If you are in a motor vehicle collision and you are injured, you should be aware that in addition to benefits you are entitled to from the insurance company of the driver at fault, your own automobile policy also has benefits which are available to you which do not affect your premium as they are a no fault benefit , so you should definitely access them. Typically, you do not need a Red Deer personal injury lawyer to access these “Section B Accident Benefits” as they are stipulated in your insurance contract and therefore are normally very straightforward. However, we discuss at the end of this blog when you in fact need a lawyer for Section B benefits.
The Section B benefits are always the same because they come from the “Alberta Standard Automobile Policy SPF No. 1” which is the standard policy we all receive upon purchasing automobile insurance. If you refer to Section B of that standard automobile policy you will find the “Accident Benefits” which includes treatment benefits up to $50,000.00 for you for two years from the date of the accident. However, the $50,000.00 is limited for certain services for example, chiropractic services are limited to $750.00 per person, massage therapy services are limited to $250.00 per person and acupuncture services are limited to $250.00. But for physiotherapy you could theoretically access up to $50,000.00 of treatment benefits.
If there is a fatality in the motor vehicle collision there are benefits for death, grief counselling and funeral benefits also available from your own insurance. The “death benefit” typically is $37,000.00 for a surviving spouse and two dependent children plus $5,000.00 for help with the funeral.
If no one died in the motor vehicle collision but the individuals are seriously injured there is a total disability benefit under the Section B portion of your policy for loss of wages which you can access from your own automobile insurance which will pay $400.00 per week or 80% of the average gross weekly earnings less any other payments you received from your employer, whichever is less. Typically, it is the $400.00 per week that is paid as that is often the lesser amount.
If you are not employed at the time of the accident but are still totally disabled, you should be aware, and many personal injury lawyers are not even aware of this provision, that you can obtain up to $135.00 per week for loss of household duties. However, this is limited to 26 weeks rather than the normal 104 weeks for benefits for Section B benefits.
When do you need an accident lawyer to access Section B Benefits
As mentioned at the beginning of this blog post, you normally don’t need a lawyer to access these benefits as they are straightforward contractual benefits your own insurance company should pay to you.
However, because there is $50,000.00 in treatment benefits available the private for-profit auto insurance company, even though it is your own auto insurance company, is still trying to minimize payments to you and maximize profits to its shareholders and therefore will try to limit the $50,000.00 in payments for treatment benefits. We typically find that after $3,000-$4,000 of physical therapy your own auto insurance company will “cut you off” benefits.
At this point in time you definitely should contact a personal injury lawyer in Red Deer to determine if it was valid for them to cut you off. Very briefly, the only way your auto insurance company may terminate your benefits is if your doctor says the treatment is no longer required from the motor vehicle collision. If your medical doctor or your physical therapist continues to say the treatment is still required from the motor vehicle accident, then your auto insurance company must continue to pay theoretically up to $50,000.00 for 2 years after the accident.
The only way they can cut you off if your treatment providers are saying it is necessary is if your insurance company sends you to their doctor and their doctor says the treatment is no longer necessary from the motor vehicle collision.
If an insurance company asks you to see their doctor in order to cut off your benefits then it is crucial that you contact a personal injury lawyer as that report could hurt your other claim against the wrongdoer’s insurance company, as well as terminating the benefits for the treatment costs.
Unfortunately, the insurance company typically use retired orthopedic surgeons who in our firms opinion (see other blog posts as to why we have this opinion) are essentially unethical doctors who do the bidding of the insurance company and are earning several hundred thousand dollars per year “in retirement” consulting a few hours a week to insurance companies writing reports cutting innocent victims off treatment benefits when ALL THE TREATMENT PROFESSIONALS say it is needed from the motor vehicle collision.
Again, if your insurance company wants to send you to one of these doctors, call our office immediately. We will make a determination based upon all of the factors in play at that time whether or not you should see that insurance company doctor who is in the pocket of the insurance company.
In conclusion just remember that you have significant treatment benefits under Section B of your automobile policy and you should definitely contact your own insurance to get these benefits rolling. You do not normally need a lawyer to access these benefits and they may be significant including $50,000.00 in treatment costs as well as $400.00 per week in lost wages for theoretically 104weeks.
However you definitely want to contact a personal injury lawyer about advancing a claim against the wrongdoers insurance company or the driver who was at fault as that claim is based on negligence and is not based upon contract and so the factors that are in play are complex and difficult to deal with so you will need the assistance of a personal injury lawyer in order to maximize your recovery.