How Does ICBC Decide How Much to Award an Injured Person?
You are involved in a car accident – what’s next? For most drivers, the first step after a car accident is to file an ICBC claim.
What type of claim you decide to file can have a big effect on how much you are awarded in benefits. The following provides a review of the different types of ICBC claims, how an ICBC claims adjuster makes a settlement decision, the types of damages available that may be included in a total settlement offer and what to do if you disagree with an ICBC settlement offer.
What Are Different Types of ICBC Claims?
A person injured in a car accident may pursue two types of ICBC accident claims.
The first is a no-fault claim. This is also called a Part 7 claim. These types of benefits are paid through Basic Autoplan, a mandatory type of insurance that nearly all drivers in British Columbia are covered under. Passengers, cyclists, and pedestrians are also usually covered as long as the injuries arise from the use and operation of a B.C. vehicle.
In a no-fault claim, Basic Autoplan coverage helps you to pay for your medical and rehabilitation costs for your personal injuries. You can receive these benefits even if you were the one who caused the crash. There is also an allowance for wage loss replacement if you are totally disabled.
Autoplan accident benefits provide up to $150,000 in medical and rehabilitation costs, as long as coverage conditions are met
The second type of ICBC claim is a tort claim. You can file this claim through the other driver’s policy. Your right to recover damages is based on the other driver’s negligence. In other words, a tort claim is fault-based and paid only if the person seeking compensation can prove that the at-fault driver committed an act of negligence, and that negligence was the direct cause of the person’s accident and injuries.
How Does an ICBC Claims Adjuster Decide ICBC Payout Amounts?
In addition to coverage limits (like the $150,000 limit for medical and rehabilitation costs mentioned above), some things that may affect your benefits award include:
- Fault – If you are found to be at fault for the accident, you may not be eligible to receive as much compensation as you would had you not been at fault. While you should still be able to receive the basic accident coverage benefits that are listed above, you would not be able to pursue a tort claim for other damages like pain and suffering. Keep in mind that, in addition to being found at fault and therefore being barred from a tort action, your insurance premiums may also increase.
- Coverage – While some insurance types are mandatory in British Columbia, others are optional. For example, if you purchased collision coverage, then this coverage type will pay for damage to your vehicle, even if you are found to be at fault.
- Actual damages – Clearly, the amount of damages that you suffer will have a large impact on the amount of compensation that you are able to receive. While your policy limit may pay up to $150,000 in medical expenses, if you incur only $50,000 in medical expenses, this is the maximum amount you will receive. Known as pecuniary damages, you can receive these damages only for the value of your actual economic losses.
While the above factors are the most obvious ones that affect a settlement amount, the job of the insurance adjuster is to pay you as little as possible and save money for ICBC. Any mistakes you make or any admissions of fault may – and most likely will – be used against you.
What Damages Can You Recover in an ICBC Claim?
You can seek myriad types of damages after an accident through an ICBC claim. Under your own ICBC insurance policy, these damages may include:
- Medical and rehabilitation expenses – As stated above, these benefits are available regardless of fault. They are paid in an amount up to $150,000. These benefits can cover emergency medical care, surgery, medication and recovery therapy.
- Wage loss benefits – Those who are unable to work because of an injury sustained in a crash may be eligible for wage loss benefits. The amount paid under Autoplan is equivalent to 75 percent of your average gross weekly wage prior to the incident, minus the total value of any other weekly disability benefits, up to $300 per week.
- Homemaker benefits – If you are a homemaker who is unable to perform your homemaking duties because of an injury suffered in a crash, you may be eligible to receive up to $145 per week to hire help with household duties.
- Funeral expenses and death benefits – In the event that death occurs, funeral benefits and death benefits are payable. These benefits are payable up to $2,500 for funeral expenses. Death benefits are calculated based on the position in the household (such as primary income earner) and the income level of the deceased.
- Underinsured coverage – If you are filing a claim against an at-fault driver, and the driver’s liability coverage is not enough to pay for the full extent of your injuries, your own underinsured coverage may provide up to $1 million in coverage.
- Collision and comprehensive coverage – These coverage types pay for damage to your vehicle. Both types of coverage are optional.
If you file a tort claim, you may be entitled to all losses not covered under your own insurance policy, including:
- All out of pocket expenses
- All wage loss – past and future
- Compensation for future medical treatment
- -Non-pecuniary damages such as pain and suffering or loss of enjoyment of life. There is a cap on this damages type.
What Can You Do If You Disagree with an ICBC Settlement Offer?
You do not have to accept an ICBC settlement offer. In fact, you can negotiate for a higher amount, file a tort claim or bring your claim to court.
The first step in seeking a higher settlement offer is to speak with your insurance adjuster. If that is not successful, you can speak with the insurance adjuster’s manager.
You should hire a lawyer as soon as possible if you do not agree with a settlement offer. A lawyer can help you to negotiate for a higher amount and prove damages, if necessary. A lawyer can also bring your claim to court if that is the option you should pursue.