Automobile Insurance - Compensation and Benefits

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Compensation and Benefits

People who are injured in collisions deserve fast and effective treatment, and this is the focus of the new diagnostic and treatment process developed for minor injuries under reforms to Alberta's auto insurance system.

Forms:
Forms relating to the diagnostic and treatment process are available online.

The treatment process for minor injuries is pre-approved, meaning that people injured in collisions don't have to pay out-of-pocket for approved treatment. There are no financial barriers to access therapy within the process.

Section B Benefits
The changes also included increasing no-fault Section B Accident Benefits coverage for medical and rehabilitation costs. The previous limit increased to $50,000 from $10,000.

Several services available through these Section B benefits were also pre-approved for all injuries up to specified amounts, allowing treatment to begin immediately. Treatment that exceeds the maximum value may require assessment by a physician to continue.

Under these changes, you do not need a referral from a doctor or approval from your insurance company to access these benefits if you are seeking treatment related to your collision, up to specified dollar limits:

psychological services ($600 per person)
chiropractic services (maximum $750 per person)
physical therapy ($600 per person)
occupational therapy ($600 per person)
massage or acupuncture therapy (maximum $250 each per person)
grief counselling ($400 per family)

Under the old system, a doctor's referral and approval from your insurance company were required for these treatments.

Changes have also set the rates practitioners can charge.

Other Section B coverage would remain unchanged.

Section B benefits are available from your own insurer, whether or not you are at fault in the collision.

Victims of collisions can continue to seek settlements from wrongdoers, including through the courts.

Compensation from wrongdoers
Victims injured in a collision by a wrongdoer continue to receive compensation for economic losses and pain-and-suffering compensation (General Damages) through the courts, as under the previous system.

Victims of serious injuries receive full compensation for economic losses, and compensation for General Damages for pain and suffering up to the limits established by the Supreme Court of Canada.

Victims' injuries that are determined to be minor under the regulations receive full compensation for economic losses, and up to $4,000 in compensation for pain and suffering. The $4,000 limit has no effect on out of pocket expenses, including for medical equipment, prescriptions, rehabilitation, home care expenses or income, business, or farming loss.

Victims with a sprain, strain or minor whiplash who disagree with the assertion by an insurer that their injury is minor can seek the opinion of an independent certified examiner, agreed to by the client and insurer — or one that is randomly selected if both parties cannot agree.

This certified examiner will consider the original diagnosis, the treatment, whether recovery is proceeding as expected, and the impact of the injury on normal activities of daily living.

The examiner would provide an opinion on whether the injury should be considered minor under the regulations. People can still go to court without this opinion, as under the previous system, but the examiner's higher standard of knowledge, education and experience would likely strengthen the validity of the opinion.

Other changes
Other changes now in place include:

eliminating double-recovery of compensation an injured person receives from their insurer and from the wrongdoer; this change means that an injured victim could not receive the same compensation from two insurance companies.
basing income replacement on net rather than gross income, as lost-income compensation is not subject to income tax, CPP, or EI deductions.