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B.C. Reg. 447/83
O.C. 1897/83
Deposited December 1, 1983 and effective January 1, 1984
This consolidation is current to March 26, 2019.
See “Amendments Not in Force” for amendments
effective after March 26, 2019.
Link to consolidated regulation (PDF)
Link to Point in Time

Insurance (Vehicle) Act

Insurance (Vehicle) Regulation

[includes amendments up to B.C. Reg. 234/2018, April 1, 2019]

Part 7 — Accident Benefits

Interpretation

78   In this Part:

"employed person" means a person

(a) who, on the date of an accident for which a claim is made, is employed or actively engaged in an occupation for wages or profit, or

(b) who

(i) Repealed. [B.C. Reg. 257/86, s. 21.]

(ii) for any 6 months during the period of 12 months immediately preceding the date of an accident for which a claim is made is employed or actively engaged in an occupation for wages or profit;

"homemaker" means the member of a household who, without payment, does the majority of the housekeeping for the household;

"insured" means

(a) a person named as an owner in an owner's certificate,

(b) Repealed. [B.C. Reg. 257/86, s. 21.]

(c) a member of the household of a person named in an owner's certificate,

(c.1) an insured as defined in section 42 who is not in default of premium payable under section 45,

(c.2) a member of the household of an insured described in paragraph (c.1),

(d) an occupant of a vehicle that

(i) is licensed in the Province and is not exempted under section 43 or 44 of the Act, or

(ii) is not required to be licensed in the Province, but is operated by a person named in a driver's certificate,

(e) a cyclist or pedestrian who collides with a vehicle described in an owner's certificate, or

(f) a resident of the Province who is entitled to bring an action for injury or death under section 20 or 24 of the Act,

and includes the personal representative of a deceased insured;

"parent" means the person entitled to claim a child as a dependant under the Income Tax Act of the Province;

"rehabilitation" means the restoration, in the shortest practical time, of an injured person to the highest level of gainful employment or self sufficiency that, allowing for the permanent effects of the injured person's injuries, is, with medical and vocational assistance, reasonably achievable by the injured person;

"rehabilitation team" means a team of individuals, including representation from the rehabilitation staff of the corporation, established

(a) to determine the appropriate group residence for an insured,

(b) to determine the care needs of an insured under section 88 (2) (c), and

(c) to evaluate any aspect of the funding, development of treatment, or rehabilitation plan for an insured.

[am. B.C. Regs. 335/84, s. 18; 257/86, s. 21; 408/87, s. 21; 383/89, s. 13; 379/93, s. 5; 491/95, s. 12; 246/98, s. 3; 166/2006, Sch. s. 62; 420/2008, App. s. 7; 421/2008, App. s. 8; 423/2008, App. s. 8; 60/2019, App. 1, s. 1; 234/2018, App. 2, s. 9.]

Coverage and benefits

79   (1) Subject to subsection (2) and sections 80 to 88, 90, 92, 100, 101 and 104, the corporation shall pay benefits to an insured in respect of death or injury caused by an accident that occurs in Canada or the United States of America or on a vessel travelling between Canada and the United States of America.

(2) Where an accident occurs in the United States or on a vessel travelling between Canada and the United States, no benefits are payable under this Part to

(a) a cyclist, or

(b) a pedestrian

unless the cyclist or pedestrian is named in an owner's certificate or a driver's certificate or is a member of the household of a person named in an owner's certificate or a driver's certificate.

[am. B.C. Regs. 335/84, s. 19; 379/85, s. 31; 257/86, s. 22; 328/97, s. 6; 234/2018, App. 2, s. 10.]

Disability benefits for employed persons

80   (1) Where, within 20 days after an accident for which benefits are provided under this Part, an injury sustained in the accident totally disables an insured who is an employed person from engaging in employment or an occupation for which the insured is reasonably suited by education, training or experience, the corporation shall, subject to section 85, pay to the insured for the duration of the total disability or 104 weeks, whichever is shorter, the lesser of the amounts determined under paragraphs (a) and (b):

(a) the applicable amount of disability benefits set out in section 2 of Schedule 3;

(b) in respect of an accident that occurred

(i) before January 1, 1987, an amount per week calculated by taking 75% of the insured's gross earnings for the 12 month period immediately preceding the accident, dividing by 52 and multiplying that amount by the weekly benefit multiplier in Column B of Table 1 of Schedule 3 opposite the year of the accident in Column A,

(ii) on or after January 1, 1987 but before January 1, 1991, an amount per week calculated by taking 75% of the insured's gross earnings for the 12 month period immediately preceding the accident, dividing by the number of weeks and fractions of weeks actually worked during that period and multiplying that amount by the weekly benefit multiplier in Column B of Table 1 of Schedule 3 opposite the year of the accident in Column A, or

(iii) on or after January 1, 1991 an amount per week calculated by taking 75% of the insured's gross earnings for the 12 month period immediately preceding the accident and dividing by the number of weeks and fractions of weeks actually worked during that period.

(2) Where disability benefits are payable to an insured for a period of less than one week, the amount payable for each day shall be determined by dividing the amount payable weekly by the number of days the insured regularly works in a week.

[en. B.C. Reg. 438/92, s. 12.]

Deduction of other benefits

81   (1) In this section:

"other disability compensation" means compensation similar to benefits

(a) paid or payable under vehicle insurance, wherever issued and in effect,

(b) paid or payable under a policy of accident, sickness or life insurance purchased by a group or individual, or

(c) paid by an employer;

"weekly net lost earnings" means the amount by which the disability benefits payable to an insured as calculated under section 80 (1) (b) exceed the weekly gross total of payments to the insured of all other disability compensation.

(2) Where an employed person is injured in an accident for which disability benefits are payable under section 80 and some or all of the insured's lost earnings arising from the accident are payable as other disability compensation, the corporation shall not pay any disability benefits to the insured under that section unless the weekly gross total of other disability compensation payable to the insured is less than 75% of the weekly gross lost earnings of the insured, in which case the corporation shall pay to the insured the lesser of

(a) the amount of disability benefits payable under section 80, or

(b) the weekly net lost earnings of the insured.

[am. B.C. Regs. 448/90, s. 13; 491/95, s. 13; 166/2006, Sch. s. 63.]

Employment during total disability

81.1   (1) If an insured who is entitled to disability benefits under section 80 becomes capable of engaging in employment or an occupation but, because of injuries suffered in the accident is incapable of earning an amount that exceeds 125% of the disability benefits determined under sections 80 and 81, the insured may keep earnings from that employment or occupation, without deduction from disability benefits, in an amount that does not exceed 25% of those disability benefits, but any amounts earned in excess of 25% of the disability benefits will be deducted from the disability benefits payable by the corporation.

(2) No disability benefit is payable under section 80 if the application of subsection (1) would result in a payment of less than $5 a week.

[en. B.C. Reg. 491/95, s. 14.]

Payments under Workers Compensation Act

82   Where an insured who is a worker to whom the Workers Compensation Act or a similar law of another jurisdiction applies is injured or killed in the course of his employment, the corporation is not liable to pay benefits under this Part for the injury or death, notwithstanding that the insured, his spouse or personal representative, has elected not to claim or has forfeited the insured's claim under the Workers Compensation Act or other similar law for the injury or death, except to the extent that the amount of any benefit payable under this Part exceeds the amount that would be payable to the insured, his spouse or personal representative under the Workers Compensation Act or other similar law for the same injury or death.

Unemployment benefits

83   Where an insured who is also an insured person under the Employment Insurance Act (Canada) is injured, the corporation is not liable to pay benefits under this Part for the injury, notwithstanding that the insured, his spouse or personal representative has elected not to claim or has forfeited the insured's claim under the Employment Insurance Act (Canada) for the injury, except to the extent that the amount of any benefit payable under this Part exceeds the amount that would be payable to the insured, his spouse or personal representative under the Employment Insurance Act (Canada) for the same injury.

[am. B.C. Reg. 246/98, s. 4.]

Disability benefits for homemakers

84   (1) Subject to section 85 and subsection (2) of this section, where, within 20 days after an accident for which benefits are provided under this Part, an injury sustained in the accident substantially and continuously disables an insured who is a homemaker from regularly performing most of the insured's household tasks, the corporation shall compensate the insured for the period of the disability or 104 consecutive weeks, whichever is shorter, for reasonable expenses incurred by the insured to hire a person to perform the household tasks on the insured's behalf, subject to a maximum amount per week as set out in section 2 of Schedule 3.

(2) No compensation is payable under this section in respect of household tasks performed by a member of the insured's family.

[en. B.C. Reg. 449/88, s. 13; am. B.C. Reg. 438/92, s. 13.]

Waiting period

85   (1) No disability benefits are payable under section 80 or 84 unless the insured is disabled for a period of more than 7 days.

(2) If the insured is disabled for more than 7 days, no disability benefit is payable by the corporation for the first 7 days after the disability commenced.

[am. B.C. Reg. 438/92, s. 14.]

Disability beyond 104 weeks

86   (1) Where an injury for which disability benefits are being paid to an insured under section 80 or 84 continues, at the end of the 104 week period, to disable the insured as described in the applicable section, the corporation shall, subject to subsections (1.1) and (2) and sections 87 to 90, continue to pay the applicable amount of disability benefits to an insured described in section 80 or 84

(a) for the duration of the disability, or

(b) until the insured reaches 65 years of age,

whichever is the shorter period.

(1.1) Subsection (1) does not apply to an insured who, at the end of the 104 week period, has reached 65 years of age.

(2) Where benefits are payable under the Canada Pension Plan or the Quebec Pension Plan to an insured during the period and in respect of a disability for which benefits are payable to the insured under this section, the amount payable each month under this section shall be reduced by an amount not exceeding the amount of the first regular monthly benefit cheque received by the insured under the Canada Pension Plan or the Quebec Pension Plan after the insured becomes eligible for benefits under this section, and that amount shall continue to be deducted notwithstanding that the amount payable to the insured under the Canada Pension Plan or the Quebec Pension Plan may be increased during the time the insured remains eligible for benefits under this section, but if the amount payable to the insured under the Canada Pension Plan or the Quebec Pension Plan decreases, the benefits payable under this section shall be increased accordingly.

(3) Repealed. [B.C. Reg. 324/91, s. 21.]

(4) Where an insured is receiving other disability payments as defined in section 81 and under the terms of the contract for payment of those other disability payments the payments are reduced by any amount received under the Canada Pension Plan or the Quebec Pension Plan, the reduction of disability payments under subsection (2) shall be prorated.

(5) Where an insured who is an employed person returns to work but, because of injuries suffered in the accident, is incapable of earning the amount of his present disability benefits, the corporation will pay the difference between his disability benefits and the amount the insured is presently earning through his employment.

[am. B.C. Regs. 335/84, s. 20; 448/90, s. 14; 324/91, s. 21; 404/94, s. 12.]

Review of benefits

87   Any benefits payable under section 80, 84 or 86 may be reviewed every 12 months and terminated by the corporation on the advice of the corporation's medical advisor.

[am. B.C. Reg. 234/2018, App. 2, s. 11.]

Medical or rehabilitation benefits

88   (0.1) In this section:

"British Columbia consumer price index" means the annual average All-items Consumer Price Index for British Columbia, as published by Statistics Canada under the authority of the Statistics Act (Canada);

"fiscal year" means the period beginning on April 1 in one year and ending on March 31 in the next year.

(1) If an insured is injured in an accident for which benefits are provided under this Part, the corporation must, subject to this section, pay as benefits all reasonable expenses incurred by the insured as a result of the injury for necessary

(a) health care services listed in Column A of Table 1 or Table 2, as applicable, of Schedule 3.1 and provided by the applicable health care practitioner,

(b) occupational therapy provided by an occupational therapist, and

(c) dental, hospital, ambulance and professional nursing services, speech therapy, medication, prostheses and orthoses.

(1.01) For the purposes of subsection (1) (a), a treatment

(a) that is in addition to the number of treatments listed in Column D of Table 1 of Schedule 3.1 corresponding to that health care service, or

(b) that is provided more than 12 weeks after the date of the accident

is not a necessary health care service unless the corporation's medical advisor or the insured's physician certifies to the corporation in writing that, in the opinion of the medical advisor or physician, the treatment is necessary for the insured.

(1.1) Repealed. [B.C. Reg. 383/89, s. 14.]

(1.2) Subject to subsection (1.3), the benefits paid under subsection (1) must not,

(a) for each health care service referred to in subsection (1) (a), exceed the fee limit set out in Column B or C, as applicable, of Table 1 of Schedule 3.1 corresponding to that health care service,

(b) for occupational therapy, exceed the fee limit of $112 per hour, and

(c) for each health care service referred to in subsection (1) (a) that is provided by a physician, exceed the fee limit set out in Column B of Table 2 of Schedule 3.1.

(1.3) For the fiscal year beginning on April 1, 2020, and for each fiscal year after that, each fee limit referred to in subsection (1.2) must be determined annually by multiplying

(a) the fee limit amount for the immediately preceding fiscal year, and

(b) the sum of

(i) 1, and

(ii) the annual percentage change in the British Columbia consumer price index, as determined under subsection (1.5) and rounded to the nearest 1/10 of a percentage point.

(1.4) Despite subsection (1.3) (b) (ii), if the annual percentage change as determined under subsection (1.5) is a negative number, the annual percentage change is rounded up to zero.

(1.5) The annual percentage change referred to in subsection (1.3) (b) (ii) must be calculated using the following formula:

APC = CPI1 - CPI2
CPI2
where
APC = the annual percentage change in the British Columbia consumer price index;
CPI1 = the sum of the 12 individual monthly British Columbia consumer price indexes for the consecutive 12 month period ending on December 31 of the fiscal year immediately preceding the fiscal year for which the fee limit is being determined;
CPI2 = the sum of the 12 individual monthly British Columbia consumer price indexes for the consecutive 12 month period immediately preceding the 12 month period referred to in the description of CPI1.

(1.6) The fee limit amount determined under subsection (1.3) must be rounded to the nearest dollar and an amount ending in .50 must be rounded up to the next dollar.

(2) Where, in the opinion of the corporation's medical advisor, provision of any one or more of the following is likely to promote the rehabilitation of an insured who is injured in an accident for which benefits are provided under this Part, the corporation may provide any one or more of the following:

(a) funds to the insured once during the lifetime of the insured for the acquisition by the insured of one motor vehicle equipped as necessary and appropriate to its use or operation by the insured, the choice of make or model of vehicle to be in the sole discretion of the corporation;

(b) funds to the insured once during the lifetime of the insured for alterations to the insured's residence that are necessary to make the residence accessible to and usable by the insured, the style and cost of the alterations to be in the sole discretion of the corporation and the alterations to be limited to necessary ramps, a necessary lift, necessary bathroom alterations and, where the insured is a homemaker or a person who lives alone, necessary kitchen alterations;

(c) reimbursement to the insured for the costs of attendant care, other than care provided by a member of the insured's family, where the insured has returned to and is residing in the community but is not capable of performing some or all of the tasks necessary to sustain an independent lifestyle, the amount of the reimbursement to be limited to the lesser of

(i) the monthly cost of a group residence, including a long term care facility, that would be appropriate to the care needs of the insured as determined by the rehabilitation team, and

(ii) the monthly cost of attendant care required by the insured as a result of injuries from the accident, the level and type of which will be determined by the rehabilitation team based on the level of care provided by Home Community Care services under the Continuing Care Act;

(d) reimbursement to the insured for costs incurred from time to time by the insured for the purchase and reasonable repair, adjustment or replacement of one or more of the following items:

(i) a wheelchair;

(ii) a medically prescribed bed for other than hospital use;

(iii) bowel and bladder equipment;

(iv) aids for communication, dressing, eating, grooming and hygiene;

(v) transfer equipment;

(vi) a ventilator;

(d.1) reimbursement to the insured for costs incurred from time to time by the insured for the purchase of health care supplies or of health care services not referred to in subsection (1), not exceeding the amount set out in section 3 (3) of Schedule 3;

(e) funds to the insured for vocational or other training that

(i) is consistent with the insured's pre-injury occupation and post-injury skills and abilities, and

(ii) may return the insured as nearly as practicable to the insured's pre-injury status or improve the post-injury earning capacity and level of independence of the insured;

(f) funds for any other costs the corporation in its sole discretion agrees to pay.

(3) Before incurring an expense or obligation under subsection (2) for which the insured intends to request payment by the corporation, the insured shall obtain written approval from the corporation and the corporation may, before giving its approval, require the insured to submit such information as it considers necessary to assist it in making a decision.

(4) The corporation is not liable to insure, repair, replace or maintain a motor vehicle acquired by an insured under subsection (2) (a) except in the course of an approved repair resulting from a subsequent claim for insured loss or damage to the vehicle.

(5) The amount by which the liability of the corporation under this section is limited is the amount set out in section 3 of Schedule 3.

(6) The corporation is not liable for any expenses paid or payable to or recoverable by the insured under a medical, surgical, dental or hospital plan or law, or paid or payable by another insurer, except expenses referred to in subsection (1) (a) and (b).

(7) The maximum amount payable by the corporation under this section for health care services, except for the health care services listed in Column A of Table 1 or Table 2 of Schedule 3.1, is the amount set out in a payment schedule for that service established by the Medical Services Commission under section 26 of the Medicare Protection Act, as that schedule is amended from time to time, for that service.

(8) Repealed. [B.C. Reg. 234/2018, App. 2, s. 12 (j).]

[am. B.C. Regs. 335/84, s. 21; 379/85, s. 33; 449/88, s. 14; 383/89, s. 14; 438/92, s. 15; 491/95, s. 15; 166/2006, Sch. s. 64; 4/2010, s. 3; 60/2019, App. 1, s. 2; 234/2018, App. 2, s. 12, as am. by 60/2019, App. 2, ss. 2 and 3.]

Requirement for receipts

88.01   (1) If an accident occurs for which benefits are provided under section 88, the insured must provide to the corporation a receipt for the expenses incurred that will be compensated as benefits under that section no later than 60 days from the date that those expenses are incurred.

(2) The corporation is not liable to an insured who, without reasonable excuse, fails to comply with this section.

[en. B.C. Reg. 60/2019, App. 1, s. 3.]

Arbitration

89   For the purpose of section 88 (1), any dispute between the corporation and an insured as to whether or not an expense is reasonable, shall be submitted to arbitration under the Commercial Arbitration Act.

[am. B.C. Reg. 449/88, s. 15.]

Power to terminate benefits for refusal to undergo treatment or training

90   (1) Where, in the opinion of the corporation's medical advisor or vocational advisor and in the opinion of the medical practitioner attending an insured who is receiving benefits under section 80, 84, 86 or 88,

(a) any medical, surgical or other similar treatment is likely to relieve in whole or part the disability of the insured, or

(b) a retraining or educational program is likely to assist in the rehabilitation of the insured,

the corporation may require the insured, at the expense of the corporation, to undergo treatment or complete the program.

(2) Subject to subsection (3), where an insured refuses to comply with a requirement under this section, the corporation may, after giving the insured at least 60 days' notice in writing, by registered mail, postage prepaid, addressed to the insured at his last address according to the corporation's records, terminate payment of benefits under section 80, 84, 86 or 88.

(3) The insured may, within the period of 60 days mentioned in subsection (2), apply to a judge of the Supreme Court for an injunction against terminating the benefits on grounds that

(a) the treatment the insured is required to undergo

(i) is unlikely to relieve the insured's disability, or

(ii) may injuriously affect the balance of the health of the insured, or

(b) the program the insured is required to complete is not likely to assist in the rehabilitation of the insured.

[am. B.C. Regs. 335/84, s. 22; 234/2018, App. 2, s. 13.]

Funeral expenses

91   Where the death of an insured is caused by an accident described in section 79, the corporation shall, subject to section 88 (6), promptly reimburse for burial and funeral expenses not exceeding the amount set out in section 4 of Schedule 3.

Death benefits

92   (1) The corporation must pay, if the death of an insured is caused by an accident for which benefits are provided under this Part, a death benefit as follows:

(a) if the deceased insured is survived by one spouse and no dependants, a single lump sum amount of $30 000 payable to the spouse;

(b) if the deceased insured is survived by one spouse and one or more dependants,

(i) a single lump sum amount of $30 000 payable to the spouse, and

(ii) a single lump sum amount of $6 000 payable to each dependant;

(c) if the deceased insured is survived by more than one spouse and no dependants,

(i) a total amount of $30 000 divided equally among the spouses and payable to each spouse, and

(ii) a single lump sum amount of $6 000 payable to each spouse;

(d) if the deceased insured is survived by more than one spouse and one or more dependants,

(i) a total amount of $30 000 divided equally among the spouses and payable to each spouse, and

(ii) a single lump sum amount of $6 000 payable to each spouse and to each dependant;

(e) if the deceased insured is survived by no spouse and one dependant, a single lump sum amount of $30 000 payable to the dependant;

(f) if the deceased insured is survived by no spouse and more than one dependant,

(i) a total amount of $30 000 divided equally among the dependants and payable to each dependent, and

(ii) a single lump sum amount of $6 000 payable to each dependant.

(2) The corporation must pay a death benefit as set out in subsection (3) or (4), as applicable, if

(a) the death of an insured is caused by an accident for which benefits are provided under this Part, and

(b) the deceased insured is a deceased dependent child within the meaning of subsection (8).

(3) If the deceased insured is survived by one parent

(a) who was legally liable to financially support the deceased insured and on whom the deceased insured was dependent, or

(b) with whom the deceased insured resided at the time of death and from whom the deceased insured received most of the insured's financial support because of a mental or physical disability,

the corporation must pay a death benefit in a single lump sum amount of $3 000 to the surviving parent.

(4) If the deceased insured is survived by more than one parent

(a) who was legally liable to financially support the deceased insured and on whom the deceased insured was dependent, or

(b) with whom the deceased insured resided at the time of death and from whom the deceased insured received most of the insured's financial support because of a mental or physical disability,

the corporation must pay a death benefit in a total amount of $3 000 divided equally among the surviving parents and payable to each surviving parent.

(5) If

(a) the death of an insured is caused by an accident for which benefits are provided under this Part,

(b) the deceased insured is a deceased dependent parent within the meaning of subsection (9), and

(c) the deceased insured is survived by a child with whom the deceased insured, at the time of death, resided and who provided most of the deceased insured's financial support,

the corporation must pay a death benefit in a single lump sum amount of $3 000 to the surviving child.

(6) Any benefits payable under this section to a dependent child of a deceased insured must be paid in accordance with section 92 of the Act.

(7) An entitlement to benefits payable under this section must be determined as of the date of the death of the insured.

(8) For the purposes of subsection (2), "deceased dependent child" means any of the following:

(a) a deceased insured who, at the time of death, was under 19 years of age and for whose support a parent was legally liable and who was dependent on the parent for financial support;

(b) a deceased insured who, at the time of death, was 19 years of age or older, resided with a parent and received most of the insured's financial support from the parent because of a mental or physical disability.

(9) For the purposes of subsection (5), a "deceased dependent parent" means a deceased insured who was a parent who, at the time of death, resided with a child and received most of the insured's financial support from the child.

[en. B.C. Reg. 234/2018, App. 2, s. 14.]

Repealed

93-94   Repealed. [B.C. Reg. 234/2018, App. 2, s. 14.]

Sixty day rule and common disaster

95   (1) Any benefits payable under section 92 must be paid only to a person who survives the deceased insured by at least 60 days.

(2) Repealed. [B.C. Reg. 234/2018, App. 2, s. 15 (b).]

(3) The corporation may, in its sole discretion, waive the 60 day survival requirement under subsection (1).

[am. B.C. Regs. 448/90, s. 15; 234/2018, App. 2, s. 15.]

Restriction on benefits

96   The corporation is not liable to pay benefits under this Part in respect of the injury or death of a person

(a) who is resident outside the Province and, at the time of the accident, is the occupant of a vehicle not described in an owner's certificate,

(b) who, at the time of the accident, is

(i) an occupant of or is struck by a vehicle that could not be licensed under the Motor Vehicle Act or Commercial Transport Act or that is of such design that if owned or operated in the Province could not be licensed under one of those Acts,

(ii) the occupant of a vehicle exempted under section 43 or 44 of the Act, whether or not the vehicle is operated by a person named in a driver's certificate, or

(iii) the occupant of a vehicle that is of such design that it could be licensed under the Motor Vehicle Act, the Commercial Transport Act or similar legislation of another jurisdiction, but that is in fact not licensed under the applicable legislation unless the occupant had reasonable grounds to believe that the vehicle was licensed,

(c) who commits suicide or attempts to commit suicide, whether he is sane or insane,

(d) Repealed. [B.C. Reg. 449/88, s. 17.]

(e) who is the occupant of a vehicle that, at the time of the accident, is being used for an illicit or prohibited trade or transport, or

(f) whose injury or death is caused, directly or indirectly, by sickness or disease, unless the sickness or disease was contracted as a direct result of an accident for which benefits are provided under this Part.

[am. B.C. Regs. 379/85, ss. 36 and 37; 449/88, s. 17.]

Notice of claim

97   (1) If an accident occurs for which benefits are provided under this Part, the insured must

(a) promptly give the corporation notice of the accident,

(b) not later than 30 days from the date of the accident, mail to the corporation by registered mail, or deliver to the nearest claims centre of the corporation, a written report on the accident with particulars of the circumstances in which the accident occurred and the consequences of the accident, and

(c) within 90 days from the date of the accident provide the corporation with a proof of claim in a form authorized by the corporation.

(2) The corporation is not liable to an insured who, to the prejudice of the corporation, fails to comply with this section.

[am. B.C. Reg. 60/2019, App. 1, s. 4.]

Repealed

97.1   Repealed. [B.C. Reg. 166/2006, Sch. s. 65.]

Medical certificates

98   (1) An insured must, on request of the corporation, promptly provide a certificate or report of an attending health care practitioner as to the nature and extent of the insured's injury, and the treatment, current condition and prognosis of the injury.

(1.1) The certificate or report required by subsection (1) must be provided to the corporation

(a) in any form specified by the corporation including, without limitation, narrative form, and

(b) in any format specified by the corporation including, without limitation, verbal, written and electronic formats.

(2) The corporation is not liable to an insured who, to the prejudice of the corporation, fails to comply with this section.

[am. B.C. Regs. 408/87, s. 23; 491/95, s. 16; 60/2019, App. 1, s. 5; 234/2018, App. 2, s. 16.]

Medical examination

99   (1) An insured who makes a claim under this Part must allow a health care practitioner selected by the corporation, at the expense of the corporation, to examine the insured as often as it requires.

(2) The corporation is not liable to an insured who, to the prejudice of the corporation, fails to comply with this section.

[am. B.C. Regs. 408/87, s. 24; 491/95, s. 17; 234/2018, App. 2, s. 17.]

Autopsy

100   (1) Where death occurs as a result of an accident for which benefits are provided under this Part, the corporation may withhold benefits payable under section 92 until the insured claiming the benefits allows the corporation to order an autopsy or post mortem examination of the body of the deceased insured to be performed at the expense of the corporation.

(2) Where death occurs a considerable time after the date of the accident and in circumstances that, in the opinion of the corporation, raise doubt as to whether the deceased insured died from natural causes or as a result of the accident, the corporation shall not pay any benefits under section 92 or 93 unless, before burial or cremation of the deceased insured, the insured claiming the benefits informs the corporation of the death and allows the corporation to order an autopsy or post mortem examination.

(3) The corporation shall refer any dispute respecting an autopsy or post mortem examination to the chief coroner or another coroner appointed under the Coroners Act.

[am. B.C. Reg. 234/2018, App. 2, s. 18.]

Time of payment

101   Benefits payable under this Part shall be paid by the corporation

(a) in the case of weekly benefits, within 4 weeks after it receives proof of claim, and thereafter at 4 week intervals if the insured complies with sections 98 and 99 when required by the corporation, and

(b) in any other case, within 60 days after it receives proof of claim.

Alteration of form of payment

102   The corporation may, at any time, make a lump sum payment of benefits or otherwise alter the form of payment to benefit the insured.

Limitation

103   (1) An insured must not commence an action in respect of benefits under this Part unless

(a) the insured has substantially complied with the provisions of sections 97 to 100 that are applicable to the insured, and

(b) the action is commenced as follows:

(i) if the insured has issued written notice to the corporation under subsection (3) and the corporation has issued a written response, the action must be commenced by the later of the following:

(A) within 3 months after the date of the response from the corporation;

(B) within 2 years after the date of the accident for which the benefits are claimed;

(C) if benefits have been paid, within 2 years after the date the last benefit payment under this Part was made;

(ii) if the insured has issued written notice to the corporation under subsection (3) and the corporation has not issued a written response, subject to subsection (2), the action may be commenced at any time;

(iii) if the insured has not issued written notice to the corporation under subsection (3), the action must be commenced within 2 years after

(A) the date of the accident for which the benefits are claimed, or

(B) if benefits have been paid, the date the last benefit payment under this Part was made.

(2) If the corporation issues a written response to a notice issued under subsection (3), the action must be commenced in accordance with subsection (1) (b) (i).

(3) An insured may issue written notice to the corporation of the insured's intention to commence an action in respect of benefits under this Part if the insured makes a claim for benefits under this Part

(a) that has been denied, or

(b) for which the corporation has not made a payment in accordance with section 101.

(4) The notice referred to in subsection (3) must be

(a) in the form established by the corporation,

(b) sent by registered mail addressed to the claim office dealing with the insured's claim, and

(c) received by the corporation within 2 years after the later of the following:

(i) the date of the accident for which benefits are claimed;

(ii) if benefits have been paid, the date the last benefit payment under this Part was made.

(5) The written response by the corporation referred to in subsections (1) (b) (i) and (2) must be either personally delivered to the insured or forwarded to the insured by registered mail to the last known address of the insured.

[en. B.C. Reg. 234/2018, App. 2, s. 19.]

Other insurance

104   (1) If benefits

(a) are provided under this Part and evidenced by an owner's certificate in respect of a vehicle involved in an accident, and

(b) are also provided under this Part and evidenced by an owner's certificate in respect of a vehicle not involved in the accident, or by a driver's certificate,

the benefits described in paragraph (a) are primary and the benefits described in paragraph (b) are available only to the extent that the amount of those benefits exceeds the amount of benefits described in paragraph (a).

(2) If an insured is also insured under vehicle insurance that provides compensation similar to benefits provided under this Part or similar benefits or insurance under similar legislation of another jurisdiction, the liability of the corporation for payment of benefits under this Part must be determined,

(a) if a claim is made in respect of an accident that occurs in the Province, as if section 179 applied in respect of benefits provided under this Part, and

(b) if a claim is made in respect of an accident that occurs in another jurisdiction, as if the provisions of the legislation of that jurisdiction respecting terms, conditions and priorities of vehicle insurance applied in respect of benefits provided under this Part.

(3) Subsection (2) does not apply in respect of benefits payable under section 80.

[am. B.C. Regs. 379/85, s. 38; 166/2006, Sch. s. 67.]

Transitional — disability benefits, funeral expenses and death benefits

104.1   (1) For the purposes of section 80 (1), the applicable amount of disability benefits set out in section 2 of Schedule 3,

(a) as it read immediately before April 1, 2019 continues to apply in relation to disability benefits payable by the corporation under section 80 (1) (a) in respect of an accident that occurred before April 1, 2019, and

(b) as it reads on April 1, 2019 applies in relation to disability benefits payable by the corporation under section 80 (1) (a) in respect of an accident that occurs on or after April 1, 2019.

(2) For the purposes of section 84, the maximum amount per week as set out in section 2 of Schedule 3,

(a) as it read immediately before April 1, 2019 continues to apply in relation to disability benefits for homemakers payable by the corporation under section 84 (1) in respect of an accident that occurred before April 1, 2019, and

(b) as it reads on April 1, 2019 applies in relation to disability benefits for homemakers payable by the corporation under section 84 (1) in respect of an accident that occurs on or after April 1, 2019.

(3) For the purposes of section 91, the amount set out in section 4 of Schedule 3,

(a) as it read immediately before April 1, 2019 continues to apply in relation to burial and funeral expenses payable by the corporation under section 91 in respect of an accident that occurred before April 1, 2019, and

(b) as it reads on April 1, 2019 applies in relation to burial and funeral expenses payable by the corporation under section 91 in respect of an accident that occurs on or after April 1, 2019.

(4) Sections 92 and 93 and sections 5 and 6 of Schedule 3 as they read immediately before April 1, 2019 continue to apply in relation to death benefits payable by the corporation under those sections in respect of an accident that occurred before April 1, 2019, and section 92 as it reads on April 1, 2019 applies in relation to death benefits payable by the corporation under that section in respect of an accident that occurs on or after April 1, 2019.

[en. B.C. Reg. 234/2018, App. 2, s. 20, as am. by 60/2019, App. 2, s. 4.]

Transitional — medical or rehabilitation benefits

104.2   Section 88 as it reads on April 1, 2019 applies in relation to medical or rehabilitation benefits payable under section 88 for expenses incurred on or after April 1, 2019 regardless of the date of the accident.

[en. B.C. Reg. 234/2018, App. 2, s. 20, as am. by 60/2019, App. 2, s. 5.]

Transitional — receipts

104.21   Section 88.01 applies in respect of an accident that occurs on or after April 1, 2019.

[en. B.C. Reg. 60/2019, App. 1, s. 6.]

Transitional — limitation

104.3   Section 103 as it read immediately before April 1, 2019 continues to apply in relation to an action in respect of benefits under this Part in relation to an accident that occurred before April 1, 2019, and section 103 as it reads on April 1, 2019 applies in relation to an action in respect of benefits under this Part in relation to an accident that occurs on or after April 1, 2019.

[en. B.C. Reg. 234/2018, App. 2, s. 20.]

Contents | Part 1 | Part 2 | Part 3 | Part 4 | Part 5 | Part 6 | Part 7 | Part 8 | Part 9 | Part 10 | Part 11 | Part 12 | Part 13 | Part 14 | Part 15 | Schedules 1 to 10