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Difference between revisions of "ICBC and Basic Coverage (12:III)"
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ICBC and Basic Coverage (12:III) (view source)
Revision as of 18:54, 1 August 2023
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{{REVIEWED LSLAP | date= August | {{REVIEWED LSLAP | date= August 1, 2023}} | ||
{{LSLAP Manual TOC|expanded = ICBC}} | {{LSLAP Manual TOC|expanded = ICBC}} | ||
{{LSLAP 12 New System Notice}} | {{LSLAP 12 New System Notice}} | ||
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== B. Enhanced Accident Benefits == | == B. Enhanced Accident Benefits == | ||
Enhanced Accident Benefits are provided as part of basic coverage | Enhanced Accident Benefits are provided as part of basic coverage and are outlined under Part 10 of the ''Insurance (Vehicle) Act'' [''IVA'']. These benefits apply to accidents on or after May 1, 2021, “in which there is bodily injury caused by a vehicle” (''IVA'' ss 113 and 114(1)). These benefits are awarded on a no-fault basis, which means that they are paid directly by the insurer to the insured, irrespective of the fault of the insured (''IVA'', s 117). This also means that, under the new system, there is no longer a right of action (an ability to bring a lawsuit for damages against the other party) for injury arising from a vehicle accident (''IVA'', s 115). There are a few limited exceptions to this bar on actions for injury from a vehicle accident, which are outlined in [[When You Can Still Sue (12:VII)|Section VII: When You Can Still Sue]]. | ||
=== 1. Entitlement to Enhanced Benefits for BC Residents vs. Non-Residents === | === 1. Entitlement to Enhanced Benefits for BC Residents vs. Non-Residents === | ||
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====a) Healthcare and Rehabilitation ==== | ====a) Healthcare and Rehabilitation ==== | ||
These benefits cover healthcare and rehabilitation for those injured in a vehicle accident. These are available on a no-fault basis | These benefits cover healthcare and rehabilitation for those injured in a vehicle accident. These are available on a no-fault basis and are typically paid directly by ICBC to your medical provider (though this is not always the case). | ||
An insured party is entitled to the following treatments if needed to treat the injury in the 12 weeks after their accident: acupuncture, chiropractic, kinesiology, massage therapy, physiotherapy, counselling, and psychology. Note that there are certain prescribed fee and appointment quantity caps for each of these treatments, which vary depending on the treatment type (see ''Enhanced Accident Benefits Regulation'', s 19, Table 1). Once the 12-week post-accident period and/or the number of pre-authorized appointments have elapsed, the insured must show that additional treatment is needed either, “to facilitate the insured’s recovery from the insured’s bodily injury” (''EABR'', s 19(a)), or to, “address a decline in the insured’s physical or mental function because of the insured’s bodily injury” (''EABR'', s 19(b)). | An insured party is entitled to the following treatments if needed to treat the injury in the 12 weeks after their accident: acupuncture, chiropractic, kinesiology, massage therapy, physiotherapy, counselling, and psychology. Note that there are certain prescribed fee and appointment quantity caps for each of these treatments, which vary depending on the treatment type (see ''Enhanced Accident Benefits Regulation'', s 19, Table 1). Once the 12-week post-accident period and/or the number of pre-authorized appointments have elapsed, the insured must show that additional treatment is needed either, “to facilitate the insured’s recovery from the insured’s bodily injury” (''EABR'', s 19(a)), or to, “address a decline in the insured’s physical or mental function because of the insured’s bodily injury” (''EABR'', s 19(b)). | ||
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====c) Income Replacement Benefit==== | ====c) Income Replacement Benefit==== | ||
Income replacement benefits are available to full-time, part-time and temporary earners in certain prescribed circumstances, as well as to certain non-earners (''IVA'', ss 131-134). The entitlement amount is, “90% of the insured’s net income” (''Income Replacement and Retirement Benefits and Benefits for Students and Minors Regulation'', BC Reg 60/2021, s 2(1) [''IRR'']), as calculated by certain formulas specified in the regulation. This amount of net income that can be used for calculation is up to a maximum of $100,000, effective until March 31, 2022. This cap will change on a yearly basis beginning on April 1, 2022 (''IRR'', ss 2(2) and (3)). | Income replacement benefits are available to full-time, part-time and temporary earners in certain prescribed circumstances, as well as to certain non-earners (''IVA'', ss 131-134). The entitlement amount is, “90% of the insured’s net income” (''Income Replacement and Retirement Benefits and Benefits for Students and Minors Regulation'', BC Reg 60/2021, s 2(1) [''IRR'']), as calculated by certain formulas specified in the regulation. This amount of net income that can be used for calculation is up to a maximum of $100,000, effective until March 31, 2022. This cap will change on a yearly basis beginning on April 1, 2022, in which the amount is obtained by multiplying $100,000 by the ratio between (a) the sum of the industrial average wage for each of the 12 months before October 1 of the year preceding the year for which the amount of the maximum yearly insurable earnings is calculated, and (b) the same sum for each of the 12 months before October 1, 2020 (''IRR'', ss 2(2) and (3)). | ||
As set out in the ''Income Replacement and Retirement Benefits and Benefits for Students and Minors Regulation'', s 1(1), full-time, part-time and temporary earners are defined as follows: | As set out in the ''Income Replacement and Retirement Benefits and Benefits for Students and Minors Regulation'', s 1(1), full-time, part-time and temporary earners are defined as follows: | ||
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Indemnification is also provided for, “reasonable expenses incurred by the insured for loss of use in relation to the eligible vehicle in respect of the following: (a) hiring passenger directed vehicles; (b) using public transportation; (c) renting a substitute vehicle that is similar to the eligible vehicle, with the corporation's approval; [and] (d) using other alternative transportation with the corporation's approval” (''BVDCR'', s 18(2)), though this indemnification for passenger directed vehicles and public transportation does not apply if these expenses, “exceed expenses that would have been indemnified for renting a substitute vehicle that is similar to the eligible vehicle” (''BVDCR'', s 18(3)). | Indemnification is also provided for, “reasonable expenses incurred by the insured for loss of use in relation to the eligible vehicle in respect of the following: (a) hiring passenger directed vehicles; (b) using public transportation; (c) renting a substitute vehicle that is similar to the eligible vehicle, with the corporation's approval; [and] (d) using other alternative transportation with the corporation's approval” (''BVDCR'', s 18(2)), though this indemnification for passenger directed vehicles and public transportation does not apply if these expenses, “exceed expenses that would have been indemnified for renting a substitute vehicle that is similar to the eligible vehicle” (''BVDCR'', s 18(3)). | ||
==D. Basic Third Party Liability== | ==D. Basic Third-Party Liability== | ||
The basic theoretical principle behind third party liability insurance is that it is meant to indemnify the insured for claims that may be brought against them by someone else. Under the no-fault system, care for injuries is provided directly by the insurer to the injured party, as outlined above. However, there are still certain instances where an insured party may find themselves facing a claim from another party in an accident, such as when the insured causes non-vehicle property damage, or is driving outside BC in a jurisdiction where the other party is entitled to sue. | The basic theoretical principle behind third party liability insurance is that it is meant to indemnify the insured for claims that may be brought against them by someone else. Under the no-fault system, care for injuries is provided directly by the insurer to the injured party, as outlined above. However, there are still certain instances where an insured party may find themselves facing a claim from another party in an accident, such as when the insured causes non-vehicle property damage, or is driving outside BC in a jurisdiction where the other party is entitled to sue. | ||
This third party liability coverage, included as part of basic mandatory vehicle coverage, provides indemnity for this sort of property damage, as well as for injury or death that occurs in other jurisdictions in Canada or the United States, with certain specified exceptions (''IVR'', s 64). This indemnity for basic third party liability is capped at $200,000 for most vehicles, with higher limits for buses, taxis and limousines (''IVR'', Schedule 3, s 1(1.1)). | This third-party liability coverage, included as part of basic mandatory vehicle coverage, provides indemnity for this sort of property damage, as well as for injury or death that occurs in other jurisdictions in Canada or the United States, with certain specified exceptions (''IVR'', s 64). This indemnity for basic third-party liability is capped at $200,000 for most vehicles, with higher limits for buses, taxis, and limousines (''IVR'', Schedule 3, s 1(1.1)). | ||
==E. Uninsured Motorists == | ==E. Uninsured Motorists == | ||
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Underinsured motorist protection provides damages for injury or death in circumstances in which the other party to the accident, “is legally liable for the injury or death of an insured but is unable, when the injury or death occurs, to pay the full amount of damages recoverable by the insured or his personal representative in respect of the injury or death” (''IVR'', s 148.1(1)). In such cases, ICBC will, “compensate the insured, or a person who has a claim in respect of the death of the insured, for any amount he is entitled to recover from the underinsured motorist as damages for the injury or death” (''IVR'', s 148.1(2)). | Underinsured motorist protection provides damages for injury or death in circumstances in which the other party to the accident, “is legally liable for the injury or death of an insured but is unable, when the injury or death occurs, to pay the full amount of damages recoverable by the insured or his personal representative in respect of the injury or death” (''IVR'', s 148.1(1)). In such cases, ICBC will, “compensate the insured, or a person who has a claim in respect of the death of the insured, for any amount he is entitled to recover from the underinsured motorist as damages for the injury or death” (''IVR'', s 148.1(2)). | ||
Circumstances in which underinsured motorist protection would apply are uncommon under the new no-fault system | Circumstances in which underinsured motorist protection would apply are uncommon under the new no-fault system but could arise in situations where the insured doesn’t have access to compensation for injury under Enhanced Care and the other driver is liable for the accident but is underinsured. | ||
The amount of coverage for underinsured motorist protection is capped at $1 million (''IVR'', Schedule 3, s 13). | The amount of coverage for underinsured motorist protection is capped at $1 million (''IVR'', Schedule 3, s 13). | ||
