Automobile insurance is mandatory in Alberta, so if you drive, you likely have an automobile insurance policy, but have you read it? Your auto insurance policy consists of different sections, each addressing different types of losses. Section A is the third party liability section; it applies if you are in an accident which is your fault and you injure someone else or damage their vehicle. Section B is the accident benefits section; it applies if you are injured in an accident regardless of who is at fault. Section B is often referred to as "no-fault accident benefits". Section C is the loss of or damage to your automobile section; it applies if your vehicle is damaged or stolen.
If you are involved in an accident, the Section B provisions of your automobile policy will be triggered so it is helpful to have a general understanding of what those benefits are.
Section B: No-Fault Accident Benefits
If you are injured in a motor vehicle accident, the first option you should consider for assistance with medical and treatment expenses is Section B of your automobile insurance policy. Section B is referred to as no-fault because the benefits available under this section are provided on a no-fault basis. This means that you are entitled to benefits even if you are responsible for the accident. It also means your insurance premiums will not go up as a result of making a Section B claim.
How It Applies
Most people involved in an automobile accident are covered by Section B benefits of an automobile insurance policy, whether their own or someone else's. If you have your own automobile insurance policy, it will apply if you are in an accident as a driver. If you are involved in an accident as a passenger in someone else's vehicle, the Section B provisions of the driver's policy will apply. If you are involved in an accident as a pedestrian, the Section B provisions of the vehicle owner's policy will apply. To access Section B benefits, you must notify the applicable insurer as soon as possible after the accident. You and your health care provider will have to complete forms as part of your Section B claim.
What You Get
Section B benefits consist of three categories of accident benefits: medical benefits, death and disability benefits, and benefits for accidents occurring outside Alberta in a no-fault jurisdiction.
You are entitled to coverage for all reasonable expenses incurred as a result of injuries suffered in the accident, up to $50,000.00 incurred within 2 years from the date of the accident. This includes expenses for necessary medical, surgical, chiropractic, dental, hospital, psychological, physical therapy, occupational therapy, massage therapy, acupuncture, and professional nursing and ambulance services, and other related rehabilitative services, supplies, and treatment. Certain services are capped at fixed dollar amounts:
- Chiropractic treatment: $750.00
- Massage therapy: $250.00
- Acupuncture: $250.00
Services are more likely to be considered reasonable and necessary if they are recommended by a doctor. Your doctor will complete and submit forms to your Section B insurer about your condition throughout your treatment.
If your doctor diagnoses you with a whiplash injury, then your insurer is obligated to pay for at least ten physiotherapy, massage or chiropractic treatments, and may be required to pay for up to 21 physiotherapy, massage or chiropractic treatments, depending on the severity of your whiplash injury. Any additional treatments must be approved by your insurer.
Death, Grief Counselling & Funeral Benefits
If you die as a result of an accident, certain sums are payable to surviving dependent relatives, spouse, or adult interdependent partner. This includes the payment of a principal sum, which varies depending on your age and family role on the date of the accident, and your relationship to surviving relatives. Grief counseling is available up to $400.00 per family with respect to death of any one person. Funeral service expenses of up to $5,000.00 are also payable.
If you are totally disabled from working, you are entitled to payment of a weekly benefit. Total disability means you are prevented from performing any and every duty of your job.
There is a one week waiting period for which no benefits are payable. After that week, your benefits are calculated at 80% of your gross weekly earnings to a maximum of $400.00 per week, to a maximum of 104 weeks (2 years).
To qualify for this benefit, you must have been employed at the time of the accident or, if 18 years or older, have worked for 6 out of the 12 months prior to the date of the accident. Your total disability payments are paid as long as you are totally disabled from your job. If you return to work, even on a part-time basis, benefits are usually terminated.
Even if you do not meet the employment criteria, you are entitled to $135.00 per week for a maximum of 26 weeks if you are completely incapacitated and unable to perform your household duties.
Benefits For Accidents Occurring Outside Alberta in a No-Fault Jurisdiction
Section B is referred to as no-fault, but it is the only element of the Alberta insurance scheme that is truly nofault. In addition to receiving Section B benefits, you are also entitled to sue an at-fault driver for compensation, including for pain and suffering, wage loss, loss of earning capacity, and out of pocket expenses incurred in relation to the accident. In Saskatchewan, Manitoba, Ontario, and Quebec, the insurance scheme is a pure no-fault system. That means, if you are in an accident, you are entitled to a standard and pre-established set of benefits regardless of who is at fault. Unlike Alberta, you cannot sue the at-fault driver for additional compensation.
If you are involved in an accident in one of these no-fault jurisdictions, your Section B policy provides you are entitled to the more generous accident benefits payable under the applicable laws of that no-fault jurisdiction.
Section B benefits are a valuable and relatively comprehensive set of benefits available through your automobile policy. They are provided as you need them, without having to wait for a personal injury claim to be settled or for liability to be determined. Familiarizing yourself with the different aspects of your Section B benefits gives you the opportunity to know what benefits you are entitled to receive if you are involved in an automobile accident, whether your fault or the other party's fault.
The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.