When ICBC says “No!” or “Rejected!”
If you have been involved in a car accident and are injured, you may have your rehabilitation treatments funded by the Insurance Corporation of British Columbia (ICBC). You may also experience, at some point in your claim, the rehab or physio clinic advising you that ICBC is rejecting or no longer funding your physiotherapy, massage therapy, active rehab or other form of recommended treatment. This can be frustrating and builds a certain level of distrust with your insurance company. What can be done about it? Here are some of the options available to you and the reasoning behind each:
1) Hire an Experienced Lawyer
Dealing with a sophisticated insurance company can be complicated and stressful. A lawyer can help deal with the stress by advancing your claim on a number of fronts, including the rehab approval process. A lawyer can take over all communications so that you no longer have to deal with the adjuster directly. Get the advice you need from an experienced lawyer and understand which benefits will be covered at various stages of your claim.
2) Extended Health Coverage
Your primary benefits will cover your rehab expenses to the extent that you have coverage. Extended Health Coverage is often provided by your employer or you may have purchased additional coverage privately. Extended Health Coverage pays for your medicine at the pharmacy (Manulife, Sunlife, StandardLife, Pacific Blue Cross, etc.) ICBC Part 7 rehab benefits are actually secondary benefits in most instances and you could benefit from using these additional private plans.
3) Direction to Pay
Some rehab clinics have discovered that ICBC often rejects continued rehab and/or delays the approval process. Patients can be left waiting even if they want to work towards getting better faster. Delays can cause patients more stress and more pain. Some clinics offer their patients the option to set up a running account that will be collected upon settlement – these agreements are often called “Directions to Pay”. You need to review the fine print because quite often, there is an interest component whereby you pay extra for the option to pay later. It’s best to seek legal advice from an experienced lawyer before entering into a Direction to Pay Agreement. If done properly, this can be an excellent way to continue your rehab without the need for ICBC approval or paying out of pocket for each treatment.
4) Part 7 Action / Law Suit
There are two components to most car accident claims. First is the claim against the other motorist(s) for causing pain and suffering, and other financial losses. People often confuse this as a claim against ICBC, when in fact you are claiming damages from the other motorist directly. This first component is the legal claim against the driver and registered owner of the vehicle that struck you. The second component of a claim is against ICBC pursuant to Part 7 benefits, also known as no-fault benefits. These benefits are available to all BC motorists, even in situations where you might be at fault for the collision. This coverage provides for basic wage loss benefits, rehab expenses, and some home-making assistance.
It’s important to get the advice you need and understand which benefits will be covered at various stages of your claim. Most lawyers practicing in the field of ICBC injury claims will provide a free initial consultation. Take advantage of that opportunity and book an appointment. Making informed decisions is key for your path to recovery.