''IVA'' (''CRT Act'', s 132(b)).
'''Note:''' See previous note about CRT above. Disputes in relation to denied accident benefits, in relation to Parts 1 and 10 of the ''IVA'', can be handled by making an application to the CRT to adjudicate the matter (''CRT Act''. s 132(b)).


'''Note:''' The case of ''Trial Lawyers Association of British Columbia v British Columbia (Attorney General)'', mentioned above, did not strike down the CRT’s ability to adjudicate on disputes regarding denied benefits. As such, unlike minor injury and liability/damages disputes, parties cannot choose whether to bring their denied benefits disputes before either a court or the CRT, and ''must bring these disputes before the CRT.''
'''Note:''' Unlike minor injury and liability/damages disputes, parties cannot choose whether to bring their denied benefits disputes before either a court or the CRT, and must bring these disputes before the CRT ([https://www.canlii.org/en/bc/bcca/doc/2022/2022bcca163/2022bcca163.html?autocompleteStr=Trial%20Lawyers%20Association%20of%20British%20Columbia%20v.%20British%20Columbia%20(Attorney%20General)%2C%202022%20BCCA%20163&autocompletePos=1&resultId=53077f2097974176ad581364b0c538df&searchId=2024-08-06T14:34:21:087/6d0f24375a154da1b76b3fb5abdec406 ''Trial Lawyers Association of British Columbia v. British Columbia (Attorney General)'', 2022 BCCA 163 (CanLII)]).


Disputes about denied accident benefits may also be made internally through ICBC’s Claims Decision Review process. However, ICBC does not provide public information on the process or deadlines for this. Speak directly to your ICBC representative for more information about options for disputing denied benefits internally.
Disputes about denied accident benefits may also be made internally through ICBC’s Claims Decision Review process. However, ICBC does not provide public information on the process or deadlines for this. Speak directly to your ICBC representative for more information.


==D. Disputes About Basic Vehicle Damage Coverage==
==C. Disputes About Basic Vehicle Damage Coverage==
Disputes related to Basic Vehicle Damage Coverage ([[ICBC and Basic Coverage (12:III)|see Section III(B): Basic Vehicle Damage Coverage]]) can be resolved either internally between the insured and ICBC, or through arbitration. This applies to disputes about:
Disputes related to Basic Vehicle Damage Coverage ([[ICBC and Basic Coverage (12:III)|see Section III.C: Basic Vehicle Damage Coverage]]) can be resolved either internally between the insured and ICBC, or through arbitration. This applies to disputes about:
<blockquote>(a) the nature and extent of required repairs or replacement,
(b) the value of the damage to or loss of the eligible vehicle, or


(c) the price received, or the estimated price that would have been received, from the sale of the damaged eligible vehicle.  
:(a) The nature and extent of required repairs or replacement;
(''BVDCR'', s 28) </blockquote>
:(b) The value of the damage to or loss of the eligible vehicle; or
:(c) The price received, or the estimated price that would have been received, from the sale of the damaged eligible vehicle (''BVDCR'', s 28).
 
This arbitration process must follow the ''Arbitration Act'', as well as the rules laid out in s 28-32 of the ''Basic Vehicle Damage Coverage Regulation''. ''There is a two-year limitation date from the date of the accident to submit for arbitration'' (''BVDCR'', s 29(2)).
 
==D. Disputes About Enhanced Accident Benefits==
An insured may dispute ICBC’s assessment of whether a benefit applies to their circumstances. These disputes may be resolved internally or through arbitration, consistent with the Arbitration Act (''IVR'', s 89). For ICBC to be required to invoke the arbitration process, certain conditions must be met (''Wichert v Insurance Corporation of British Columbia'' (1987), 22 CCLI 165 (BCCA)):
1) There is a claim involving the payment of an expense
2) ICBC decided the payment of that expense as a benefit would be unreasonable
3) ICBC communicated this decision to the claimant
4) The claimant disputes ICBC’s decision


This arbitration process must follow the ''Arbitration Act'', as well as the rules laid out in ss 28-32 of the ''Basic Vehicle Damage Coverage Regulation''. ''There is a two-year limitation date from the date of the accident to submit for arbitration'' (''BVDCR'', s 29(2)).




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Latest revision as of 17:46, 7 August 2024

This information applies to British Columbia, Canada. Last reviewed for legal accuracy by the Law Students' Legal Advice Program on August 6, 2024.



NOTE: The following portion of this chapter is meant to serve as a basic primer covering some of the key principles of the new ICBC system, which applies to claims for accidents occurring on or after May 1, 2021. Given that this no-fault system is new as of May 1, 2021, there are still certain portions of it that are being clarified, or that may adapt with implementation.

If you have an issue with the outcome of your claim or with how it was decided, there are processes available to dispute your claim. Different procedures apply to different types of claim disputes. The following outlines the remedies for some common types of disputes that may arise. This section should be used with caution as certain parts of the ICBC dispute process have been the subject of litigation in BC and may continue to be reviewed.

A. Minor Injury Determination Disputes

Non-pecuniary damages are capped for minor injuries (IVA, s 103(2)). Minor injury has a specific legal meaning, and is defined in s 101(1) of the IVA as: “a physical or mental injury, whether or not chronic, that

(a) Subject to subsection (2), does not result in a serious impairment [(defined in s 101(1) of the IVA)] or a permanent serious disfigurement [(defined in s 101(1) of the IVA)] of the claimant, and
(b) Is one of the following:
(i) An abrasion, a contusion, a laceration, a sprain or a strain;
(ii) A pain syndrome;
(iii) A psychological or psychiatric condition;
(iv) A prescribed injury or an injury in a prescribed type or class of injury;[(defined in s 1(1) of the Minor Injury Regulation)].

Minor injury classifications may be disputed either internally, by speaking with your claim representative and their manager, or by making an application to the Civil Resolution Tribunal (CRT) to adjudicate on the matter. Note that ICBC does not make further information publicly available about the process or deadlines for disputing a determination internally.

The CRT is an independent administrative tribunal, authorized by the Civil Resolution Tribunal Act to adjudicate on minor injury determination, among other matters. The CRT process does not involve legal representation, although certain parties who require assistance can apply to have a helper or advocate to assist them in the tribunal process. For more details on the CRT, see the LSLAP Manual on the CRT and its procedures.

Note: As of June 2022, the BC Court of Appeal has upheld the CRT’s authority to adjudicate on minor injury determinations as being constitutional (See Trial Lawyers Association of British Columbia v. British Columbia (Attorney General), 2022 BCCA 163 (CanLII)). The Supreme Court of Canada denied the application for leave to appeal in Trial Lawyers Association of British Columbia, et al. v. Attorney General of British Columbia, et al., 2022 CanLII 121522 (SCC). Thus, the CRT has jurisdiction on minor injury determinations below $50,000.

B. Liability And Damages Disputes

Following an accident claim, ICBC will compile information from various sources to determine liability. Per ICBC’s website, this internal process includes gathering information from other drivers, witnesses, or police reports, as well as conducting comparisons with similar accidents, or determining if there are any Motor Vehicle Act violations.

In circumstances where a person is found to be more than 25% responsible for an accident, it is often worth it to dispute a questionable liability feeling, because often times being more than 25% responsible for an accident will result in an increase in insurance premiums.

The first step is for the insured to speak with the claims representative on their file to ensure that no information was missed when the claim was filed or when the assessment was made. The second step is to request a secondary review by emailing responsibility.review@icbc.com (please note that this email address may change; please refer to ICBC’s website for an update to date contact). This must be done within 90 days of receiving the initial notification of responsibility. The secondary reviewer will contact the insured to discuss their claim and provide them, in writing, a detailed responsibility assessment.

If an insured is not satisfied with the detailed responsibility assessment, they can then proceed to file a dispute with the CRT. As per the ICBC website, the deadline to file in most cases is 90 days after the date on the insured’s detailed responsibility assessment. The CRT has jurisdiction over liability and damages in cases where an accident occurred in BC, and was “caused by a vehicle or the use or operation of a vehicle as a result of which a person suffers bodily injury” (IVA, s 101) and where the total damage amount is less than or equal to $50,000 (note that this damage cap to fall within CRT jurisdiction is, “including loss or damage to property related to the accident but excluding interest and any expenses referred to under section 49” of the CRT Act) (CRT Act, s 133(1)(c)).

An insured may also elect to dispute a responsibility assessment in Small Claims Court or BC Supreme Court. However, these processes tend to be slower and take longer than the CRT.

Note: See previous note about CRT above. Disputes in relation to denied accident benefits, in relation to Parts 1 and 10 of the IVA, can be handled by making an application to the CRT to adjudicate the matter (CRT Act. s 132(b)).

Note: Unlike minor injury and liability/damages disputes, parties cannot choose whether to bring their denied benefits disputes before either a court or the CRT, and must bring these disputes before the CRT (Trial Lawyers Association of British Columbia v. British Columbia (Attorney General), 2022 BCCA 163 (CanLII)).

Disputes about denied accident benefits may also be made internally through ICBC’s Claims Decision Review process. However, ICBC does not provide public information on the process or deadlines for this. Speak directly to your ICBC representative for more information.

C. Disputes About Basic Vehicle Damage Coverage

Disputes related to Basic Vehicle Damage Coverage (see Section III.C: Basic Vehicle Damage Coverage) can be resolved either internally between the insured and ICBC, or through arbitration. This applies to disputes about:

(a) The nature and extent of required repairs or replacement;
(b) The value of the damage to or loss of the eligible vehicle; or
(c) The price received, or the estimated price that would have been received, from the sale of the damaged eligible vehicle (BVDCR, s 28).

This arbitration process must follow the Arbitration Act, as well as the rules laid out in s 28-32 of the Basic Vehicle Damage Coverage Regulation. There is a two-year limitation date from the date of the accident to submit for arbitration (BVDCR, s 29(2)).

D. Disputes About Enhanced Accident Benefits

An insured may dispute ICBC’s assessment of whether a benefit applies to their circumstances. These disputes may be resolved internally or through arbitration, consistent with the Arbitration Act (IVR, s 89). For ICBC to be required to invoke the arbitration process, certain conditions must be met (Wichert v Insurance Corporation of British Columbia (1987), 22 CCLI 165 (BCCA)): 1) There is a claim involving the payment of an expense 2) ICBC decided the payment of that expense as a benefit would be unreasonable 3) ICBC communicated this decision to the claimant 4) The claimant disputes ICBC’s decision


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