If you're injured in a motor vehicle accident

“Last month, I got into a fender bender on my way home from work. I tweaked my neck pretty badly, so I booked in with my physiotherapist right away. Luckily, my ICBC insurance coverage paid for all my appointments. I’m glad I didn’t have to foot the bill — the physical discomfort has been punishment enough!”

– Gordon, Terrace, BC

For British Columbians injured in a motor vehicle accident, the main source of compensation is enhanced accident benefits. These benefits are available as part of ICBC’s basic Autoplan insurance coverage. (Everyone in BC who owns a vehicle must buy basic Autoplan insurance from ICBC.) 

Enhanced accident benefits are available to you even if you’re found to be responsible (“at fault”) for an accident. For that reason, they’re often referred to as “no fault” benefits. Coverage for these benefits extends to anyone in a vehicle that is licenced and insured in BC. Enhanced accident benefits are also available to all British Columbians involved in an accident, whether it occurs in BC, elsewhere in Canada, or in the United States.

For more on enhanced accident benefits, start with our overview of insurance benefits for accident victims. Below, we take a closer look at the types of medical costs that ICBC covers. As well, we explain the income replacement benefits available. 

In the unfortunate case that you’re injured in a motor vehicle accident, you may need to seek medical care. Often, even minor injuries require some level of treatment. The road to recovery can be long, and the expenses can add up quickly. 

Medical treatments covered

BC’s Medical Services Plan provides primary health care coverage when you’re hurt in an accident. But if you need additional treatment to fully recover, you can make a claim to ICBC for accident benefits. These benefits cover the cost of certain medical treatments, up to a maximum, within the first 12 weeks after your accident. Medical treatments covered include:

• physiotherapy 

• chiropractic

• massage (RMT)

• counselling

• acupuncture

ICBC’s website has the full list of treatments and fees covered. If you’re unsure if a treatment is covered, you can ask your recovery specialist. (This is someone ICBC will assign to you when you report the accident.)

If you have other insurance

You may have insurance coverage from a provider other than ICBC. For example, maybe your employer offers an extended health care plan. Or maybe you have a disability insurance policy. In these cases, your other insurance provider will generally be the primary payer for medical expenses. If your medical fees exceed the amount covered by your other provider, ICBC may cover the difference.

If you aren’t able to work following a crash, ICBC’s accident benefits can cover a portion of your lost wages. These are called income replacement benefits.

Income replacement benefits are based on 90% of your net income, up to a maximum amount. (You can buy optional top-up coverage if you earn more income than the maximum amount.) These benefits are secondary to any other wage loss benefits you receive, like an employer’s health plan or employment insurance. You’ll need to apply for those benefits first. Then, your income replacement benefit calculation will take those amounts into account.

How your benefits are calculated

The amount of your income replacement benefit is based on what you were earning prior to your accident. To determine this, ICBC looks at your past income tax returns, paystubs, and information from your employer (or your proof of income, if you’re self-employed). In some cases, they may consider your future expected earnings as well.

For an in-depth look at how income replacement benefits are calculated, see this guide.

With some exceptions, BC law says that a person injured in a motor vehicle accident can’t sue the other driver for compensation (called damages). Instead, they can access accident benefits through ICBC. These benefits cover medical costs and loss of income if you’re hurt in a crash. They’re available regardless of whether you were responsible (“at fault”) for the accident. See our guidance on insurance benefits for details.

There are limited situations where you can sue for damages. For example, you may be able to sue for damages if:

• the accident was between ATVs or other off-road vehicles

• your claim is against someone who was convicted of a criminal offence (for example, impaired driving)

• your claim is against a garage or repair shop (for example, if a faulty repair caused the accident)

In certain cases, you may be able to make a claim for non-pecuniary or punitive damages. Non-pecuniary damages is compensation for something that you can’t put a money value on (for example, pain and suffering). Punitive damages are meant to punish the other party for exceptionally blameworthy conduct.

To start your claim with ICBC, report the accident by calling:

• 604-520-8222 in the lower mainland

• 1-800-910-4222 elsewhere in BC, Canada or the United States

ICBC’s phone line is open 24 hours a day, seven days a week. You can also report your claim online.

Once you make a claim, ICBC will assign you a claims representative. They will get in touch with you to gather information about the incident.

After reporting your claim, an ICBC recovery specialist will contact you. They will explain the benefits available to you based on the details of your claim. It’s their job to work with you and your health care team to come up with a treatment plan for your recovery. For an explanation of the types of medical care covered, see above under what you should know.

You don’t need to wait to hear back from ICBC before going to your health care provider. You should seek any medical treatment you need right away. Just make sure to bring your ICBC claim number with you to the appointment.

As soon as possible (or at least within 24 hours) after the accident, you should see a medical professional — even if you feel okay. Your injury may be more serious than you think.

It’s ideal if you can visit your regular doctor, as they know your medical history. Otherwise, go to a hospital or clinic. Report that your injuries are the result of a motor vehicle accident. A medical professional can document your injuries, treatment and prognosis.

Your health care provider may bill ICBC directly

Ask your health care provider if they bill ICBC directly. If they do, you won’t have to submit receipts for reimbursement or be out of pocket. If they don’t, you can submit your receipts for ICBC to review to see if they’re eligible for reimbursement. You must submit your receipts within 180 days of the treatment or purchase to be eligible for reimbursement.

If ICBC decides to deny you certain benefits, and you want to challenge that decision, you have options. The first step is to raise the issue with your ICBC recovery specialist. They can explain the factors taken into account in determining your entitlement to benefits. This is your opportunity to ask questions or point out anything you think they overlooked.

If you aren’t satisfied with your recovery specialist’s explanation, you can ask to talk to their manager. The manager will look at the circumstances of the denied benefit and may decide to reverse the decision.

If dealing with your recovery specialist and their manager doesn’t resolve the problem, you can bring a formal dispute. There are a couple of ways to dispute ICBC’s decision to deny you benefits.

First, you can bring your dispute internally using ICBC’s claims decision review. Speak to your claims representative if you’re considering this option. 

You can also apply to the Civil Resolution Tribunal for dispute resolution. This is an online tribunal that is simpler and less expensive than going to court. It has the authority to make decisions about entitlement to ICBC accident benefits. If the tribunal makes a ruling that changes a decision, ICBC will adjust their assessment to match it. For details on how to apply, see the tribunal’s website.

In limited circumstances, you may be able to dispute your claim in court. For example, if the accident falls within one of the exceptions that allows you to sue for damages (like if your claim is against someone who has been criminally convicted of impaired driving). Or if the crash happened outside of BC. This can get complex, so it’s best to seek legal advice if you’re considering this option.