{"id":7272,"date":"2019-08-26T10:02:23","date_gmt":"2019-08-26T17:02:23","guid":{"rendered":"http:\/\/www.brainstreams.ca\/?p=7272"},"modified":"2025-07-04T09:32:17","modified_gmt":"2025-07-04T16:32:17","slug":"icbcs-new-accident-benefits-coverage-what-you-need-to-know","status":"publish","type":"post","link":"https:\/\/messageinabottle.ca\/bcbia\/icbcs-new-accident-benefits-coverage-what-you-need-to-know\/","title":{"rendered":"ICBC’s New Accident Benefits Coverage: What you Need to Know."},"content":{"rendered":"

In 2017, there were 350,000 motor vehicle crashes in British Columbia that were reported to ICBC. Of those, 95,000 resulted in injuries to a driver, passenger, pedestrian or cyclist.<\/p>\n

ICBC identified that accessing medical treatment as soon as practically possible is crucial in these instances. Thus, they have improved Accident Benefits. They also changed the insurance process to ensure their top priority \u2014 you, their customer \u2014 get the care and support you need.<\/p>\n

Effective April 1st, 2019: <\/strong>Find all of the changes to the ICBC Accident Benefits coverage<\/a><\/u><\/strong> by clicking the link.<\/p>\n

Navigating the Fine Print of ICBC\u2019s New Accident Benefits Coverage<\/strong><\/h2>\n

BC Brain Injury Association (BCBIA)<\/strong>, a non-profit provincial organization in BC committed to improving the lives of people who live with acquire brain injury, recognizes that these changes will impact a significant number of people. We also know the claims process can be challenging to navigate. We can help. Having the right knowledge can make the difference in your claims process to ensure you receive all of the care and support \u2014 when you need it most.<\/p>\n

We have created a series of blog posts with user-friendly language to describe these changes. Our goal is to help individuals, especially ABI survivors and their supporters, navigate the new system.<\/p>\n

This first post is an introductory overview of the changes to ICBC\u2019s Accident Benefits. Below you will find answers to questions you may have about ICBC\u2019s new coverage and claims process. If you are a BC resident and were injured in a car crash after April 1st, 2019, this is everything you need to know.<\/p>\n

Future posts will focus on the different stages of the process – ranging from early days after the accident, to the middle of the process where treatment is taking place, to the end of the process where settlements are occurring.<\/p>\n

If I am in a crash, how will ICBC guide me through the process?<\/h2>\n

\"\"<\/p>\n

If you’ve been in a crash, you can\u00a0report your claim\u00a0online<\/a> or by phone.<\/p>\n

After you first report your crash, if you are injured, a Customer Claim Specialist will be assigned to you. ICBC representatives are available to answer your questions and guide you through your claim from start to finish.<\/p>\n

In some cases, a Customer Recovery Specialist may be assigned to provide additional recovery support.<\/p>\n

We will refer to these supports as your \u201cClaim Representative(s)\u201d in this article.<\/p>\n

If I am injured in a car crash after April 1st, how will my benefits change?”<\/h2>\n

\"\"<\/p>\n

ICBC\u2019s new benefit increases are in addition to the increase in overall allowance for medical care and recovery expenses (from $150,000 to $300,000) that took place in January 2018. For further information, please visit ICBC\u2019s web page on the new and increased benefits<\/a><\/u>.<\/p>\n

Other benefits have also increased,\u00a0such as disability payments for employed persons<\/a><\/u> and benefits to support you at home<\/a><\/u>. If you think you are eligible, please click on the links to read more.<\/p>\n

Will there be changes to treatment options available to me?<\/h2>\n

\"person<\/a><\/p>\n

Pre-Approved Treatments<\/u><\/h4>\n

Yes. ICBC now covers more types of pre-approved treatments, including: physiotherapy, chiropractic, massage therapy (RMT), kinesiology\/active rehab, psychological counselling, clinical counselling and acupuncture. You can seek care from these health care practitioners for pre-approved numbers of treatments<\/a> within the first 12 weeks following a crash without a written referral from a doctor.<\/p>\n

Choosing Your Healthcare Practitioner<\/u><\/h4>\n

ICBC does not currently have an approved, or preferred health care provider list. This allows you the flexibility of choosing your own healthcare practitioner. While ICBC wants to ensure continuity of care as much as possible, you may change your medical provider at any point during the recovery process.<\/p>\n

Fee Increase<\/u><\/h4>\n

Fees for pre-approved treatments that occur after April 1st<\/sup>, 2019 are now set at the fair market rate<\/a>. Pre-approved treatments include: physiotherapy, chiropractic, massage therapy (RMT), kinesiology\/active rehab, psychological counselling, clinical counselling and acupuncture. The updated fee increase is applicable to all claims regardless of when the accident occurred, and regardless of fault. This means that in most cases, crash survivors will not be out of pocket for treatment costs.<\/p>\n

Please note:<\/em><\/p>\n

Customers who seek treatment from healthcare practitioners who charge more than the regulated fees will not be able to recover their out of pocket expenses from ICBC. If you have extended or private health plan coverage, you can apply for reimbursement through your plan to cover excess cost of treatment sessions\u201d See the ICBC Recovery and Treatment Payment Guide<\/a><\/u> for information about submitting your receipts.<\/p>\n

Ongoing Treatment <\/u><\/h4>\n

If you require ongoing treatment beyond\u00a012 weeks after a crash, you or your healthcare practitioner may contact the Claim Representative. In most cases, a doctor\u2019s note is not required in advance of the approval for more treatment. To prevent gaps in the treatment plans, your healthcare practitioner can also request approval for additional treatments from the Claim Representative using a web-based application.<\/p>\n

How are additional treatments approved?<\/h2>\n

The Claim Representative will approve additional treatments when they are \u2018reasonable and necessary\u2019 to the recovery process. To help with the decision process, the Claim Representative may request additional information from your healthcare practitioner by way of a telephone conversation, or a reassessment report if required.<\/p>\n

Please note:<\/em><\/p>\n

Some treatment providers choose not to bill ICBC directly and may ask that you cover treatment costs and seek reimbursement by ICBC. ICBC will pay up to the established rates for treatments<\/a>. However, expenses must be submitted to the Claim Representative within 60 days of the treatment date of date the expense was occurred.<\/strong><\/p>\n

What is the definition of a minor injury?<\/h2>\n

\"\"<\/p>\n

ICBC will not<\/strong> diagnose your injury. Your doctor or healthcare practitioner must diagnose your injury, and together with your functional capacity, the diagnosis will help ICBC determine whether or not your injuries call within the minor injury definition. Doctors or healthcare practitioners can update a diagnosis at any time.<\/p>\n

ICBC\u2019s minor injury<\/a><\/u> definition includes sprains, strains, general aches and pains, cuts, bruises, road rash, minor whiplash, temporomandibular joint disorder (TMJ) \u2013 pain in your jaw joint and in the muscles that control jaw movement, as well as Short term changes related to concussions and mental health conditions.<\/p>\n

If your injury meets the definition of a minor injury, this will only impact the general damages portion of your claim settlement. General damages is the term for payments received to compensate you for such things as pain and suffering and the inability to perform certain activities. This is one component that makes up a claim settlement.<\/p>\n

Whether or not an injury falls within the minor injury definition does not<\/u> impact your entitlement to the $300,000 Accident Benefits coverage available for medical care and treatment.<\/p>\n

Minor injury payouts<\/h2>\n

The determination of an injury falling under the definition of minor only affects your compensation for pain and suffering. This is just one part of your claim and is separate from your medical treatments and benefits to help you recover. As of April 1, 2019, a limit of $5,500 will apply to pain and suffering payouts for injuries that fall under the definition.<\/p>\n

For concussions or mental health conditions, if there is a substantial inability to perform essential tasks beyond 16 weeks, the limit on pain and suffering will not apply. See the next section \u201cAre there specific considerations for concussions?\u201d for more details.<\/em><\/p>\n

If the injury results in serious impairments to your life for more than 12 months [e.g., you’re still not able to go to work or school, you have to modify your work hours or duties, or you’re unable to care for yourself] it will no longer comply with the minor injury definition. As such, there will be no limit on pain and suffering.<\/p>\n

Are there specific considerations for concussions?<\/h2>\n

\"\"<\/p>\n

ICBC considers a concussion to fall within the minor injury definition when it does not result in an incapacity beyond 16 weeks after the initial symptoms. Incapacity[1]<\/sup><\/a> refers to your ability to perform the activities of daily living, which include but aren\u2019t limited to: going to work or school, preparing your own meals, driving or taking transit, managing personal finances, performing personal hygiene, and managing personal medication.<\/p>\n

If your concussion or brain injury impacts your life for more than 16 weeks [e.g., you’re still not able to go to work or school, you have to significantly modify your work hours or duties, or you’re unable to care for yourself] it will no longer be considered to fall within the definition and the limit on pain and suffering will not apply.<\/p>\n

Whether or not your concussion falls within the definition, it does not change your entitlement to the $300,000 Accident Benefits coverage available for medical care and treatment.<\/p>\n

[1]<\/sup><\/a> Insurance (Vehicle) Act. R.S.B.C. 1996, c.231. Minor Injury Regulation, 234\/2018 amended by 60\/2019 (effective April 1, 2019), pg. 14. http:\/\/www.bclaws.ca\/civix\/document\/id\/oic\/oic_cur\/0595_2018<\/a><\/u><\/p>\n

Who is eligible to support my recovery in addition to my doctor and other healthcare practitioners?<\/h2>\n

\"\"<\/p>\n

Registered Care Advisors (RCAs) are medical professionals whose role is to support family doctors on best practices, as well as appropriate diagnosis and treatment pathways. They are available for a second opinion in the following scenarios:<\/p>\n