Did you know that if you are injured in an accident in Alberta, you may be entitled to Section B benefits regardless of who is at fault? Even if your insurance adjuster or lawyer has mentioned these benefits, you may still have questions like… What do Section B benefits cover? How much coverage am I eligible for? Are there deadlines to apply for these benefits? We sat down with our legal team to get the answers.
What are Section B benefits?
Section B benefits are automatically included in the Alberta Standard Owner’s Automobile Policy. They may provide some coverage for medical treatments, disability, and loss of income due to an accident. These benefits are available to anyone involved in the accident, regardless of who is at fault.
If you have been injured in an automobile accident, you may be eligible to receive Section B benefits – also sometimes referred to as “accident benefits’ by auto insurance companies. According to the law, every Alberta automobile insurance policy must contain a Section B clause. Section B benefits are “no-fault”, meaning you have a right to claim these regardless of whether you were at fault for the automobile accident. These benefits cover certain expenses related to medical treatments, disability, and death. As an Alberta automobile insurance policy owner, you will have paid for these benefits as part of your insurance premiums.
What do Section B benefits cover?
Section B insurance covers the expenses for certain medical treatments required to treat injuries and provides some disability coverage. The idea is that accident victims can quickly and easily access treatment without having to pursue legal action or wait for the outcome of an injury claim. While Section B benefits offer some support if you have been injured in an accident, they are often limited in terms of how much they will cover.
Which medical services are covered by Section B benefits?
Your Section B benefits may cover a portion of medical costs such as an ambulance ride, acupuncture, dental treatment, chiropractic treatment, massage therapy, medication, physiotherapy, psychological treatment, and more. Treatments must be approved by your treatment providers, who will fill out the necessary paperwork during your treatment period.
Do I need to sign a Release of Information Authorization to receive Section B benefits?
Yes, you must provide your insurance company with written consent authorizing access to your personal information. This is a necessary step in order for you to receive your Section B benefits. The insurance company will be unable to process the request without your signature of approval.
IMPORTANT: You are never under any legal obligation to provide information (medical or otherwise) to the other party’s insurance company or adjuster. If you have an ongoing injury claim, do not speak to any insurance companies about your claim besides your own.
How much Section B coverage am I eligible for?
The maximum amount of Section B coverage for medical treatment in Alberta is $50,000 per person.
If three people are injured while traveling in the same car, and that car is insured in Alberta, each person is entitled to a maximum of $50,000 in Section B medical benefits. In reality, very few people receive the full $50,000. In part, this is because the law requires you to use up any personal health insurance benefits before you are entitled to the entire Section B coverage. It is also due to the fact that insurance companies will often send you to a doctor of their choice to determine if you require ongoing treatment. If that doctor believes that ongoing treatment is not medically essential, you will not be approved for Section B coverage. Keep in mind that a treatment such as chiropractic care could be incredibly helpful in your recovery, but not necessarily deemed as “medically essential.” Another factor is that Section B benefits offer very limited coverage for certain treatments, such as the following:
Treatment Maximum – Section B Coverage
Acupuncture $350
Chiropractic $1000
Massage Therapy $350
What do Section B benefits cover for disability?
Section B benefits cover up to a maximum of $600 per week of lost earnings or 80% of your pre-tax average weekly earnings (whichever is lower). If you were earning less than an average of $500 per week, before taxes, at the time of the accident, you would be entitled to less than $600 per week under Section B disability benefits. If you have personal or work benefits that provide you with disability coverage, you must claim those benefits first and then claim the Section B benefit. The amount you will receive from Section B in addition to your work benefits will be calculated by your insurance provider. Many rules and exceptions may apply depending on your situation.
If you have questions about your entitlement to Section B disability benefits or how to calculate your Section B disability amount, you can contact us at any time. It won’t cost you anything to speak with our legal team.
How do I qualify for Section B disability benefits in Alberta?
In order to be eligible for Section B disability benefits…
- You must have been injured in an accident involving an automobile. Keep in mind that you don’t have to be the one in the vehicle. If you were hit by a car as a pedestrian, while riding your bicycle or e-scooter, etc., the driver’s Section B benefits would likely cover you.
- You must have been employed at the time of the accident OR at least 18 years old and actively employed for at least 6 out of the 12 months prior to the date of your accident. The 6 months of employment do not have to be consecutive.
- The injuries caused by your automobile accident must prevent you from performing all the duties of your job within 60 days from the date of the accident.
- If the insurance company chooses, they can request that a qualified medical professional (usually a doctor) must certify that you are disabled.
In Alberta, you cannot claim Section B disability benefits unless you are “wholly and continuously” disabled by the injuries from your accident. This means that the disability must prevent you from doing any and all of your job duties. Keep in mind that once you go back to work, the disability benefits stop and cannot be reinstated if you find that you are unable to maintain your duties. You cannot claim Section B benefits for the first seven days of your disability, so payment for that week is lost unless you are able to claim it back through a personal injury claim. If the Section B disability benefits do not cover all of your lost earnings, you may also be able to recover the difference through an injury claim.
Are there any deadlines I should know about?
Section B benefits must be claimed within a specific amount of time after your accident. Here are some important deadlines you should know about:
- You must notify your insurance company of the accident within 30 days if you were in your vehicle at the time of the accident. If you weren’t in a vehicle (I.e. pedestrian, bicycle, etc.) , you would notify the insurer of the party that hit you with their automobile.
- For medical benefits, you must complete a Notice of Loss and Proof of Claim Form (AB-1 Form) for the Section B insurer within 90 days.
- For disability benefits, you must complete a Claim for Disability Benefits Form (AB-1A Form) for the Section B insurer within 60 days.
- The ultimate deadline for all Section B benefits is two years from the date of the accident. After two years, all Section B benefits end. The Section B insurer will provide you with the right forms for you and your doctor or medical practitioner (physiotherapist, chiropractor) to fill out (AB-2, AB-3, and AB-4). You can find all the forms here.
Knowing which forms you need, what to do with them, and how to fill them out can be confusing during an already difficult time. If you have missed a deadline, do not panic, as you may still be able to receive benefits. Contact your insurance provider as soon as possible. Notify them of the accident and try to open your medical or disability claim or both.
If you need any help with any of these forms or deadlines, or with opening a Section B claim, just give us a call. It won’t cost you anything to speak to a lawyer and get your questions answered (even if you may have been at fault).
Can I access Section B benefits if my claim is capped?
Your insurance company is legally entitled to send you to their own doctor or medical provider to verify your injuries and eligibility for medical or disability benefits. If your claim is “capped” or believed to be capped, the insurance company must wait 90 days to send you to a medical provider or doctor of their choosing to review your injuries for eligibility. The good news is that there is no waiting period for disability benefits. If your claim is capped (or initially believed to be capped), you will typically get faster access to treatment and payment. In these cases, the Section B insurer may also lead you to believe that you are limited to 21 treatments or less under Section B benefits. This is not true. Section B medical benefits may cover medical services or supplies that are essential for your treatment or rehabilitation, up to a limit of $50,000.
If you have questions about whether or not your claim is capped and how that may affect your Section B benefits, please don’t hesitate to contact us.
Do Section B benefits cover any costs related to death, grief counselling, or funeral expenses?
While no amount of money could possibly replace the loss of a loved one, there are some financial supports available to the deceased’s family through Section B insurance. The first type of coverage is rather insensitively called the “death benefit.” The coverage for this benefit varies according to the age of the deceased and the relationship of the deceased to the person making the claim. It is also possible to claim funeral expenses for up to $6,150.00 for each deceased person and $500 for grief counselling. The grief counselling amount is $500 per family. If more than one family member has passed, it is possible to claim grief counselling for each deceased person.
If you are dealing with the loss of a loved one due to an accident, please know that you have our sympathies and that we’re here if you need help accessing Section B benefits or filing a claim.
What if I am denied Section B benefits or want to file an injury claim?
This is a complex area of law. There are rules, deadlines, and exceptions that can make Section B insurance benefits inaccessible. But even if you are denied Section B benefits, you may be able to recover treatment costs, lost earnings, and compensation for many other accident-related things through a personal injury claim. If you have any questions about Section B insurance benefits or filing an injury claim, it won’t cost you anything to speak to our legal team.
Find all of this really confusing? You’re not alone. This is a complex area of law, and one that even insurance adjustors can misapply at times. That’s why it can be a good idea to ask for help from a legal team to make sure you are taking full advantage of the benefits you may be entitled to.
A legal team to answer your questions.
We have helped thousands of Albertans with their accident claims over the years. Our legal team understands the complexities of Section B insurance and injury claims, and they also understand what you may be going through at this time. It won’t cost you anything to speak to our legal team to ensure that you have all the facts and access to the maximum benefits you are entitled to receive. We are here for you. If you have any questions, we’re just a phone call away. You can also fill out our contact form online, and we’ll reach out to you.
