Using Section 'B' Benefits After an Accident

injured man from a car accident in the hospitalNova Scotia has a standard form policy for automobile accident insurance benefits regulations. Section B of this standard policy provides up to $50,000 in medical expense coverage to insured drivers. Section B is often referred to as No-Fault Coverage or Accident Benefits. Many people misunderstand the terms of Section B benefits, thinking they only have access to this coverage if they did not cause the accident. As a result, valuable resources for treatment and financial assistance are not provided, significantly impacting the injured person’s recovery.

What is Section ‘B’ Accident Benefits & Treatment Coverage?

Section B Accident Benefits cover medical expenses for the recovery and treatment of injuries sustained in a motor vehicle accident, regardless of who is at fault. All motor vehicle insurance policies in Nova Scotia include no-fault accident benefits coverage to pay for any reasonable and necessary medical expenses.

Who is covered under Section ‘B’?

  • The policyholder
  • The driver of the insured vehicle
  • Any passenger in the insured vehicle
  • Pedestrians who are hit by the insured vehicle
  • Dependants and family members who were occupants of other vehicles

Loss of Income After an Auto Accident

Section B also provides income replacement if you are unable to work due to your injuries. These benefits are referred to as Weekly Indemnity benefits. To qualify for income replacement, you must have a signed document from your doctor stating that you are unable to work for at least seven days due to your injuries caused by the motor vehicle accident. This document must also be dated within the first 30 days following the accident.

Weekly Indemnity benefits can cover up to 80% of your regular wages or up to $250 per week, whichever is less. You can claim income loss benefits for up to two years if you cannot return to your previous job. You can also claim loss of income under Section B after the two year period if you are unable to return to any position you are suited for based on your education, training, and previous work experience.

For example, if you are a personal care worker and cannot go back to patient care after two years, but you can manage medical records while seated at a desk, you may not be eligible to continue receiving benefits. However, if you are a trucker and there are no jobs available to utilize your knowledge and training, you may be eligible to receive benefits after the two year period.

What Medical Treatments Are Covered Under Section B?

In broad terms, the purpose of Section B benefits coverage is to provide accident victims with the financial means to access the medical treatment required to recover from their injuries. All medical treatments and associated services deemed necessary by the injured person’s physician usually fall under Section B. Accident Benefits can also provide coverage for prescription and non-prescription medication essential to the treatment or management of injuries and related pain caused by the car accident.

Medical expenses covered under Section B:

  • Ambulance services
  • Surgical treatment
  • Chiropractic treatment
  • Dental reconstruction
  • Hospital fees (generally not applicable in Canada)
  • Psychological counseling
  • Physical therapy
  • Occupational therapy
  • Massage therapy
  • Medication
  • Acupuncture
  • Nursing care
  • Funeral expenses
  • Death benefits
  • Medical equipment

An important detail to keep in mind is that Section B benefits are not unlimited. Your medical and treatment expenses will be covered up to $50,000 or four years after that accident, whichever comes first. Suppose someone else is responsible for the car accident causing your injuries. In that case, you can file a claim against the at-fault driver’s insurance to pay for medical costs above what is covered by Section B in your car accident insurance policy.

How Do I Set Up My Section B Benefits?

One of the first things you should do after a car accident is to contact your insurance company. You, or your personal injury lawyer, need to report the accident to your provider or the provider of the other party involved. The insurance company will send forms you must fill out to initiate an insurance claim for no-fault accident benefits. Managing insurance claims and all the documents you need to submit can be overwhelming, especially if you are dealing with pain from your car accident injury. A car accident lawyer can help with the entire claims process, from the initial filing to representing you in court if necessary.

What are the Diagnostic Treatment Protocols?

Treatment protocols are intended to be a simplified, user-friendly way for injured car accident victims to access medical treatment. Suppose you are diagnosed with a sprain, strain, or whiplash associated disorder (WAD) caused by a car accident. In that case, you can choose to receive medical benefits through treatment protocols or through Section B of your auto insurance policy.

Do I Have a Time Limit on How Long I Can Take to Make a Section B Claim?

Insurance claims can take time to process, which can delay benefits that could impact your access to the treatments needed to recover from your injuries. If you are injured in a motor vehicle collision, you should report the accident to your insurance company as soon as possible. Generally, a car accident insurance medical claim for Section B benefits should be opened within 30 days from the accident date. However, this is not a strict deadline.

Coverage for treatment protocols will expire in 90 days from the date of the accident. The forms needed to apply for treatment protocols typically need to be submitted within ten days of the car accident. You are entitled to a pre-set number of treatments if you proceed under the protocols. All treatments must be completed within the 90 day period.

Two-Year Limitation Period

For injury claims in Nova Scotia, there is a two year limitation period from the date the accident occurred. There are, however, circumstances in which the two-year deadline could be extended.

Ultimate Fifteen-Year Limitation Period

The Limitations Act prevents someone from filing a claim any later than 15 years after the day the car accident occurred. Even if you discover your injury and identify that it was caused by the car accident that took place more than 15 years ago, you are barred from taking legal action to pursue financial compensation.

What Happens if I Have Difficulty Accessing My Section B Benefits?

Your insurance policy is a contract between you and your insurance provider. In exchange for your monthly insurance payments (insurance premiums), the insurance company agrees to provide financial coverage for damages outlined in your policy.

Your own insurance company has what is called a “duty of good faith” towards you. This means they are required by contract (your policy) to act in your best interests. If you feel that your claim was wrongfully denied or that you did not receive the financial compensation you deserve, you have the option of bringing a bad faith claim forward. A bad faith claim means you are essentially suing your insurance company for failing to uphold their end of the contract.

What if my insurance company refuses to pay my medical expenses covered under Section B?

Your insurance provider may deny coverage under Section B benefits if they believe you have recovered from your car accident injuries or you have received the maximum number of approved treatments. If you are still injured and have not reached the $50,000 coverage of the four-year limit, visit your family doctor to have additional treatment prescribed.

Talk to a Personal Injury Lawyer in Halifax Now

Before you contact your insurance company, or if you are unsure of what benefits under Section B of your insurance policy you are entitled to, contact Valent Legal. We understand the stress a car accident can have on you and your loved ones.

Our team of car accident lawyers can help explain the claims process or take it over for you entirely, so you can focus on recovering from your injuries. Using our experience and expertise, we will do everything in our power to get you the financial compensation you are entitled to.

Call us or reach out online to schedule a free legal consultation today.