Accident benefit claims provide compensation due to automobile accidents, and refer to its related expenses, such as medical treatment, occupational retraining or rehabilitation, income replacement benefits. In Nova Scotia, this is referred to as Section B benefits.
These benefits are paid for by your own insurance company, under your automobile insurance policy, and covers drivers or passengers of an insured vehicle, pedestrians, or any person who fits into the definition of “insured” in the policy. If you are at fault, you are covered, subject to specific exception.
You have up to $50,000 in medical rehabilitation benefits and income replacement benefits may be available if you qualify. Entitlement to the full $50,000 is subject to the approval of the insurance company.
The Medical Benefits include, but are not limited to, medical therapies such as physiotherapy, cognitive therapy, psychotherapy, prescription drugs, chiropractic, massage, and travel expenses related to treatment.
The Income Replacement Benefits is a weekly income payment, and covers the lesser of $250 or 80% of your net salary. You must be employed at the time of the accident, or for any 6 months of the previous 12 months to be entitled to this benefit.
Limits to claim the $50,000 in medical rehabilitation funds may apply if your injuries fit into one of the minor injury criteria (whiplash for example), and you elect to follow the Automobile Accident Diagnostic and Treatment Protocols for initial treatment. This can limit the number of treatment sessions and the timing in which these sessions can occur. For example, for serious whiplash II (WAD II), the maximum number of treatment sessions is 21, and they must be completed within 90 days of the accident.
Income replacement benefits will be paid to you for 104 weeks, so long as your injuries prevent you from engaging in activities of your regular employment. If your injuries are more severe and they restrict you from engaging in any employment for which you are reasonably suited, by way of education and experience/training, then you may be entitled to be paid for longer, depending on how long you meet the test of disability. Also, to qualify for income replacement benefits, you must be unable to perform your own occupation for at least 7 days.
Your benefits will last 4 years for medical expenses, or when the $50,000 maximum is reached, whichever comes first.
To claim your benefits, you must first apply to your insurance company, or the relevant insurance company, depending on the circumstances. To be eligible, you must be injured and provide your insurance company with written notice of your intention to do so within 30 days of the accident, and by filing a proof of claim within 90 days of the accident.
Your insurance company will determine whether you qualify for the benefits based on medical evidence.
To assist you in applying for your benefits, you should contact your doctor, a treatment provider, and Preszler Injury Lawyers today for a FREE initial consultation.
The insurance company you deal with for medical expenses depends on the accident circumstances:
- If you are in your own vehicle, you make the claim with your own insurance
- If you are the passenger in someone else’s vehicle, you make the claim with the vehicle owner’s insurance company
- If you are a pedestrian or a cyclist, you apply to the insurance policy of the driver who hit you. If the driver does not have insurance, it then depends on the details of your insurance
- If the at-fault party doesn’t have coverage, you may seek compensation from the Unsatisfied Judgement Fund
Additionally, other benefits available may include housekeeping and death benefits, depending on circumstances.