Section B Benefits and What They Mean
Anyone who has been in a traffic accident knows how stressful the ordeal can be, no matter how minor the collision. However, an accident that results in an injury can be traumatizing. If you have been hurt, seeking immediate medical attention will no doubt be foremost on your mind. However, once the initial shock wears off, your thoughts will likely turn to your future and how to deal with your injury. You will likely have many questions. What is your prognosis? Will you miss time from work? Who will pay for any medical bills or treatment? Are you eligible for insurance benefits?
You may not have given much thought to automobile insurance, aside from the premiums you are paying. Policies can be complex and you may not know what is covered or how benefits are paid. In Nova Scotia, all auto insurance policies include no-fault accident coverage, also known as Section B Benefits and there can be much to consider when filing a claim.
We are here to cut through the boilerplate to ensure you get the help you deserve. Wagners is one of the Maritimes’ leading personal injury law firms. Our team is knowledgeable, compassionate and practical. We are passionate about providing you with effective advocacy and strong legal representation.
We are located in Halifax, but serve clients throughout Atlantic Canada. Contact us for a free consultation and learn how we can help you.
What are Section B Benefits?
All licensed vehicle owners in Nova Scotia must carry liability insurance. This coverage extends to any person who has a valid licence and drives your car with your permission. Nova Scotia, like six other provinces in Canada, has a no-fault insurance system, though the name is a bit of a misnomer. It doesn’t mean if there is an accident that no one is to blame. In every accident someone is at fault. This system just ensures that if your car is damaged in an accident or if there are injuries, your policy provider will handle the claim. If you are not to blame, your insurance company will seek to recover the cost of the claim from the other driver’s insurer.
Your insurance policy includes mandatory Section B Benefits that are available to accident victims who require medical treatment to recover from their minor injuries. These benefits not only cover the driver and any passengers but can include pedestrians or cyclists.
If you have been injured, you are covered for medical and rehabilitation costs. Common expenses could include ambulance bills, prescriptions or medical aids, physiotherapy, chiropractic care or massage therapy. If a treatment recommended by your family doctor is considered necessary for your recovery, Section B has a duty to provide coverage.
Section B Benefits max out at $50,000 and can last up to four years, whichever comes first.
In the event of death, the deceased’s family is eligible for $2,500 in funeral expenses, $25,000 in death benefits for the head of household or their spouse, and $5,000 for dependents.
What if I am Unable to Work?
If the injuries you sustain prevent you from working, you can apply for a Section B Benefit known as a Weekly Indemnity payment. This provides up to 80 percent of your gross regular wages (less any other income you receive including EI benefits) up to a maximum of $250 a week, or whichever is less.
You are eligible for this benefit if a doctor has placed you off work for at least seven days within the first 30 days following your accident. The doctor must provide written documentation verifying that you are unable to work as a result of your injuries to initially qualify and to continue to qualify.
These Section B payments can continue for up to 104 weeks, or two years, if your injury leaves you unable to work. Following that, you would have to prove that you cannot work in any employment you are reasonably qualified for by education, training or experience to continue to receive benefits.
If you are the principal unpaid housekeeper in your home and an injury suffered in a traffic accident leaves you unable to do your tasks, you may qualify for benefits that pay $100 a week for up to 52 weeks.
How do I Apply?
Following a traffic accident, you will have to contact your insurance provider or the owner/driver of the vehicle involved. You will need to complete the necessary forms for a Section B Benefits claim. Don’t assume these forms will automatically be sent to you. It is your responsibility to get them.
Your family doctor will need to document your injuries and, if applicable, your employer will need to complete the necessary forms confirming your employment details before you can receive payments.
Your injury will be assessed under the Automobile Accident Diagnostic and Treatment Protocols Regulations. The protocols were developed to help those suffering from minor injuries to receive immediate treatment. Minor injuries include sprains, strains and Whiplash Associated Disorder I or II. You will have direct access to physiotherapy and chiropractic treatment without waiting for approval from the insurance company or obtaining a physician’s referral if you meet the criteria under the protocols.
If you are approved under the regulations you can receive up to 21 treatments for your injury. However, if you do not fall within the protocols, you must first use your private insurance coverage. Section B Benefits would commence when you exhaust your private treatment coverage as long as the treatment continues to be necessary for your recovery.
What Happens if my Application is Rejected?
The last thing you need when you are recovering from an injury is to have your claim denied or your benefits terminated. But it does happen. For example, at any time during your treatment the insurance company can request an independent medical examination by a doctor of their choosing. After the examination, the doctor may determine you have recovered sufficiently and recommend that benefits be terminated. Failing to comply with treatment recommendations could be considered a failure to mitigate and you may not be entitled to further benefits. If the insurance company requests an independent examination, contact us and we can guide you through the process. We will also take up your fight if your benefits are terminated.
You are entitled to an explanation from your Section B insurance adjuster if your claim has been delayed, denied or terminated. If you believe you have been treated unfairly, our dedicated team can help. We will meet with you to gather the facts of your claim and advise you of your legal options. It’s our job to ensure you receive the benefits you deserve while you recover from your injuries.
Do I Get a T4 for the Weekly Indemnity Benefits Received?
No, you will not get a T4 if you have been receiving weekly indemnity benefits through Section B. The Weekly Indemnity is considered a benefit, not income and it is not something that is claimed on the Income Tax Return.