What is ‘Section B’ insurance?
Every automobile policy in Alberta has a Section ‘A’, ‘B’ and ‘C’. These Sections are standard and do not vary from policy to policy. Section ‘B’ deals with certain types of benefits for any treatment required after a car accident. It also provides for income replacement benefits if you are unable to work as a result of your injuries. Note that this is insurance that you claim from your own insurer (even though your injuries were caused by the other driver).
Section B insurance covers all reasonable expenses incurred within 2 years from the date of the accident for necessary medical, surgical, chiropractic, dental, hospital, psychological, physical therapy, occupational therapy, massage therapy, acupuncture, professional nursing and ambulance services and, in addition, for other services and supplies that are, in the opinion of the insured person’s attending physician and in the opinion of the Insurer’s medical advisor, essential for the treatment or rehabilitation of the injured person. The Section B limits of coverage is $50,000 (except for Chiropractic ($750), Massage ($250) and Acupuncture ($250).
Can my ‘Section B’ insurer ‘authorize’ or control my medical treatments?
Please note that your insurance company doesn’t get to ‘Authorize’ anything (notwithstanding their suggestions to the contrary). They are obligated to reimburse you for treatments given under the Section B portion of your policy that are advised by your medical doctor. Remember that your own insurer (under Section B of the policy) is responsible for reimbursing you for all treatment (after the first 21 treatments which are paid by your insurer directly to the treatment provider) that are not covered by any extended insurance you may have (typically through your own or a spouse’s workplace insurance plan).
It is common for insurers to suggest that they will only ‘authorize’ a certain number (usually three or four) physiotherapy or massage treatments. Make sure you ignore this suggestion. You are entitled to receive whatever and however many treatments your family doctor recommends. Simply get that treatment and send the receipts in to your insurer for reimbursement (subject only to the limits under Section B).
How do I pay for treatments when ‘Section B’ benefits end (after two years or policy limits reached)?
The ‘Section B’ policy only covers you for two years post-collision. From this point forward you either have to :
1. Pay yourself (or borrow from friends/family) and keep the receipts which we will claim when it comes time to settle your claim;
2. Arrange an ‘Assignment of Proceeds’ with your treatment provider(s) that they’ll treat you and be paid out of your settlement (we claim however much is owing at the time of settlement discussions and then pay the amount outstanding directly to the treatment provider once we receive settlement funds); or
3. Arrange a ‘litigation loan’ to assist with payment – these sorts of loans are generally very expensive and I would only do it as a last resort (typically interest is in the low 20% range).
If you don’t want to or can’t do any of the above options, please discuss it with your family doctor so that we document the fact that you don’t have the funds to obtain proper treatment (we don’t want to give the other side the argument that you are not treating because you aren’t injured). This ties into a ‘failure to mitigate’ argument ( see
What is meant by a failure to ‘mitigate’ my injuries?).
Get in touch to discuss your injury to discover your options.