Grab the life preserver

Are extended medical benefits available after a car crash?

Those lucky enough to have an extended medical plan have a financial safety net to help pay for the expense of being injured.

It’s an important safety net. A recent survey revealed that 48 per cent of Canadians are $200 or less away from not being able to meet their monthly financial obligations (CBC news report).

Even a day or two of missed work can push you over the financial brink. Add in twice or three times per week massage, chiropractic or physiotherapy and you’ve got a serious and ongoing financial problem.

Each care session is likely to cost in the range of $50-$70. The up-front contribution billed directly to ICBC is under $18 for a typical physiotherapy or chiropractic session and $23 for massage therapy. It’s up to you to pay the remaining user fee.

ICBC adjusters regularly provide a $500 “advance” to help pay these expenses, but obviously that doesn’t go far. Some injured victims are encouraged to send in their receipts for periodic reimbursement, but many face lengthy delays.

If you are lucky enough to have extended medical benefits, can you access them for these expenses even though you have an ICBC claim?

Absolutely. I’ve never heard of an extended medical plan that excludes care for crash related injuries.

Why, then, are injured victims often discouraged from accessing that financial relief?

Rather than encourage financially strapped victims to submit user fee receipts to their extended medical plans, ICBC adjusters regularly encourage them to keep track of their receipts for reimbursement at the end of the claim as part of a final settlement.

That leaves injured victims in ongoing financial distress, unnecessarily.

I suspect it’s a negotiating strategy. The more financially desperate you are, the more likely you will prematurely settle your claim for less than fair compensation. 

My advice is to minimize your financial stress by accessing whatever financial relief might be available to you.

ICBC’s legal obligation to compensate you for your injuries, expenses and losses (on behalf of the negligent driver who caused your injuries) does not have any impact at all on your separate right to expense reimbursement through an extended medical plan.

ICBC can wait all they want to reimburse your expenses. If you have already been reimbursed through your plan, that money is simply handed over to the plan when it finally arrives.

The obligation to reimburse the plan is called the plan’s “subrogated interest”, and is a term of most extended medical plans. When you submit your receipts for reimbursement, you are typically asked if the expenses were incurred because of a third party who you are making a claim against.

Answering “yes” to that question will trigger some paperwork where you are required to commit to paying the plan back with the proceeds of your ICBC settlement.

It is critical that you be honest with your extended medical plan (as you must be with everyone else you deal with), so please answer this question honestly.

And keep that commitment in mind! Ensure that ICBC reimburses all your expenses in your final settlement, including those already reimbursed by your plan. Otherwise, you might find your extended medical plan reaching into your own pocket to recover their subrogated interest.

Does this sound complicated? Most personal injury lawyers offer a free initial consultation. Take advantage of that opportunity to learn about your rights and obligations.

This article is written by or on behalf of an outsourced columnist and does not necessarily reflect the views of Castanet.