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The Advice Centre

ICBC Accident and Injury Reimbursement Agreement

Tuesday, September 18, 2018
Insurance Basics, How to make a claim

ICBC Accident and Injury Reimbursement Agreement

Why the Reimbursement Agreement is Necessary:

All Pacific Blue Cross Plans contain an exclusion that prohibits us from paying claims that are related to any automobile injuries.

ICBC Accident benefits are available to most British Columbians who have suffered injuries in an automobile accident, regardless of who is at fault. Because these are excluded on your PBC plan, you must make a claim to ICBC to have your injury-related expenses paid with respect to extended health benefits and wage loss. We recommend that you engage legal advice to help you through the ICBC claims and settlement process.

We recognize that these claims can take a long time to settle. We do not want your recovery to be delayed because you are waiting for payment from ICBC.

Our solution has been to build a provision into all PBC plans that allows us to advance funds for claims that would have been eligible expenses if they were not part of an automobile accident.

Part of this contract provision to advance funds is the Reimbursement Agreement. In order for us to be permitted to advance funds for eligible expenses, we must have a completed and signed Reimbursement Agreement in place.

These advanced funds must be reimbursed to us for the full amount claimed, regardless of the amount and terms of any settlement received.

What You Can Expect:

  • You may notice that your eClaims access has been suspended. This is temporary as we await the signed Reimbursement Agreement, and it will be reinstated at that time.
    • Until this is reinstated, you must submit your non-auto injury related claims by paper.
  • When you make claims with our Extended Health Claims form, or when you make claims online, you must identify the claims that are related to your auto injury. There is a check box for you to tick.
    • Claims that are not related to your injury can be submitted and will be processed as usual
  • As your lawyer works on your behalf with ICBC, we will continue to advance funds for your eligible claims as you submit them.
  • From time to time, you may receive communications from our Finance Recoveries team asking about your progress with ICBC. Our intention is to assist you and or your lawyer in fulfilling your obligation to reimburse the plan.
  • Your lawyer may contact our Finance Recoveries department, regarding the amounts that we have advanced for your auto injury related expenses.
  • When your ICBC claim is closed, the accident related amounts advanced will become due, in accordance with the terms in the Reimbursement Agreement.

Future Claims:

Claims arising from auto related injuries are excluded from your plan. If your ICBC case has been closed, and you are still experiencing symptoms of your related injuries, the related claims will not be eligible for reimbursement.

Please ensure that your settlement from ICBC includes consideration for future claims that may be related to your injuries.

Any Questions:

Our Customer Service Representatives are available for your calls from Monday to Friday from 8:00 am to 4:30 pm. Alternately, you can drop by our customer service centre at 4250 Canada Way, Burnaby between the hours of 8:30am and 4:00pm, Monday through Friday. We are here to help.

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