Outline of Motor Vehicle Accident (MVA) Compensation in Alberta (prepared 2012)
There are two types of insurance involved in a motor vehicle accident. First party insurance (aka Section B, aka “your own insurance company”) and the liability insurer (also known as “the other side’s insurance company”)
Section B Claim
- Your own motor vehicle insurance provides certain benefits:
- You have this coverage with basic liability insurance (the cheapest insurance available in Alberta – basic liability coverage only).
- It is provided as Section B in every insurance policy sold in Alberta.
- It is provided on a no fault basis. This means it covers you even if you are at fault for the accident. If you are in a vehicle that has valid motor vehicle insurance purchased in Alberta, you have this coverage.
- It will also cover you if you are a pedestrian and hit by a motor vehicle
- It provides the following:
- Medical treatment cost insurance -“reasonable” medical expenses for two years or $50,000 whichever first happens.
- Weekly indemnity – this is like a disability insurance policy. It covers you if you are unable to wok as a result of the motor vehicle accident. It has a one week waiting period where no benefits are payable. It is then supposed to pay 80% of your weekly salary (with a maximum of $400 per week.) There is a two year maximum on these weekly indemnity benefits.
To qualify for the weekly indemnity you must employed at the time of the accident. In the alternative if you were not employed at the date of the accident, you must have worked for 6 out of the 12 months prior to the date of the accident.
Weekly indemnity benefits are paid for so long as you are totally disabled from your job. If you return to work on a part time basis, benefits are usually terminated.
Weekly indemnity benefits are coordinated with other benefits. So if you have disability insurance from your employer there is a specific calculation as to how much your Section B insurer pays.
Your insurance company is to be contacted and forms are to be completed within 10 days of the date of the accident or as soon thereafter as is reasonable.
If you have access to private insurance, you have to exhaust your private medical coverage first.
You will usually have to pay for your treatment in advance, and then claim reimbursement from your Section B insurer. In exceptional cases, the insurer does have the discretion to allow for direct billing.
When submitting expenses for reimbursement, keep a photocopy as it is not unknown for the insurer to claim they never received the receipts and you will have to resend them.
If you have no other coverage, Section B is supposed to reimburse you for the cost of any ambulance bill.
- You have a claim against the party (or vehicle) at fault for the accident.
- The claim is against the driver and owner of the vehicle at fault. The other driver’s insurance company usually steps into the shoes of their insured and looks after the claim on their behalf.
- It is not unusual for the driver at fault to not even know that a claim is being made against them.
- They are obligated to pay you the following (shortened for simplicity):
- Damages for pain and suffering and loss of amenities (pleasures) of life. This is usually determined by looking at similar cases and seeing what a judge awarded in similar circumstances. It really depends on how long you are injured and on how long it lasts. It also depends on the medical evidence. Everyone says it hurts and everyone says it hurts forever. The only way the insurer or court can determine the extent of you injuries if from your medical documentation and the treatment you have taken. Otherwise everyone looks the same, claims it hurts and hurts a lot and without medical corroboration of you injuries you do not have much of a claim.
- Damages for past wage loss. You are entitled to damages for wage loss calculated up to the date of settlement or trial. The wage loss is calculated on a net basis. It is net of any disability benefits you were entitled to (whether or not you actually applied for them.). It is also net of income tax that you would have paid on your wages and CPP and EI premiums. So if your gross monthly earnings are $3,000 per month and you take home net of income tax, CPP premiums, and EI premiums is $2400 per month and if Section B paid you weekly indemnity of $1600 per month you are out of pocket $800 per month. That is what the insurer is supposed to pay. Also if you were off work, Section B has a one week waiting period so you should be paid for the first week.
- Damages for future wage loss. If you are out of work or there is a reasonable possibility you will be out of work in the future due to the injuries sustained int the motor vehicle accident you are entitled to a claim for this future wage loss.
- Damages for other expenses incurred in the accident
- Damages for loss of homemaking abilities.
- Interest under the Judgement Interest Act. (Approx 3 or 4% per year.)
All claims have to be corroborated by paperwork. For example the insurance company may want the following to verify the nature and extent of your injuries and damages. The extent of documentation required depends on the nature of the claim and the dollar amount you are claiming. Also note this list is not exhaustive. If your claim goes into litigation, the insurance company and their lawyer will be entitled to any records that are substantially relevant to the issues in dispute. The normal documents requested in a moderately severe accident are as follows:
- Ambulance records
- Emergency room records
- Hospital records
- Doctors records and notes and reports
- Any documents you filed with your own disability insurer or with Section B
- A record of what benefits you received from Section B or your own disability insurer or medical benefits insurer
- A copy of your pay stubs, income tax returns, record of employment and other wage verification
- Your resume
- Copies of job applications
- Pharmacy records confirming your medication pre and post accident
- All medical records post accident.
- Your Medical records before the accident in so far as they are relevant to the issues (really depends on how much you are claiming)
- Facebook computer records if relevant to your injury etc.
In a smaller type accident where you recover within a year of the accident, the list may only include your family doctor’s records and the physiotherapy or chiropractic records or report. You will usually not be compensated for anything significant that is not corroborated by paper evidence. This means you have to keep your receipts and stay organized with your paperwork.
If you have any specific questions about your claim, call Bayda Law Firm at 403-670-0070.
Let’s work together to ensure you get the benefits you paid for. Contact a disability lawyer today to set up a free consultation.