Here you will find basic information on ICBC Accident Benefits and WorkSafeBC claims; it is not meant to be a substitute for legal advice.
If you were working at the time of the accident, ICBC does not have to pay you ICBC Accident Benefits because you are entitled to WorkSafeBC coverage, even if you decide not to make a claim for WorkSafeBC benefits. This is because ICBC is a secondary insurer and WorkSafeBC is the primary insurer. The one exception is if ICBC’s coverage would supplement WorkSafeBC’s coverage by paying for things that WorkSafeBC does not.
For example, ICBC might pay for the cost of a medically necessary, specially equipped vehicle, if WorkSafeBC benefits would not cover that expense. Sorting out the various obligations of WorkSafeBC and ICBC can be complicated, and most people require the assistance of a lawyer.
Contact Acheson Sweeney Foley Sahota today for a free consultation with one of our expert ICBC lawyers to learn how we can help you find the best lawyer for your case and ensure you receive the medical care you need during your recovery.
How do you know if you were a worker at the time of the accident?
Determining whether or not you were working at the time of the accident can be quite complicated.
Consider these two situations:
- Running errands for your boss on your lunch hour may make you a worker at the time of the accident;
- However, running personal errands on company time will probably not.
WorkSafeBC may hold a hearing in order to determine whether or not you were working at the time of the accident. For more information on WorkSafeBC benefits or to make a WorkSafeBC claim, visit WorkSafeBC at www.WorkSafebc.com/claims.
If you are an injured federal government employee, report the accident to your employer, who will submit a claim to your Labour Program regional injury compensation office of Human Resources and Social Development Canada. Visit http://www.hrsdc.gc.ca/eng/labour/workers_compensation/index.shtml for more information.
WorkSafeBC claims and innocent victims
If both you and the at-fault driver were workers at the time of the accident, you must make a WorkSafeBC claim. You do not have a Personal Injury Claim or a claim for ICBC Accident Benefits.
If you were working at the time of the accident and the at-fault driver was not, you must choose between making a WorkSafeBC claim and making a Personal Injury Claim. If you choose to bring a Personal Injury Claim, you will not be able to make a claim for ICBC Accident Benefits. This means that you will not receive any ongoing coverage for medical care or income loss while your Personal Injury Claim is proceeding, which could take months or years depending on how complicated your case is.
Sometimes a WorkSafeBC claim is better and sometimes a Personal Injury Claim is better. George’s situation as described below illustrates an example of when you might decide to make a WorkSafeBC claim and when you might choose a Personal Injury Claim. In some cases, for example where a significant injury is coupled with significant liability issues, it is possible to have WorkSafeBC provide a lawyer to pursue a Personal Injury Claim on your behalf. This would ensure that WorkSafeBC is reimbursed for the benefits it paid to cover medical care, rehabilitation and disability income loss.
Example 1: George is Better Off with a WorkSafeBC Claim
George made $36,000 per year delivering magazines with his truck. He was in an accident with another driver; George was making a left-hand turn and failed to see the other driver, who was speeding.
Both George and the other driver were at fault for the accident, and George was found to be 50% liable, which means he would only recover 50% of his medical and rehabilitation expenses and disability benefits for income losses.
George fractured his right leg and cannot return to work for at least six months, but he will make a full physical recovery.
The following Table illustrates what he can expect to receive from a WorkSafeBC claim as compared to a Personal Injury Claim. In this case, George is better off with a WorkSafeBC claim.
| PERSONAL INJURY CLAIM (AT 50% RECOVERY) |
WORKSAFEBC CLAIM (FAULT NOT RELEVANT) |
|
|---|---|---|
| Pain and suffering | $25,000 | $0 (WorkSafeBC does not pay for pain and suffering) |
| + Past-wage loss | + $14,400 ($18,000 less 25% tax) | + $12,690 ($18,000 at 90% net of tax) |
| + Rehabilitation expenses | + $ 5,000 | + $ 5,000 |
| = SUBTOTAL | = $44,400 | = $17,960 |
| – Reduction for 50% liability | – $22,200 ($44,400 x 50%) | N/A (WorkSafeBC is a no fault plan) |
| = TOTAL | = $22,200 | = $17,960 |
| – Net of lawyer fees (one-third of Total) | – $7,400 | N/A (There are no lawyer fees for WorkSafeBC claims) |
| = ACTUAL RECOVERY | = $14,800 | = $17,960 |
Example 2: George is Better Off with a Personal Injury Claim
If George goes back to work delivering magazines but continues to suffer from residual pain, George would be better off with a Personal Injury Claim. Consider the Table below.
| PERSONAL INJURY CLAIM (AT 50% RECOVERY) |
WORKSAFE CLAIM (FAULT NOT RELEVANT) |
|
|---|---|---|
| Pain and suffering | $100,000 | $0 (WorkSafeBC does not pay for pain and suffering) |
| + Past-wage loss ($18,000 gross) | + $14,400 ($18,000 less 25% tax) | + $12,690 ($18,000 at 90% net of tax) |
| + Rehabilitation expenses | + $ 5,000 | + $ 5,000 |
| = SUBTOTAL | = $119,400 | = $17,960 |
| – Reduction for 50% liability | – $ 59,700 ($119,400 x 1/2) | N/A (WorkSafeBC is a no fault plan) |
| = TOTAL | = $ 59,700 | = $17,960 |
| – Net of lawyer fees (one-third of Total) | – $ 19,900 | N/A (There are no lawyer fees for WorkSafeBC claims) |
| = ACTUAL RECOVERY | = $ 39,800 | = $17,960 |
WorkSafeBC claims and at-fault drivers
If you were working and caused an accident, you must make a WorkSafeBC claim. You do not have a claim for ICBC Accident Benefits because of a section in the Insurance (Vehicle) Regulation. The regulation states that ICBC is not liable for benefits, “except to the extent that the amount of any benefit payable (by ICBC) exceeds the amount that would be payable to the insured… under the Workers Compensation Act.”
If you were not working and caused an accident, you have a claim for ICBC Accident Benefits for medical care and income loss, to the extent that you are not fully covered by a private/group extended medical or income loss benefit plan. You do not have a WorkSafeBC claim or a Personal Injury Claim.
For more information on ICBC Accident Benefits and Personal Injury Claims, see:
Contact Acheson Sweeney Foley Sahota – Victoria ICBC Coverage Law Firm
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