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So......you got into a car accident......Now What?

Posted 4/19/2018

Being involved in a car accident. You have injuries, your car is damaged, you have no transport, you are upset and frustrated......and now you have to navigate the insurance system to figure out what to do.

Stay calm, there is plenty of help. 

Make sure you exchange information with the other driver. If  there are any injuries, damage exceeds $2,000, if any driver does not have documentation such as a driver’s licence, registration or insurance, if one or more of the vehicles isn’t drivable or you are the victim of a hit and run make sure you contact the police. If there are no injuries and damages are minor, exchange insurance information and contact your insurance provider. 

If you have been injured in an automobile accident in Alberta, you are entitled to accident benefits coverage regardless of whether you were at fault for the accident. The benefits you receive depend on the type of injury you have and here is where we can help. It is relatively simple to navigate the injury benefits, although with all the medical jargan and other things you are dealing with, it can seem daunting. 

We will give a little run down on the process, but remember we have dealt with many car accident claims in the past and we can help guide you through the process. We will try to keep it as simple as possible:

 

Within 90 days from the date of accident - Protocol coverage

The coverage you are entitled to depends on your diagnosis; but don't you worry about that. We will do the assessment and fill out the paperwork required. You will need to fill out an Notice of Loss and Proof of Claim Form - but we have them on hand at the clinic. You do not have to wait for the insurance company to send you your paperwork. Most injuries fall under the WAD (Whiplash Associated Disorders) classification which is a classification system that categories injuries based on severity/symptoms. But don't worry, we can help you out with that!

  • If your injury is a soft tissue injury, you are entitled to 10 (WAD1) or 21 units (WAD2) of treatment without the need for prior approval from your insurance company. This coverage is legislated, which means we do not have to wait for an insurance company to approve this. This was implemented to allow patients to commence treatment earlier as early intervention has been shown to have positive effects on recovery. 
  • If your injuries fall outside of the of a WAD1 or WAD2 classification, approval is required form your insurance provider.
  • With any injuries, all the necessary paperwork must be submitted to 'activate' the injury claim. Physiotherapists are Primary Care Providers and as such are able to make the diagnosis and complete the necessary paperwork required.
  • If you have commenced treatment elsewhere, either at another physiotherapy clinic or with a chiropractor you will need to advise other healthcare providers so that 1) they can coordinate treatment and 2) your insurance company only covers ONE ASSESSMENT fee and treatment with a different provider may result in an assessment fee that you are responsible for. 
  • You are entitled to up to $160 in necessary supplies to aide in your recovery.

After 90 days from the date of accident (or after your 10/21 units - Section B coverage

  • Prior approval is required for all injuries after 90 days, WAD1 and WAD2 injuries after the 10 or 21 units or for any injuries that do not fall in the WAD1 or WAD2 classifications. Again, don;t worry about that, our assessment will help determine where you fall. 
  • For any injuries outside 90 days, WAD1 and WAD2 injuries after the 10 or 21 units or for any injuries that do not fall in the WAD1 or WAD2 classifications, your extended health care must be exhausted prior to your car insurance coverage. 
  • After 90 days, WAD1 and WAD2 injuries after the 10 or 21 units or for any injuries that do not fall in the WAD1 or WAD2 classifications there are some 'absolute' limitations that are available through your car insurance unless you pursue legal action.
  • Once your extended health care insurance in exhausted, your car insurance will cover treatment, if approved, and up to  limits that are set forth by legislation. For example, under Section B coverage, you are entitled to a maximum of $250 for massage and $750 for chiropractic care. Physiotherapy has no set limit.

This and That

  • Insurance coverage is for treatment of injuries sustained as as result of the car accident in which you were involved only. We can not bill your car insurance for any injuries which are not a result of the car accident. 
  • Insurance benefits are non-transferable; we can not bill your insurance provider for treatment obtained by anyone other that yourself. 
  • Everyone loves massage! While massage can be an important part of your treatment program, please ensure you are following the recommendations of your primary care provider, be that a medical doctor, chiropractor or physiotherapist, and attending you other treatments as well. 
  • If you are attending treatment at multiple clinics, please let us, and the other clinic know. This is important so that we can all work together to ensure we are working towards the same goals. 
  • We will do our best to help you keep track of your insurance coverage, but ultimately the responsibility to track this coverage lies with you. 

You have the right to choose where you want to receive your treatment. If you have been attending another facility and want to move to a new one to continue treatment you must inform your adjuster of your wish to do so. You will need to inform the new clinic you are attending how many treatments you have received. You may also have to pay to have your file transferred depending on the policy of the clinic you were previously attending.  Any costs you incur that a third party funder will not cover are your responsibility to pay.

Please note: This information is NOT a legal advice and does NOT modify or replace your automobile insurance policy.  For more information on your specific situation, speak to your insurance agent, broker, company representative or contact legal counsel. 

 

Hmmmmmmm, so it is harder to explain than we thought. Do you have more questions? Did we miss something? Feel free to comment below, email us or call us to see how we can.

 

Here are some links for more  information:

http://www.finance.alberta.ca/publications/insurance/automobile-insurance/automobile-collision.html

 

https://justice.alberta.ca/programs_services/mvac/Documents/MVAC-Resource-Booklet.pdf

 

https://s3.maic.qld.gov.au/files/Whiplash-Injury-Recovery-booklet-2015.pdf

 

http://www.finance.alberta.ca/publications/insurance/forms/what-to-do-auto-collision-worksheet.pdf