Does ICBC have to pay for my treatment?

Many people do not realize they are entitled to benefits from ICBC regardless of whether they are at fault for an accident or not. When you have been injured in a motor vehicle accident, Part 7 of the Insurance (Vehicle) Regulations creates an obligation for ICBC to fund treatments including all necessary: medical, surgical, dental, hospital, ambulance or professional nursing services, or physical therapy, chiropractic treatment, occupational therapy or speech therapy or for prosthesis or orthosis. It is important to remember that ICBC has an obligation to pay these expenses, under various circumstances, to those injured in motor vehicle accidents. These payments are not discretionary and should not be used as bargaining chips.

Unfortunately ICBC does not need to pay for the entirety of these treatments. They are only obligated to pay for amounts set out in the Medicare Protection Act. The excess not covered by ICBC is often referred to as a “user fee”.

The injured party is initially responsible for payment of the user fee. However, if you have been injured by another party, and the court deems these expenses reasonable and necessary, the other party will ultimately be liable for these expenses. Other options for payment of user fees may include having extended health care pay for these expenses.  Many extended health care plans will cover treatment payments.  However, be aware that they may take a subrogated interest in these payments or simply treat them as a loan. The end effect is that the injured party then has an obligation to repay the extended health care provider.

An additional pitfall exists in that a lawsuit for medical benefits owing under Part 7 must be started against ICBC separately from the lawsuit against the driver of the vehicle who injured you. If a lawsuit is not started any amounts owed to you under Part 7 by ICBC can be deducted from a liability settlement against another driver.

Management of who pays what and what is owed gets very complicated quickly. As such, it may be best to hire a lawyer to recover benefits. When my clients come to me with a personal injury issues, I will also take care of issues related to securing benefits from ICBC.

 

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