Common Questions and Concerns on Section B

posted in: Personal Injury + Section B Benefits

Introduction

Finding all the benefits you may be eligible for after a motor vehicle accident is complicated. Insurance companies do little to explain the process or assist you in your application. 

But Section B benefits are one of the key benefits that you may be eligible for. Here are the answers to your questions about your section B Benefits.

What are Section B benefits?

Section B is a mandatory insurance benefit in your motor vehicle insurance policy. You can receive these benefits if you are injured in a motor vehicle accident. Benefits fall into  three categories: 

1. Medical Payments  
2. Death, Grief, Funeral, and Counselling Benefits, and 
3. Total Disability. 

Let’s focus on the medical benefits you might be eligible for under Section B. 

How do I know if I qualify for Section B benefits?

If you were involved in a motor vehicle accident as a driver, passenger, or pedestrian, and the accident has left you with injuries that require treatment from the accident, it is very  likely that you are eligible for Section B benefits. 

But the insurance company won’t just give you your Section B benefits. You have to apply for them first.

What do I need to Provide to the Insurer to get Approved for Section B Benefits

To receive Section B benefits, you will have to fill out a claims form and provide it to your insurer. The form must describe the accident and the injury you have suffered. 

You must send the Section B claims form to your insurer no more than 30 days after the accident occurred. If it is not possible for you to send the insurer your Section B benefits claims form within the 30 days, you must at least send it to the insurer as soon as you can.

The approval process does not end there, however. Most insurers require that you have a medical practitioner provide (a) proof of the injury described in your Section B claim and (b) a treatment plan for your injury. If you are completing a Section B claim, make sure to speak to a medical practitioner, such as a chiropractor, doctor, or physiotherapist, to help prove your claim. And don’t worry about the cost: the insurance company has to cover any payment you make for a medical practitioner to fill out the medical expert portion of your Section B claim form. 

You can deliver your claim form personally, by mail, fax, or email to the head office of the Section B insurer. This link provides the list of addresses of insurers in Alberta.

Who Pays for my Section B benefits?

If you were a driver or passenger, the insurer of the vehicle you were in when the accident occurred must provide you with Section B benefits. If you are a pedestrian or cyclist who was struck by a motor vehicle, the insurer of the vehicle that hit you will provide your Section B benefits. 

Do I need a lawyer to fill out a section B application?

You do not need a lawyer to complete your Section B application. However, if you have trouble completing your application yourself, or if your insurer is being difficult, the lawyers at KMSC are here to help.

How long and How much do Section B Benefits cover?

Section B benefits will cover up to $50,000 in medical expenses within a two-year period following the accident. The benefits will expire either at the end of the two-year mark or when they exceed $50,000. If your Section B Benefits have expired, please see our blog post called, “What to Do When Your Section B benefits Expire” and contact us with any questions about your coverage. 

What will my Section B benefits cover?

The Alberta Standard Automobile Policy states that Section B covers “injuries to which the Diagnostic and Treatment Protocols Regulation applies and that are diagnosed and treated in accordance with the protocols under that Regulation.”  This coverage includes: 

• Diagnostic imaging
• Laboratory testing, 
• Specialized testing
• Physiotherapy treatment
• Medication
• Massage Therapy (limited to $350 per person) 
• Psychological Treatment
• Chiropractic Treatment (limited to $1000 per person)
• Acupuncture Treatment (limited to $350 per person) 
• Dental Treatment 

Please note that your insurance provider must first approve treatments for those treatments to be covered by your Section B benefits. 

Will Section B benefits apply if my accident happens outside of Alberta?

If you are a resident of Alberta but are involved in an accident outside of Alberta, Section B benefits will apply unless the accident occurred in a no-fault province. In Canada, the no-fault provinces include British Colombia, Saskatchewan, Manitoba, Ontario, and Quebec. If your accident occurs in one of these provinces, the benefits you receive will be subject to the laws of that province and the insurer will compensate you as if you were a resident of that province. 

What Happens if my Section B benefits are denied?

If your insurer denies your Section B benefits you may have the opportunity to challenge them. We recommend you seek legal counsel to do so. Our experienced team of lawyers at KMSC Law LLP has dealt with insurers countless times and will assist you with an application against the Section B insurer. We will ensure you receive the coverage you deserve.