ICBC Part VII expense coverage after April 1, 2019

Posted on by Mussio Goodman

There is a lot of confusion with the adjusters about how part VIIs work post April 1, 2019. There are three points:

  1. Under Part VII, ICBC will only compensate treatment expenses incurred after April 1, 2019 at “prescribed rates”, regardless of when the accident occurred;
  2. The requirement to furnish ICBC with receipts within 60 days of the service/treatment only applies to accidents that occur on or after April 1, 2019; and
  3. For accidents before April 1, 2019, the claimant can still claim “user fees” when a treatment costs more than the “prescribed rates”. However, for accidents on or after April 1, 2019 the recovery of “user fee” is no longer recoverable.

The reasons behind the above are set out below.

Section 88 deals with medical and rehabilitation benefits.  Subsection (1) outlines the benefits that must be paid by ICBC.  Subsection (1.2) provides that the benefits paid under subsection (1) must not exceed the fee limit set out in table 1 of schedule 3.1 (i.e., the new prescribed rates). :

(1.2) Subject to subsection (1.3), the benefits paid under subsection (1) must not,

(a) for each health care service referred to in subsection (1) (a), exceed the fee limit set out in Column B or C, as applicable, of Table 1 of Schedule 3.1 corresponding to that health care service,

(b) for occupational therapy, exceed the fee limit of $112 per hour, and

(c) for each health care service referred to in subsection (1) (a) that is provided by a physician, exceed the fee limit set out in Column B of Table 2 of Schedule 3.1.

Section 88.01 provides that receipts for benefits under s. 88 must be submitted to ICBC within 60 days.

Requirement for receipts

88.01   (1) If an accident occurs for which benefits are provided under section 88, the insured must provide to the corporation a receipt for the expenses incurred that will be compensated as benefits under that section no later than 60 days from the date that those expenses are incurred.

(2) The corporation is not liable to an insured who, without reasonable excuse, fails to comply with this section.

The transitional provisions for section 88 and 88.01 are at section 104.2 and 104.21 respectively.  Section 104.2 says that the new section 88 as it currently reads applies to expenses incurred after April 1, 2019 regardless of the date of the accident. Conversely, section 88.01 only applies in respect of accidents that occur after April 1, 2019.

Transitional — medical or rehabilitation benefits

104.2   Section 88 as it reads on April 1, 2019 applies in relation to medical or rehabilitation benefits payable under section 88 for expenses incurred on or after April 1, 2019 regardless of the date of the accident.

Transitional — receipts

104.21   Section 88.01 applies in respect of an accident that occurs on or after April 1, 2019.

For accidents before April 1, 2019, claimants can still claim “user fees” when treatment costs more than the “prescribed rates”. Section is 82.2 (4) clearly restricts coverage for accidents on or after April 1, 2019 so the “user fee” is no longer recoverable.

The Briefing Podcast: What happens when ICBC finds your case to be a “minor injury”?

Posted on by Mussio Goodman

Mussio Goodman’s new Podcast, The Briefing, Talks About the Legal Issues Affecting You in B.C.

In this episode, Wes Mussio explains what happens if the ICBC categorizes your injury from an accident as a “minor injury.”

This podcast gives advice and explanation in civil legal cases within British Columbia, Canada. Presented by Mussio Goodman and hosted by Managing Partner  Wes Mussio, we specifically tackle issues of ICBC claims, estate litigation and more.

Subscribe to our YouTube channel for more Podcast episodes or Like us on Facebook or Twitter to be notify when we release new episodes.

Press Release: New Version of B.C. Best Seller “What ICBC Doesn’t Want You to Know”

Posted on by Mussio Goodman

Wes Mussio, Managing Partner of Mussio Goodman Injury Lawyers has written a new version of the book titled “What ICBC Doesn’t Want You to Know”. The book series has over 50,000 copies in circulation and the latest version is sure to be even more popular than the others. After recently being featured in the Vancouver Sun and the Daily Hive the book has been published in its entirety on ICBCAdvice.com.

The reason being, the government has introduced a complete overhaul of the ICBC injury claim system for accidents on or after April 1, 2019 which will take away many of the rights of injured victims of car accidents. Wes Mussio remarked “If you read the press releases of the NDP government on the new system and read ICBC’s propaganda, most people would conclude that the changes are beneficial not harmful to the injured victims of car crashes in B.C.. Truth be told, there is going to be a severe restriction on victim’s rights under the new system as the ICBC no-fault scheme put in place by the NDP government is clearly one-sided in favour of reducing the level of compensation payable to injured victims. After all, David Eby is boldly predicting that the changes will save ICBC well over a $1 billion annually.”

Under the new system, B.C. motorists suffering injuries in a car crash at no fault of their own will have a difficult time finding a lawyer that will assist on ensuring that their rights are protected. The book, “What ICBC Doesn’t What You to Know” will help many unrepresented claimants, and there will be many, understand the new system so they will be able to best pursue their claim. In other words, the book will help balance the playing field which is now tilted heavily in favour of ICBC under the new system.

The book covers topics such as what injuries are considered “minor”, how to deal with the new Civil Resolution Tribunal, how to receive treatment for your injuries under the new system and dealing with your medical doctor under the new system. Without this book, if a claimant relied only on ICBC for information, an unfair outcome on the claim is a real possibility.

Mr. Mussio noted “Trying to simplify this new no-fault scheme put in place by the NDP government into an easy to understand book was a time consuming task. I cannot imagine the average citizen, without some legal training, being able to stickhandle their way through the process for a fair outcome. Indeed that injured victim will be up against a trained ICBC adjuster or ICBC defence lawyer. Without some knowledge from non-ICBC or government sources, expect most injury victims to not get a fair outcome through ICBC. I am hoping this book will give these injury victims a fair chance to get the compensation they deserve.”

If you have any questions on the book or the ICBC no-fault scheme fell free to contact Wes Mussio at mussio@mussiogoodman.com or 604-603-8335. The books are available free from the author as a public service to ensure the many unrepresented claimants have a fair shot at a reasonable outcome.

Mussio Goodman Class Action Lawsuit Against FortisBC

Posted on by Mussio Goodman

Commercial Drive businesses want fair compensation for financial disruptions caused by FortisBC

Wes Mussio of Mussio Goodman Law has filed a lawsuit against Newfoundland utility company Fortis inc. The ongoing lawsuit was reported by British Colombian news outlets, Global News and CityNews 1130. Fifteen business located on or near Commercial Drive have signed up for the class action lawsuit.

FortisBC was replacing a 20 kilometre section of pipeline and shut down traffic in the area for construction . The construction was supposed to last a total of four months from May until August of 2018. FortisBC also promised free advertising to minimize the financial damage to the businesses.

However, the construction project was extended without a reasonable excuse and the businesses were left unaware until it was too late. FortisBC also did not adequately advertise the businesses as promised.

As a result, businesses in the local area lost tens of thousands of dollars from the recklessness of FortisBC, which left them at risk of closure. Mussio Goodman is fighting to receive fair compensation for their clients.

Read more on Global News: Commercial Drive businesses suing FortisBC for lost revenue during pipeline replacement

Read more on CityNews 1130: More Commercial Drive businesses likely to join FortisBC lawsuit

Wes Mussio is Featured in Canadian Lawyer Magazine

Posted on by Mussio Goodman

Mussio Goodman lawyer featured in national magazine publication, Canadian Lawyer Magazine

With the introduction of a restrictive no-fault system by ICBC for accidents on or after April 1, 2019, if ICBC has their way and categorizes most claims as “minor injuries”, ICBC will be able to avoid paying much of any compensation to injured victims involved in car crashes.

The level of compensation available to victims will impede the ability of victims to retain a lawyer to help him/her deal with ICBC and the Civil Resolution Tribunal. Judging from public statements by David Eby, the Attorney General, one of the purposes of the NDP’s legislative changes is to reduce lawyer involvement in ICBC files which, in turn, means reducing access to justice for victims of car crashes.

The of clear consequences of these changes is a lot less legal work which will almost certainly create extensive layoffs across the industry, whether it be lawyers, paralegals, legal assistants, receptionists, clerks, etc. This article discusses the impact of ICBC’s new no-fault system on the legal community.

You can read the article here: Insurance Cap Article

ICBC’s New “Care Model” Results in Less Care for Injuired People

Posted on by Mussio Goodman

Before April 1, ICBC let injured people have options, now they do not

 

On April 1, 2019 the new NDP legislative regime designed to save ICBC money kicked in. The scheme was purported by the Attorney General David Eby to “provide enhanced care for people injured in crashes” by increasing the amount ICBC pays for treatment like physiotherapy or active rehabilitation. The reality on the ground now being realized shows that Mr. Eby is at best a naive idealist and at worst deceptive.

The legislation did indeed increase the amount ICBC will pay for treatment up front, but also capped the total amount ICBC has to pay for each treatment. Therein lies the fine print.

 

ICBC’s New Policy

Before April 1, 2019, an injured person had the option of going to any clinic they wanted, and pay for the treatment they needed, resting assured they could recover that sum from ICBC when they settled their claim. The legislation now forces claimants to only go to clinics that adhere to ICBC’s policies, because if they go elsewhere and pay one penny more than ICBC’s prescribed rates, they are barred from getting that money back from ICBC.

More importantly, because the amounts ICBC pays per treatment session are not market rates, physiotherapists and other treatment professionals are now doing what is obvious to make the new rates work; they are spending less time actually treating injured people.

As indicated to us by one physiotherapy clinic “…our new session fee schedule will not charge a user fee, but have a reduced time 1:1 physio (20 mins) and 1:1 kin (45 mins) vs the [old] 30 and 60 mins respectively.”

ICBC will surely just say, “Well, to make up for the shorter treatment sessions, injured people can just go to the clinics more often.” Never mind the life disruption of having to book more sessions to get the same result. Or is it the same result? Surely there was a rehabilitative reason why a kinesiologist wanted to see a patient for a full 60 minutes at a time rather than 45 minutes once they started getting paid less by ICBC.

If Mr. Eby believed that highly trained physiotherapists and kinesiologists in this province would simply provide so called “enhanced” care for less money, he wassorely naïve. An alternate explanation is that Mr. Eby’s stated goal of providing care for injured persons is misdirection. Perhaps his real goal is to save ICBC money at the expense of injured people in British Columbia.

Written by Wes Mussio of Mussio Goodman