Injured, Poor, and Living Off of ICBC Benefits

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W. Eric Pedersen

Parties injured in a motor vehicle accident in BC have access to no-fault disability benefits and payment of some treatment costs through ICBC.  If the injuries were caused by another driver who as at fault, the injured party can bring a lawsuit to recover their additional losses.  In reality, this can play out very differently for individuals, depending on their economic status.  Parties that were barely scraping by before suffering injuries in a motor vehicle accident, are at a comparative disadvantage to those parties that have access to savings or outside streams of incomes, due to a number of compounding factors.

Let’s imagine the case of Sam.  Sam is the sole breadwinner in a family of three, and manages to scrape by earning $40,000 a year.  After tax and deductions, Sam’s family lives on approximately $3,000 a month.  Sam lives in Victoria, where the average rent for a two bedroom apartment, according to a recent report by the Victoria Foundation is $1,076. Sam is in a motor vehicle accident.  As a lower wage earner in Victoria, Sam does not have access to a private disability plan, and doesn’t get paid time off.   Sam’s family will need to rely on payment of ICBC no-fault benefits until Sam is well enough to work.

As set out in our previous post on ICBC benefits, Sam’s ICBC benefits max out at $300 per week.    The amount of the benefit hasn’t changed since 1990 (if the benefit had increased to match inflation, the benefit would be approximately $480 per week, or $1,920 per month).  Sam is able to get medical EI benefits, but these are subtracted from the ICBC benefits dollar for dollar.

Sam goes to a walk-in clinic, and the doctor prescribes physiotherapy, massage and chiropractic treatment.  Sam cannot afford to pay for these out-of-pocket, but is relieved when the ICBC adjuster explains that they will pay for the treatment under Sam’s no-fault insurance.   Unfortunately, that’s not the whole story – ICBC will only pay for the price of the treatment costs at the cost that they are covered under BC’s Medical Service Plan, but all of the treatment providers that Sam talks to charge much more than that – meaning that Sam could be responsible for paying between twenty and forty dollars a visit.  It is simply too much for Sam to pay this, when Sam’s family is living off of $1,200 a month.

Sam learns that welfare recipients with the “Person’s With Disability” designation can have some of their medical expenses taken care of, but Sam finds out that their family doesn’t qualify for income assistance so long as they continue to have income from ICBC.

Sam seeks legal advice, and decides to start a lawsuit against the driver who was at fault.  This is a good idea, because it means that they will be able to recoup their lost earnings, out of pocket medical expenses, and be compensated for their pain and suffering.  However, someone in Sam’s situation can be at a serious disadvantage when bringing a lawsuit and dealing with ICBC, for the following reasons:

  • Lawsuits take a long time.  In order to be properly compensated for their injuries, lawyers need to work with doctors to obtain medical and other evidence to support the claim.  Often, the full extent of the injured persons’ injuries, and the full extent of their losses, cannot be known or calculated until years after the accident.  Without money in the bank, or private insurance plans, this means enduring the hardship of living on ICBC benefits;
  • Because treatment costs are prohibitive and ICBC only pays a portion of the upfront costs, the injured party will miss some appointments, or may not be able to treat their injuries effectively.  The fact that the injuries went untreated, and that plaintiff isn’t following their doctor’s instructions, is harmful to the plaintiff’s health, and will be held against the plaintiff, and defence counsel and ICBC adjusters will try to use this to weaken the case and reducing the overall claim.
  • Because proving losses in a personal injury case requires medical evidence, the plaintiff is at a disadvantage if they don’t have access to regular medical care.  If the plaintiff is one of the 4.6 million Canadians without access to a family doctor, they may have to rely on visits to walk-in clinics, where they might not see the same doctor each time.  If a doctor is needed to speak on your behalf, the court is better served by a doctor who knows you well, and has consistently tracked the progress of your injuries;
  • Because living solely on ICBC benefits is a near impossibility, many Plaintiffs find themselves borrowing money, often at high interest rates.  While there are some court authorities indicating that the interest charges are recoverable, the burden will always be on the plaintiff to show that the costs were necessarily incurred as a result of the accident.  Bringing such a claim will inevitably result in an invasive investigation into your personal finances;
  • Because of financial pressure, and mounting debt, the plaintiff may prefer to compromise their claim, and choose to accept an early settlement that doesn’t fully compensate them for their losses.

While we are fortunate as British Columbian’s to have access to a no-fault insurance scheme that will pay disability benefits and treatment costs to people injured in motor vehicle accidents,  the fact is, it is barely possible for an individual, let alone a family, to subsist on $1,200 a month, especially when they are paying treatment costs out of pocket.   If you have private insurance, a rainy day fund, or friends and relatives to rely on, the blow is softened.  But for plaintiffs like Sam – the numbers just don’t add up. If you are injured in a motor vehicle accident, it is crucial that you seek legal advice to address your individual needs.

Photo by Meddy Garnet: