How Do Alberta Accident Benefits Work?

If you are recovering from a motor vehicle accident in Alberta, Canada, you likely have medical bills for your injuries, lost income from missed time at work, and other expenses. Bills can pile up quickly after an accident, adding to many injured victims’ stress. Figuring out how Alberta accident benefits work could help you recover from your accident.

Your automobile insurance policy includes accident benefits. If you are not sure whether you can claim these benefits, consult with a car accident lawyer who can explain your options. They can also explain how accident benefits in Alberta work and protect you from bad faith insurance practices.

What Are Accident Benefits? How Do They Work?

Accident benefits cover several types of expenses from motor vehicle accidents, such as medical treatment, disability, and death. They are widely known as Section B benefits because they appear in Section B of the Alberta Standard Owner’s Automobile Policy. All drivers and their passengers in an automobile accident can pursue a Section B claim. Pedestrians can also seek Section B coverage.

Alberta Law Requires Auto Insurers to Provide Accident Benefits

All auto insurers in Alberta must provide no-fault accident benefits under Section B. Motor vehicle accident victims can file a claim regardless of the accident’s cause. Another reason motor vehicle owners can seek Section B benefits is because they are covered by a contractual agreement between the owner and the auto insurance company. If you have an auto insurance policy in Alberta, you are automatically covered for these accident benefits when you paid your insurance premiums.

You can deal with your own auto insurer to start the Section B claims process. Even if you were in an accident with an uninsured vehicle in Alberta, you may still apply and receive Section B benefits. Section B benefits are available up to two years from the accident date.

Section B Offers Medical and Disability Benefits

Claimants can recover medical expenses and disability under Section B. One purpose of these benefits is to help accident victims receive prompt medical care. They do not have to wait until they settle their claim to seek treatment.

Collision-Related Medical Expenses and Payments

Injured claimants could apply to recover accident-related medical expenses under Section B. Your health expenses likely began almost immediately after your collision occurred and need to be repaid.

Medical expenses can vary widely, but generally, under (1)(B)(iii) of Subsection 1 – Medical Payments, accident victims can claim costs for:

  • Ambulance services
  • Medical services
  • Medications
  • Surgery
  • Dental treatment
  • Chiropractic treatment
  • Hospitalization
  • Massage therapy
  • Occupational therapy
  • Physical therapy
  • Physiotherapy
  • Psychological treatment
  • Acupuncture
  • Professional nursing services

Claimants can also seek Section B medical benefits to cover medical supplies, medical equipment, and home or vehicle modifications. These changes must be essential to the person’s treatment or recovery. Furthermore, this is not a complete list of services that accident victims can claim. If you do not see your expense listed here, you can ask your healthcare provider or a lawyer for further guidance.

Section B Benefits Limit Accident-Related Medical Expenses to $50,000

You must see your doctor or another approved healthcare provider to find out what specific treatments you will need for your recovery. In addition to your family doctor, you could see other approved healthcare providers, such as a physiotherapist, chiropractor, or psychologist. The medical professional who treats you must approve the care you receive and offer a detailed explanation regarding your treatment plan.

Section B limits your accident-related medical care to $50,000 in Alberta. However, in some circumstances, you must first exhaust your private healthcare insurance benefits to cover your medical costs before you can apply for Section B coverage. It is important to speak to an accident injury lawyer to understand some of these rules. 

Section B-Approved Medical Treatments Have Coverage Limits

While Section B covers specific treatments, some of them have caps, per Section (2)(a-c) under Subsection 1 – Medical Payments.

These caps include:

  • Chiropractic services – $1,000 limit per person
  • Massage therapy services – $350 limit per person
  • Acupuncture services – $350 limit per person

The Kind of Injury You Have Can Make a Difference in Treatment

According to the Government of Alberta, the kind of injury you have will determine the benefits you receive. If you have a soft tissue injury, such as a sprain, strain, or a whiplash-related condition, your healthcare provider does not have to check with your insurance company before billing for your injury-related treatment. However, for this to happen, you must provide notice of your claim to your insurer in addition to taking other steps.

If the services you receive for your injuries fall under the Diagnostic and Treatment Protocols‘ guidance, and your private health benefits do not cover them, then your healthcare provider can bill your auto insurance company. If you have injuries that are not a sprain, a strain, or related to whiplash, you can submit your receipts for eligible expenses to an extended benefits healthcare provider, and it can reimburse you.

Generally, if you have invoices for eligible expenses, you may submit them to your auto insurance if any of these conditions apply to your situation:

  • You do not have extended healthcare benefits coverage.
  • You have reached your extended health care benefits coverage’s limit.
  • Your extended healthcare benefits cannot cover the full cost of eligible expenses.

Claiming Section B Disability Benefits in Alberta

If you have become disabled and cannot work after an auto accident, you may qualify for disability benefits. Because missing time away from your job likely means lost income, this benefit can replace some of your earnings so you can pay your bills.

Per Part II – Total Disability of Section B, claimants can receive either a) 80 percent of their weekly gross (pre-tax) earnings or b) $600 a week (as of November 1, 2020), whichever is lesser of the two. The claimant can receive this benefit for a maximum of two years (104 weeks).

You must meet certain conditions to be eligible to claim this benefit, including:

  • You must be employed at the time of the accident. If you are not working, you must have worked six to 12 months before the accident occurred. They do not have to be consecutive months.
  • You must be unable to work at all within 60 days from the accident date.
  • You must have at least one week off before you apply for benefits.
  • A motor vehicle accident must be the clear cause of your injury.

Unemployed Accident Victims Can Make Claims

These benefits can apply to motor vehicle accident victims aged 18 and older. If they are not working at the time of their accident and unable to perform any household duties because of their injuries, they could receive $135 a week for no more than 26 weeks.

A Medical Professional Must Certify Your Accident-Related Disability

As Part II – Total Disability (4) says, you also must be certified as disabled if your insurance company requires it. As is the case with medical benefits, you must exhaust your personal or work disability benefits before you can claim disability under Section B.

If you are approved for total disability benefits, they apply only during the time that you can’t work. If you return to work in any capacity, your benefits will likely end.

Section B does not pay disability benefits for the first seven days of a person’s disability. Any payment lost for that week is recoverable through the injury lawsuit, which a lawyer files on your behalf.

Section B Accident Benefits Can Cover Funeral Expenses in Alberta

In addition to the medical and disability benefits under Section B, some family members who lost loved ones to fatal motor vehicle accidents can recover death, grief counselling, and funeral benefits, per Subsection 2, Part 1 of Section B.

Certain individuals can receive a payment of a principal sum, which depends on the decedent’s age, family status on the accident date, and their relationship to surviving family members. They can claim up to $5,000 for funeral expenses for each decedent.

Additionally, one family can receive up to $400 for grief counselling expenses. You can also consult with a lawyer to learn more.

Meeting Section B’s Deadlines and How a Lawyer Can Help

Knowing how Alberta accident benefits work is only one aspect of seeking financial recovery. You also need to know about key deadlines when applying for Section B benefits.

To preserve your right to compensation, you must:

  • Report your motor vehicle accident within 30 days. If you have been in an accident, you must tell your insurer about it within 30 days after it occurs.
  • Fill out the appropriate forms. After you report your accident, you must fill out specific forms for Section B benefits and complete them within 90 days. Your insurance company can send them to you, or you can find them online and download them from the web. You must complete a Notice of Loss and Proof of Claim Form (AB-1 Form) for medical benefits. For disability benefits, you will need to fill out a Claim for Disability Benefits Form (AB-1A Form).

How an Alberta Section B Lawyer Could Help Your Claim

A lawyer who knows how Alberta’s accident benefits work can explain if you qualify for Section B benefits, when you can use it (if you can), and how it affects your accident recovery. While you can read guidance about the law, applying it to your situation could be quite a different matter. This is why some people turn to lawyers for help.

An Alberta accident injury lawyer who knows about Section B benefits will do the following:

  • Represent you and your interests in attaining Section B benefits
  • Explain how Section B medical, disability, and death benefits apply to your case
  • Investigate the accident scene to determine what happened
  • Identify the liable parties in your accident and prove their roles
  • Collect and review evidence to document your accident and the scope of your injuries
  • Determine if you can receive Section B benefits
  • Build and present your case proving your benefits claim
  • Review your application for technical errors that could delay or derail your claim
  • Evaluate whether an insurer is acting in good faith and treating you fairly during the claims process
  • Handle all communications in your case, including negotiating with the liable party’s insurer or your insurer
  • Ensure you meet all filing deadlines for Section B forms
  • File your injury case before the Limitations Act expires on your case (a two-year deadline for most injury claims)
  • Take your case to trial if insurer negotiations do not lead to a settlement

A lawyer managing Section B claim cases for accident victims in Alberta can also review your Section B disability claim to seek lost earnings, including the money you lost during the “waiting period.” The waiting period refers to when you received no payment while waiting for your disability coverage to start.

Consult a Lawyer About Your Section B Benefits in Alberta

If you want to learn more about how Alberta accident benefits work, you can start today by speaking to an accident injury lawyer. As noted, you have only two years to pursue a Section B benefits claim. If it expires, you could lose your right to seek compensation that could pay for your collision-related losses. If you wish to speak with a law firm, many offer free consultations where you can review your options.

Section B benefits are part of your insurance policy, and you could receive them, regardless of who caused your accident. You can have a lawyer review your situation and advise you on your next steps. You owe it to yourself to explore your options and give yourself the best possible chance of recovering benefits.

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