By: Luke Jones, Published on May 24, 2016 08:15 PM, Last Update on May 31, 2016 02:02 PM
The British Columbia Court of Appeal has held a ruling against the provincial auto insurance provider, Insurance Corporation of British Columbia, which allows disability payments after the 104-week period denoted by the regulations regarding auto accident benefits. The decision upheld an earlier lower court ruling that stipulated accident benefits regulations should be interpreted in a manner consistent with auto insurance legislation.
While the ruling is new, the case stems from an incident in April 2008 when Heidi Symons was involved in a collision near Charlie Lake in British Columbia. Her vehicle was rear-ended by a truck and the ICBC paid disability for the two weeks she was off work. Symons later applied in January 2013 (long after returning to work) to the ICBC to reinstate her benefits.
The provincial insurance provider refused the claim and said it had fulfilled its obligation when Symons had returned to work. The group added that she would not be eligible for benefits because she had returned to work before the end of the 104-week benefit period.
Symons took her case to the lower court, which ruled in her favor. The appeal court had now upheld that ruling.
Disability benefits for employed persons injured in auto collisions are stipulated in BC Regulation 447/83. Section 80 (1) states: “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)”
Disability benefits beyond 104 weeks are stipulated in section 86 (1), which states: “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”
“The 104-week period for payment to Ms. Symons under s. 80 ended on April 27, 2010,” Justice Bennett wrote. “At that time, she last received a disability benefit dated May 2, 2008. Her total disability occurred later. Section 86 says ‘where an injury for which disability payments are being paid to an insured under s. 80 … continues, at the end of the 104 week period, to disable … the corporation shall … continue to pay.’ That section, ICBC says, is clear and unambiguous, and therefore, that is the end of the analysis.”