When Should You Litigate Your ICBC Claim?

You may view that ICBC will protect you financially if you get injured in a car accident. While this is true in certain cases, many times you will want the advice of a personal injury lawyer in Vancouver to let you know if you better off to litigate your ICBC claim.

In the event of an accident causing injury to you or your passengers, the standard ICBC policy provides coverage for first party Part 7 no-fault accident benefits. Regardless of whether you or the other driver is at fault for the accident, this basic coverage is still accessible.

Under the ICBC standard policy, up to $150,000 in medical and rehabilitation benefits are typically available, and up to $300 per week in wage loss benefits for a period if your injuries prevent you from carrying on with your employment. Under the policy and BC’s Insurance (Vehicle) Regulation, ICBC is required to pay out medical expenses as are “reasonable and necessary” in the circumstances.

Although this coverage is available despite any fault you may have for the accident, your injuries and the consequences of those injuries must still be proven to ICBC in order to access benefits. If you make a claim pursuant to your policy for medical and wage loss benefits, ICBC will more often than not eventually subject you to an Independent Medical Evaluation, or “IME” in order to determine your entitlement to benefits, and the amount of benefits.

ICBC Disagrees With You Regarding What Treatments You Require

Despite you or your family doctor’s opinion that you are injured and require certain treatments, rehabilitation, or medication, the doctor hired by ICBC to complete the IME may disagree. Where doctors are at odds with each other, and you genuinely believe that you require the treatments that your doctor has recommended, it may be time to commence a claim against ICBC.

ICBC tends to hold its insurance adjusters to fairly rigid guidelines in assessing whether to grant or deny benefits. Sometimes, the policies implemented by ICBC will result in an unfair denial of benefits.

In the decision Tiessen v. ICBC, 2008 BCSC 1822 (CanLII), ICBC had denied the plaintiff, Mr. Tiessen, payment for benefits relating to prescribed Botox treatments in relation to chronic back pain arising from a motor vehicle accident. Mr. Tiessen claimed for a declaration of entitlement to said benefits and was successful in court; the court found that ICBC presented insufficient evidence that the treatments were not reasonable or necessary.

ICBC Disagrees With You About Your Ability to Work

In addition to assessing whether you require certain types of treatment and medication, ICBC’s IME will also involve opining on whether you are capable of performing the duties if your work. As above, the doctor performing the IME may hold a different opinion as you, your doctor, or other medical professionals who assess functional abilities, including occupational therapists and physiotherapists.

ICBC may perform limited medical evaluation before determining that you are capable of performing your work, when in fact, you are not. Again, a lawyer can guide you through the process of gathering the appropriate evidence to show that you are genuinely struggling to perform you duties at work, and therefore entitled to benefits.

In the decision Powell v. ICBC, 2016 BCSC 1432 (CanLII), the plaintiff, Ms. Powell, had been denied total disability benefits by ICBC, on the basis that the medical evaluator used for ICBC’s IME determined that the plaintiff was not unable to perform her work duties. Ms. Powell brought a claim with respect to her entitlement to benefits. The court ruled in her favour after her lawyer had called her own medical experts as witnesses at trial. Ms. Powell’s medical experts were found to have reached more credible conclusions than ICBC’s experts regarding her medical conditions and ability to perform her job duties.

No-Fault Benefits Are Insufficient To Cover Your Losses & Another Driver Is At-Fault

Where you are seriously injured, your losses are substantial and the coverage provided in the no-fault benefits scheme is insufficient to cover your losses, you may elect to commence a claim against a third party at-fault driver.

The Extent of Your Liability Is In Dispute

In some cases, who is at fault is relatively clear, but in some cases, the extent of each party’s liability is in dispute. You might wish to go to a trial if the extent of your liability is in dispute as this could significantly impact the compensation you ultimately receive.

The Amount of Your Compensation is in Dispute

Further, even where liability is clear-cut, ICBC and/or the third party may disagree with respect to what award of damages you are entitled to in a tort claim at common law. A tort claim is simply an action in negligence against the other driver. Commencing a tort claim can help you recover losses above and beyond what is provided for in the no-fault benefits scheme, including damages for general pain and suffering, also known as “non-pecuniary general damages”.

In the decision Risling v. Riches-Glazema, 2016 BCSC 2423 (CanLII), the plaintiff, Ms. Risling, commenced a claim in tort against the defendant driver. The extent of the defendant’s liability was not in dispute, but the amount of compensation entitled was in issue. Ms. Risling tendered sufficient evidence to show that she would require significant future care in relation to her chronic back pain, and that her livelihood running a painting business had been hindered. The court found that Ms. Risling was entitled to $622,500, taking into account future costs of care, loss of future income, and pain and suffering.

Hire an Experienced Personal Injury Lawyer in Vancouver for Your ICBC Claim

At Paine Edmonds LLP, we have extensive experience with car accidents involving ICBC lawyers in Vancouver. A personal injury lawyer at our firm can help you assess the extent of your damages, assess the extent of your own liability (if any), and determine whether you have a strong case. We can answer your questions and help assess whether ICBC is treating your claim for benefits unfairly. We can guide you through the process of commencing a claim and gathering all necessary to support your claim. We will fight hard to achieve a fair settlement for you and will frequently be able to avert a trial. Contact us at 604-683-1211.