What are no-fault benefits?
In New Brunswick, the Standard Owner’s Automobile Policy is regulated by law. That means that every car insurance policy is basically the same. In the event of a car accident, different parts of your insurance will kick in depending on exactly what happened. For a complete explanation of each part, check out Understanding your automobile insurance policy.
This blog will look at “Section B” insurance, which covers every driver, passenger, cyclist, or pedestrian who has been injured in a car accident, no matter whose fault it was. For this reason, it is also called “no fault benefits”. While your adjuster is probably a very friendly person, the insurance company he or she works for is NOT your friend. It is also important to remember that if your insurer denies you benefits or stops paying you should notify your lawyer immediately.
Your Section B insurance should pay for:
- Loss of income – it won’t cover your whole paycheque; the maximum amount is $250 per week and could be less depending on other income replacement you get from other sources.
- Treatment – Any treatment your doctor prescribes, such as physiotherapy, massage therapy, chiropractic care, a gym program, or many other things should be covered.
- Mileage – Section B should pay you for the money it costs to travel to and from treatments.
- Medication – Any prescription medications that are new since the accident and are prescribed because of the accident should be covered.
- Death benefits – If someone dies in a car accident, Section B will pay $2,500 for funeral expenses and another amount ranging from $5000 – $50,000 depending on whether the deceased person was a dependent or the bread-winner in the household
While you are entitled to them, these benefits are not automatic. There are certain responsibilities you need to fulfill first. In order to receive money from your Section B insurer you must:
- Notice – Give notice of your claim to your insurer within 30 days after the accident.
- Proof – In addition to the Notice, you will be required to submit additional information to support your claim.
- Medical examinations – Section B insurers are entitled to ongoing medical information within reason. This includes asking you to see a specific doctor who will report back to them.
The way that your Section B insurer pays could vary. For example, some insurers will allow your physiotherapist or pharmacy to bill them and you do not need to pay anything for services. Other insurers require you to pay upfront for the service and submit your receipt to them. Your insurer has 30 days after you submit a receipt to pay you back.
Often, clients are able to deal with the Section B insurer themselves. As you can imagine, it is simpler and quicker for you to submit receipts to your insurer than for you to bring them to your lawyer and have him or her submit them for you. While your Section B insurer is not your friend, it is a good idea to try to play nice with them as long as they are playing nice with you.
However, sometimes Section B insurers do not follow the insurance contract, or push it right to the limit. If you have fulfilled all of your responsibilities and you fit the requirements for a certain benefit but your Section B insurer refuses to pay or stops paying, it is time for a lawyer to step in. Likewise, if they seem to be bullying you for information they already have or are trying to dictate who you should see for treatments, they should speak to your lawyer. If you think their conduct is wrong, you are probably right.
It is important to understand that the adjuster appointed to your claim is not a doctor and does not have the ability to tell you when you are able to return to work or to stop certain treatments. Only a physician has this ability. Do not let yourself be pressured. Always consult your family physician or other specialists.
If you provide your Section B insurer with complete and truthful information in the required time, they will pay for many of your accident-related expenses. If you hold up your end of the bargain and your insurer does not, tell your lawyer immediately.