5,109
edits
Difference between revisions of "ICBC and Basic Coverage (12:III)"
Jump to navigation
Jump to search
ICBC and Basic Coverage (12:III) (view source)
Revision as of 19:42, 8 August 2021
, 19:42, 8 August 2021no edit summary
| Line 22: | Line 22: | ||
Note that there may be other deadlines related to your Enhanced Accident Benefit claim not noted here. | Note that there may be other deadlines related to your Enhanced Accident Benefit claim not noted here. | ||
=== 3. Other Sources of Compensation:=== | |||
When awarding Enhanced Accident Benefits, ICBC will not pay a benefit that is available from another source as, “compensation for the same accident” (''IVA'', s 122(2)), although they may pay the difference between the Enhanced Accident Benefit and the other source. Other sources listed include those such as workers compensation, the Canada or Quebec Pension Plans, an employment or union plan, or other insurance (''IVR'', s 18(2)). Note that the above still applies even if the insured makes the choice not to access these other sources that are available to them. | |||
===4. Summary of Enhanced Accident Benefit Types:=== | |||
The following is a basic explanation of some of the Enhanced Accident Benefits included. Insured individuals should refer to their policy for more details, and up-to-date information. | |||
====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, 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)). | |||
Various prosthetics, other medical equipment and certain prescription and non-prescription medications are also covered by this benefit (''EABR'', ss 21(1) and (4), and s 23), as are, “ambulance services from the scene of the accident” in certain prescribed circumstances (''EABR'', s 20). | |||
Rehabilitation benefits are also available, “to contribute to the rehabilitation of an insured and to facilitate the insured's recovery from the insured's bodily injury” (''IVA'', s 124), which may include modifications to the insured’s home or vehicle (''EABR'', ss 24 and 25). In certain specified circumstances, compensation is also available to assist with the insured’s, “activities of daily living” (''IVA'', s 125(1)) which they could otherwise carry out before the accident. The amount of this benefit varies depending on the type of activity and the degree of assistance that the insured needs (see ''EABR'', ss 27-31 for detailed calculations). | |||
Certain transportation, lodging and meal expenses are also covered if required for the insured to receive care. Note that there are relatively strict requirements for reimbursement or coverage of such expenses, which can be reviewed in detail under ''EABR'' ss 32-34. | |||
Finally, in certain instances, reimbursement is also available to cover certain travel, lodging and meal expenses for an individual to travel to assist the insured. This applies in cases where an insured is under 16 years old, is in intensive care, requires “major healthcare” (defined in section 1 of the ''Health Care (Consent) and Care Facility (Admission) Act''), has a “life threatening” bodily injury, or when their life is in, “imminent danger” (''EABR'', s 35(2). The travel must be either: | |||
<blockquote>(a) to authorize treatment for the insured, | |||
(b) to assist the insured to make a decision respecting major health care, | |||
(c) to assist in the treatment of the insured’s bodily injury, or | |||
(d) to assist the insured on other medical or compassionate grounds. </blockquote> | |||
(''EABR'', s 35(3)) | |||
Note that there is a cap on the amount that ICBC will cover, and that they will only cover these expenses for up to two individuals (''IVA'' s 125(6) and ''EABR'' s 35(4)). | |||
For all of the above benefits, ''make sure to consult your policy closely to see which benefits require pre-approval from ICBC, and which do not.'' | |||
{{LSLAP Manual Navbox|type=chapters8-14}} | {{LSLAP Manual Navbox|type=chapters8-14}} | ||