While this post may provide you with a basic overview, it is not a replacement for the expertise of our lawyers here at Umbrella Injury Law. We encourage you to contact us after reading through this information to ensure your questions are fully answered and to protect your rights as you navigate your personal injury claim.

Overview

One of your first questions after being injured in a motor vehicle accident may be how to pay for the costs associated to assess and treat your injuries. Automobile Accident Benefit Regulations mandate that every company selling motor vehicle insurance policies contain a clause commonly referred to as ‘Section B’ benefits. Whether you were injured as a result of your own actions, or through the actions of another driver, Umbrella Injury Law can assist with how best to proceed based on the individual circumstances of your accident.

What ‘Section B’ Covers

Section B benefits are only accessible for the two years following the motor vehicle accident. Generally, Section B benefits cover:

• Ambulance transport charges
• Hospital admission
• Acupuncture (capped at $250)
• Massage (capped at $250)
• Chiropractor (capped at $750)
• Medications
• Physiotherapy
• Dental
• Medical supplies/equipment
• *Disability benefits (if you are unable to work due to your injuries)

Insurance companies know that delaying treatment can sometimes intensify or worsen your injuries. Therefore, the ability to access benefits quickly to begin treatment (and reimbursement of pursuing such treatment) can provide important peace of mind in the early stages following your motor vehicle accident.

There are important deadlines to keep in mind: It is important to notify your insurance company of your accident within 30 days. If you wish to access Section B coverage for medical benefits, a Notice of Loss and Proof of Claim Form (AB-1 Form) must be filled out and returned to your insurance company within 90 days.

Section B benefits are coordinated through your insurance company, any private insurance benefits you may have and with treatment providers. Accessing Section B benefits require these providers to fill out certain forms in order to obtain re-payment of their fees and this is only after you submit the claim for expenses to any private medical insurance to which you have access. Should additional treatment be necessary after Section B limits are exhausted, the insurance company may ask that you attend a specialist (of their choosing) to make a medical determination regarding the recommendation for ongoing treatment. If their specialist agrees that ongoing treatment is necessary, the insurance company will advise you how many additional treatments are approved. Should the specialist advise that additional treatments are not warranted, your insurance company will advise that should you choose to continue treatment, it will not be reimbursed through your Section B coverage from that point forward.

Section B benefits are capped at a maximum of $50,000 per injured person. Accordingly, if you are injured, the insurance company has an obligation to address your injuries – physical, mental and emotional – through Section B coverage. There may be times when the insurance company is hesitant to pay for various expenses. This is where the expertise of a lawyer at Umbrella Injury Law can assist you maximize the coverage you are entitled to receive.

Section B Disability Benefits

If you are unable to work as a result of your injuries and you need to access Section B Disability benefits, a Claim for Disability Benefits Form (AB-1A Form) must be filled out and returned to your insurance company within 90 days. Your healthcare provider will need to certify you as disabled; you must have been working at the time of the accident for at least 6 months (out of the previous 12 months), and your injuries prevent you from performing your job duties.

If your healthcare provider advises you are completely disabled from performing your job duties as a result of the accident within 60 days of the accident, Section B Disability (after a waiting period of seven days AND after you access any employer disability benefits you have access to) must pay 80% of your wages to a maximum of $400 per week, whichever is less. If you earn in excess of $400 per week, the residual amount can form part of your claim against the at-fault insurer. It is important to note that any residual amount you are claiming for lost wages is not payable until the conclusion of your claim.

Contact our office discuss your specific situation as the law is complex and we want to ensure you have access to all benefits you are entitled to receive.

What Else Do I Need to be Aware Of?

• Memorialize the details of the accident by filing a police report
• Notify the insurance company as soon as possible following the accident to report the accident, as well as asking them to send you the required forms to begin a claim (ie: AB-1 Notice of Loss and Proof of Claim)
• Attend your primary physician at your earliest ability to document your injuries and follow through by attending any referrals they recommend you attend
• We recommend you do not sign documents or give a statement to the at-fault driver’s insurance company until you speak to a lawyer at Umbrella Injury Law to discuss your claim. Explain that you are seeking legal advice and prefer not to correspond with them until you have retained us
• A common misconception is that hiring a personal injury lawyer means the law office will cover your medical expenses. You are retaining a lawyer to ensure your legal rights are protected and that important deadlines are met. While your lawyer may arrange specialists to assess your injuries, the costs to cover ongoing medical treatment, medications and other injury related expenses are the responsibility of you, any private insurance benefits you may have and Section B coverage. If you cannot afford recommended treatment, please tell your lawyer as you do not want the at-fault insurance company to claim you are not mitigating your injuries by failing to treat
• If you have a pre-existing injury, unless you can show the motor vehicle accident exacerbated the issue, Section B benefits may be difficult to access to cover these injuries. Attending a specialist to show how the accident exacerbated the pre-existing injury may be required
• Accessing Section B benefits will not increase your insurance premiums. Section B benefits are ‘no-fault benefits’ and will not impact your rates

We hope this answered some of your questions. Contact Umbrella Injury Law today to book your free consultation. Alberta Injury Lawyers: At Umbrella Injury Law, We Got You Covered.

 

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