What Should You Do if an ICBC Adjuster Says You Have No Claim?

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Our Vancouver car accident ICBC lawyers discuss what you should do if an ICBC adjuster says you have no claim.

After a car accident in Vancouver or elsewhere in British Columbia, most drivers turn to ICBC to file a claim and recover compensation. Drivers may file two types of ICBC claims: Part 7 claims, also referred to as no-fault claims, and tort claims.

While a driver or passenger who has been injured in a crash is likely relying on ICBC to process the claim quickly and provide the full settlement amount, the truth of the matter is that ICBC can – and often does – deny claims.

The following explains what to do if you find yourself in the midst of a denied ICBC claim after an auto accident.

Why ICBC Claims May Be Denied

A no-fault claim seeks benefits through one’s own auto insurance policy. These benefits are payable regardless of who caused a crash.

Because no-fault benefits include medical and rehabilitation benefits, ICBC may deny this claim if there is not enough evidence to substantiate the need for these benefits. For example, if you never actually sought medical care, there will be no record to support your claim for medical expenses.

A claim may also be denied based on:

  • A perceived failure to prove that all the requirements for coverage have been met
  • A belief that your claim may be covered by someone else A misunderstanding or lack of knowledge by the adjuster You failed to file the claim within the required time frame.

Note: For a Part 7 claim, you must provide ICBC with notice of the accident within 30 days after it happened.

An ICBC tort claim seeks compensation under the other driver’s ICBC policy. It is based on that driver’s negligence.

Common reasons for ICBC tort claim denials include technical reasons or mistakes in filing the claim as well as denial of fault. In other words, ICBC may assert that its insured driver did not cause a crash, and thus, the driver is not liable for your injuries and losses.

The Process of Appealing a Denied ICBC Claim

According to ICBC, three steps go into appealing a denied claim. These steps are:

  • Talk to your insurance adjuster – Your insurance adjuster is obligated to tell you the reasoning behind why your claim was denied. The adjuster may also be able to provide you with other information that could affect your claim.
  • Talk to the manager of your insurance adjuster – Your insurance adjuster may be dismissive, unresponsive or unwilling to provide you with the answers that you are looking for after your claim is denied. If this is the case, you should bring your concerns to your insurance adjuster’s manager. The manager can review the details of your claim and may even refer your Part 7 claim to ICBC’s claims coverage committee. The claims coverage committee will review your Part 7 claim. The claims coverage committee will not deal with your tort claim denial.
  • Bring the claim to court – This step can be time-consuming and complex. It may take as long as two years to resolve. Bringing the claim to court is reserved for instances where a settlement cannot be reached with ICBC.

If you bring your case to court, it is recommended that you hire a car accident lawyer who can guide you through the process. Keeping that in mind, the following is a brief overview of what to expect:

First, there are two types of courts: Small Claims Court and Supreme Court. Small Claims Court decides claims totaling $25,000 or less. Many settlement disputes involve a higher dollar amount. So, they are litigated in Supreme Court.

In most cases, you must bring your court case within two years from the date of the accident or the date of your last ICBC benefits payment.

If you do not file your case within this time limit, it is unlikely that you will be eligible to fight the denied claim in court at all.

Why You Should Contact a Lawyer Early On If Your ICBC Claim Is Denied

Many people are hesitant about bringing a lawyer into the ICBC claims process. However, if your claim is denied, having a skilled and experienced lawyer on your side is a good idea.

A lawyer who has a background in fighting back against ICBC and appealing denied claims can be an incredibly valuable asset and improve the chances of your claim or court case being successful.

A lawyer can gather evidence and prepare a thorough and compelling case on your behalf. The lawyer can also negotiate with an insurance adjuster for ICBC, hopefully striking a settlement deal before going to court becomes necessary.

Remember: You have only a limited period of time to file a claim in court. So, it is important that you act quickly if your claim is denied.

At Klein Lawyers LLP, we are ready to help you seek your maximum benefit amount. You can count on us to work aggressively on your behalf.

We know how important ICBC claims benefits are to you. Contact us today and allow us to get to work on your case.

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