How to get these benefits
In order to receive Part VII benefits, the injured person is required to give prompt notice to ICBC of the accident. In addition, within the 90 days of the accident, the person must complete an accident benefit claim form, setting out the injuries they sustained in the accident. ICBC has the right to request the injured person to undergo a medical examination “as often as it requires” to determine whether benefits are payable.
ICBC is required to pay weekly benefits within 4 weeks of receiving proof of claim, and in all other cases, within 60 days of receiving proof of claim. If ICBC improperly refuses to pay benefits, a lawsuit must be commenced within 2 years after the accident, or the last benefit payment.
For some injured people, Part VII benefits may be the best monetary help available. For innocent accident victims Part VII benefits provide a helpful first step in the sometimes long process of recovering all their losses in a tort claim.
What the benefits cover
- Income replacement
If a person’s injury disables them from working, after the first week of disability when nothing is payable, ICBC must pay up to $300/week as income replacement benefits until the person can work again. With permanent disability, income benefits are payable to age 65.
If a person qualifies for other disability income benefits (e.g. EI, CPP or group disability) they must apply for those. ICBC will then only pay the difference between the other benefits and the $300/week limit.1 Part VII benefits aren’t payable beyond 75% of the injured person’s pre-accident income.
If an injured person returns to work, but can’t earn as much as before because of their injuries, they may get reduced income benefits
Disabled homemakers can claim for hiring a person needed to do the work the homemaker can no longer do. The limit is $145/week, only payable in the first 2 years after the accident.
All of these benefits are subject to annual review by ICBC and may be terminated “on the advice of the corporation’s medical adviser.”
- Medical or rehabilitation benefits
As with income benefits, the injured person has to first apply for compensation from any and all other insurance policies they may be able to access. Part VII only kicks in if other insurance is inadequate or nonexistent.
If Part VII is called up, it’s benefits cover “all reasonable expenses incurred by the insured as a result of the injury for necessary medical, surgical, dental, hospital, ambulance or professional nursing services, or for necessary physical therapy, chiropractic treatment, occupational therapy or speech therapy or for prosthesis or orthosis.”
Some expenses which might not be obviously reimbursable are specifically listed – e.g. vocational training. Others, like an ICBC-approved wheelchair or renovations to make a home accessible, are singled out as reimbursable only once in a claimant’s lifetime.
Two other limitations:
- all significant expenses technically require the insured to obtain written approval from the corporation before incurring the expense, and
- there’s a lifetime limit for medical and rehabilitation expenses of $150,000.
III. Death benefits
Where an insured dies, the following benefits may be payable:
- burial and funeral expenses not exceeding $2,500.00;
- death benefits, based on the age of the person who died and whether they were “head of the household”, the spouse or a dependent child, ranging from $500 to $5,000;
- ongoing death benefits of $145/week and survivor’s death benefits of $35/week if the deceased is survived by a spouse and/or one or more dependents.
¹If a person qualifies for CPP benefits, only the amount of the first payment will be deducted. The amount of the annual CPP increases in benefits will not be deducted from Part VII benefits.
Excerpt from “ACCESS TO JUSTICE: Legal issues for the injured and people with disabilities,” written and produced by Faith Hayman, Barrister and Solicitor.
This is for informational purposes only and its contents are not intended nor should be considered to be legal advice.
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