In an automobile accident involving personal injuries, a claimant, even one who is at fault in a collision, is potentially entitled to section B disability and medical benefits. The purpose of this brief article is to highlight what benefits are payable. It is important to note that these benefits are above and beyond what is potentially payable by the at-fault insurer. Often, insurers will prematurely attempt to cut off claimants from such benefits. At no additional charge, it is the policy of every lawyer of Assiff Law Office to closely monitor their clients’ section B file (in addition to the main claim against the at-fault party). This ensures the insurer treats the client fairly and acts in good faith.
This article is designed to provide the reader with a quick overview of accident benefits and is not to be construed as legal advice nor is it a broad and comprehensive review of accident benefits. For more details and legal advice, always consult a personal injury lawyer at Assiff Law Office.
As a general rule, the maximum benefits payable are $50000 and last a maximum of 2 years. This sum is generally not accessible for the vast majority of cases and is also secondary insurance. For example, if a claimant has work insurance, that must be accessed before Section B benefits kick in. The exception is the first 90 days after an accident where, generally, 11 or 21 direct billed visits are payable by the section B insurer for WAD 1 or WAD 2 injuries respectively. These, along with sprains and strains are governed by the Diagnostic and Treatment Protocols Regulation. Once those 90 days or 11 or 21 visits expire, there is a limit of a further $750 in chiropractic care or $250 for massage therapy or acupuncture. There is no such limit on Physiotherapy. After 21 days or the requisite number of visits has been reached, an insurer is no longer obliged to direct bill. Strangely, there is no compulsory direct billing for more serious injuries like WAD 3 or WAD4. A claimant must pay and wait to he reimbursed in these cases or after the 90 fa protocol period for the less serious injuries.
In fatalities, there is a death benefit for most claimants and funeral benefits up to $5,000.
Where the DTPR does not apply, psychological or occupational therapy services up to $600 are payable as well. There are other benefits available as well such as dental treatment. Consult an experienced injury lawyer at Assiff Law Office for more detailed advice of accident benefits.
If a claimant is completely disabled from work as a result of a collision the insurer must pay 80 percent of their wage to a maximum of $400 per week. Any shortfall will have to be collected from the at-fault insurer if applicable.
Who is eligible for these benefits?
Any driver or passenger injured in an automobile or a pedestrian. Section B coverage attaches to the vehicle and is mandatory in all auto insurance policies in Alberta, even those carrying only “one-Way” insurance.
Actions and Conclusion
Nore-Aldein (Norm) Assiff has stated repeatedly over the years to lawyers he has mentored that “the best injury lawyer is the one that closely monitors his or her client’s section B benefits”.
These benefits are inextricably linked to their tort claim against the at-fault party. For no charge, Assiff Law Office will often pursue the section B insurer on behalf of their clients for unpaid medical or disability benefits. Often, an insurer will set up their insured with a doctor of their choice. Almost invariably, such doctors will provide a biased and unfavourable opinion as to the need for future treatment or the need to discontinue disability benefits. Often, an insurer will unfairly cut off an injured person from such benefits prematurely. Assiff Law Office will fight hard to get such benefits reinstated when warranted and will do whatever it takes to do so, including setting a claimant up with an expert to review the insurer’s expert opinion as well as obtaining the opinion of the claimant’s family doctor or paying for a camera to be in the examination room to ensure a fair assessment. We will not hesitate to start a court action if a claimant’s own insurer treats them unfairly or does not act in good faith. As far as we are aware, we have done that more than any other law firm in the Province of Alberta since we opened our doors 5 years ago and have been successful in virtually every case of bad faith against an insurer that we have commenced.
A client’s treatment and recovery are just as important as their claim against the at-fault party.