ICBC went to ‘enhanced care’ on May 1, 2021. What does this mean for ICBC insured drivers?
Enhanced is an interesting word
They did not enhance anything the average car accident victim would be entitled to under the old insurance. They always were entitled to hundreds of thousands of dollars of treatment costs to get better. That hasn’t changed and very few injury victims used the full amount available unless they were catastrophically injured, such as paralysis or severe brain injuries requiring full-time care.
The only enhancement now is that ICBC adjusters have been instructed to approve more treatments. Where before, it was like pulling teeth to get adjusters to approve even basic treatments after 3 months, now they probably won’t arbitrarily cut you off until 6 months.
They have a basic amount they “must pay” which is a very limited quantity of initial treatments and then it is at the adjuster’s discretion based somewhat on what the medical advisors are saying.
That isn’t always true, as I just had a client that was denied a gym membership, which is where she would attend to do her rehab. There was no real reason except the adjuster says it wasn’t a necessary recovery expense. It really isn’t any enhancement at all, they are just providing what they always were supposed to
The most shocking and terrible thing about the ‘enhanced care’ is that ICBC took away the right for accident victims to get any compensation other than treatment costs. That means that you can no longer get any payments for pain and suffering, wage loss, or future loss of capacity to earn income unless you are totally and completely disabled from working. Even then it is capped at $100,000 a year and is only for total, but temporary disability from working.
ICBC slid this major change in but put the emphasis on mailing out rebate cheques (mine was $2) and essentially decreased the amount of coverage we receive for the same basic premium amount. They also hiked the rates first, as you recall, so the reduction seems like a deal but it just went back to the original rate.
What have been your experiences representing people injured in accidents since this came into force?
Accident victims under this legislation are prohibited from suing in court and it seems that no one knows this. I received my renewal papers for my insurance and the literature says “now, you don’t have to give 30% of your payments to lawyers as you will get 100% under the enhanced care model”. This is so misleading, as the only payments are to your treatment providers and lawyers never took a percentage on that anyway. Lawyers always helped clients get treatment coverage on a pro bono basis as part of their claim
Lawyers take a percentage of the negligence claim against the at fault driver, not the treatment payments. ICBC has now outlawed negligence claims against at fault drivers (that is why it is called no fault). So, there is no payment to lawyers because there is no payment to the accident victim at all. And if the accident victim doesn’t like it, there is nothing they can do about it because court actions against ICBC are also outlawed.
My experiences have been heartbreaking. Clients call, they are injured, they can only work ½ time because the accident caused broken bones or chronic pain and headaches and they don’t qualify for the wage loss payment because they are not totally disabled and they don’t get any payments for pain and suffering to offset their out of pocket costs for time spent in rehab, seeing doctors, attending for pain therapies, nothing. They get treatments paid for, maybe, if they are well enough to organize and access treatments and the adjuster approves it, and then nothing else.
What has changed then for people injured in accidents when dealing with ICBC?
ICBC has no say in your treatments for the first 8 weeks. It is automatically approved for that short period so injury victims need to get in and get treatments while they can. All they need is their claim number and the treatment provider will direct bill ICBC. I recommend establishing a good rapport with the adjuster so they continue to approve treatments.
Lawyers can’t help anymore, so accident victims need to advocate for themselves. If the accident victim isn’t getting better, they should get approval for an Occupational Therapist right away so that OT can advocate for them to ICBC to get future treatments. Also, people are entitled to housecleaning and mileage payments for medical visits – but they need to demand it. ICBC never offers it or even says it is available.
What are the specific challenges you see injury victims in car accidents facing under this ‘enhanced care’ model?
If ICBC wrongly denies them, the accident victim can ask the CRT (Civil Resolutions Tribunal) to review the case. The CRT is online, so if the accident victim isn’t computer savvy or has unreliable internet, this will be an issue.
Getting treatments in rural areas is also an issue, as there are less providers available. ICBC will pay for a provider to travel to more rural areas but again, the injured person has to demand that, as it won’t be offered. If a person is too injured to really advocate for themselves, chances are they will not receive treatment or assistance. If a person is not fluent in English or not good with paperwork, they will have difficulties accessing treatment or advocating for themselves.
Again, legal representation is now prohibited, as is asking an independent judge to make a decision. The CRT are government employees, much like the WCB. In fact, this whole scheme by ICBC is just WCB on wheels. I have not yet seen one difference between the two models
Trial Lawyers have tried and continue to try to advocate against this change, but the government has created a smear campaign saying we are self-interested and that is why we are getting involved. That is nonsense as lawyers can do all sorts of things, we do not need this type of work to carry on, and to say so is insulting.
Lawyers helped a lot of people doing this work, and now those people will have to fend for themselves against a huge government insurance company, while they are already hurt and weak. People will be taken advantage of and only the insurer and the government win on this one.
