- What benefits am I entitled?
- (i) Medical Benefits
Your motor vehicle accident benefits can cover a wide range of expenses, including:
- Physiotherapy and chiropractic
- Massage therapy
- Psychology
- Prescription medications
- Medical equipment
- Ambulance bills
- Ambulance bills
- Home modifications
- Home modifications
- Gym memberships
- Mileage expenses between physician and therapy treatments
If your injury prevents you from returning to work, then your insurer is required to pay for vocational rehabilitation, return to work programs and modifications to your work space. Medical and rehabilitation benefits last up to 4 years or until you reach a maximum amount whichever comes first (like a car warranty). The maximum benefits vary for each province:
- New Brunswick: $50,000
- Nova Scotia: $50,000 as of April 2012
- Prince Edward Island: $25,000
(ii) Weekly Loss of Income Payments
Weekly loss of income payments If your injuries keep you from working, you may qualify for weekly loss of income payments. The payments are 80% of your weekly income, up to a maximum of $140 or $250, depending on your province:
- New Brunswick: maximum of $250 per week
- Nova Scotia: formerly a maximum of $140 per week, now a maximum of $250 per week as of April 2012
- Prince Edward Island: maximum of $140 per week
In order to qualify you for weekly loss of income payments, you must meet the following criteria:
- You were employed at the time of the accident, or had arranged to start a new job soon, or were employed for 6 of the 12 months before the accident;
- Your injuries kept you from working for 7 day out of the 30 days following the accident; and
- You have not returned to work, or are earning less money because of your injuries.
(iii) Duration of loss of income payments
The duration of loss of income payments is determined by your ability-to return to work. For the first two years, you must prove that you are unable to perform the essential duties of your own job. After two years, it is up to the insurance company to prove that you can work in a job that you qualify for based on your experience, training and background.
(iv) Housekeeping and home maintenance benefits
If you were not employed at the time of the accident and you are a homemaker, then you may qualify for payments for housekeeping services – snow removal, mowing the lawn, etc. You cannot quality for weekly loss of income payments and housekeeping expenses – it has to be one or the other.
- New Brunswick: maximum of $100 per week up to a maximum of 52 weeks
- Nova Scotia: $70 per week up to a maximum of $840 over 12 weeks
- Prince Edward Island: $70 per week up to a maximum of $840 over 12 weeks
- (i) Medical Benefits
- What forms are required to be completed to open my Section B claim?
- (i) Accident Benefits Notice of Claim
Fill this Form out yourself and send it back to the insurance company right away.
(ii) Medical Form
This form should be filled out by your family doctor. Make an appointment and take the form with you. Have the doctor fill it out while you are there. Take the form and send it back to the insurance company. The doctor may charge you a fee. Make sure the doctor writes down all his or her recommendations for treatment or medication. If your doctor wants you to stay off work for awhile make sure that is written on the form as well.
(iii) Employers Confirmation of Income & Benefits Form
If you are going to miss time from work, then you must get your employer to fill out this Form. Send it back to the insurance company right away. If you have not yet been provided with these forms they are contained on our website.
- (i) Accident Benefits Notice of Claim
- Tips for avoiding delays with payment for accident benefits
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- Always send original documents to the insurance company and keep copies for yourself
- If your doctor gives you a referral slip make sure he or she write on the slip it is due to the motor vehicle accident
- Fill-out and return the accident benefits forms as soon as possible.
- Submit all medical expenses to your private insurance plan before you submit them to your accident benefits insurer (the accident benefits insurer does not have to pay for things that are covered under your private medical plan)
- If your doctor is placing you off work, then his or her off-work note must give an estimate of the time you will be off, or at least when he or she will re-evaluate the ability to return to work.
- If you plan to apply for loss of income payments you must also apply for short term disability benefits (if applicable) or Employment Insurance Sickness Benefits (Call Service Canada – Toll Free 1-800-206-7218)
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- What is the deadline to apply for Section B benefits?
- You have one month from the date of the accident.
- What if Section B cuts off my benefits?
- If this occurs, or understand that it is pending, please contact your lawyer immediately. There are many different reasons this may occur, so if they are notified right away, they can get specifics and investigate the problem to see if it is justified. Also, there is 12 months in which to start a lawsuit from the date of denial of benefits.
- What do I do if my Section B adjuster wants me to see their medical advisor?
- Occasionally, your Section B adjuster will want to seek direction from their medical advisor or consultants, which they are entitled to do under the Standard Automobile Policy. If so, it is essential that you advise your lawyer and your family physician of this, as soon as possible, so everyone is aware of the type of assessment and examiner. Also it is important to attend these appointments to prevent termination of your Section B benefits. These examinations may occur several times over the course of your claim. You are also encouraged to discuss the independent medical report with your family doctor to address any concerns and/or recommendations.
- Will Section B cover my travel costs to the appointment with the medical advisor?
- Yes, the Section B insurer must pay for the costs associated to attend the appointment, including mileage, meals, tolls, parking and overnight accommodations if necessary.
- How long does the insurance company have to reimburse me for my medical/travel expenses?
- The Section B insurer has 30 days upon which you have submitted your expense to requisition payment.
- If was a pedestrian and was hit and struck by an unknown vehicle, am I entitled to Section B benefits?
- Yes, you would be entitled to Section B benefits if you have your own automobile insurance policy.
Free Interview with Cantini Law - No Fee Unless Successful
We offer a free interview, and there is no fee for your personal injury claim unless we are successful. Please contact us by calling 1-800-606-2529 or by completing an online contact form. We have offices in Moncton, Fredericton, Saint John, Halifax and Charlottetown. Consultations can be held at any of our office locations.