Part 7 Accident Benefits – Preserving the limitation date for benefits

Are you familiar with the limitation deadlines related to accident benefits in BC? We will outline some key limitation dates to be aware of in this article. 

The key timelines to be aware of:

  1. Whether ICBC has denied payment to you; or
  2. Whether ICBC has failed to make payment to you for a claimed benefit.

These timelines are identified in Section 101 “Time of Payment” of the Insurance (Vehicle) Regulation and it is enumerated below.  It states:

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.

If payment has not occurred, you may proceed with commencing an action with the Civil Resolution Tribunal, which has sole jurisdiction over Part 7 Accident Benefit claims.  However, in order to present your claim, you must be aware of the provisions of the Insurance (Vehicle) Regulations and proper notice must be provided to the insurer.  In particular Section 103 (3) requires a claimant to provide ICBC with written notice of your intention to commence an action for accident benefits.

Limitation

Section 103 (3) “Limitation” states the following:

(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.

Once a claimant provides written notice to ICBC about their intention to pursue an action, an insured may commence an action for accident benefits within the time limits outlined in Section 103 (1)(b). 

The time limits are noted here for ease of reference:

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).

The published decision Mu v. ICBC 2020 BCCRT 267 2020-03-06  offers an example of a case where a Dispute Notice was filed to preserve the limitation deadline under Part 7 of the Insurance (Vehicle) Regulations.  Written notice was not provided to the insurer by the claimant however, and benefits were not denied by the insurer, nor was there a failure of ICBC to make payment. 

The Dispute Notice was filed for the sole purpose of preserving the limitation deadline – as the Act is not specific on this issue.  The CRT said the following:

  1. In this case, it is undisputed that Ms. Mu has not given ICBC written notice under section 103(3). Ms. Mu submits she does not meet the requirements of section 103(3). I take this to mean that ICBC has not denied any benefits sought by Ms. Mu, and has not failed to make payment for any benefits within the prescribed time limits. It is also undisputed that Ms. Mu filed her Dispute Notice within the applicable limitation period.
  2. The issue before me is to determine whether Ms. Mu’s Dispute Notice can stand as a “placeholder” to preserve her limitation period for making a claim for accident benefits, given no specific claims or remedies are requested at this time. It is trite law that generally, in the absence of specific rules laid down by statute or regulations, administrative tribunals control their own procedures, subject to the rules of fairness and natural justice (see: Prassad v. Canada (Minister of Employment & Immigration), [1989] 1 SCR 560). I find there is no statutory direction on this point, and therefore, the tribunal must develop procedures and timelines which are consistent with its mandate, including deciding whether or not to allow “placeholder” claims.
  3. Mu submits that, prior to April 1, 2019, before the CRT had exclusive jurisdiction over Part 7 accident benefit claims, the proper course was to file a “pro forma” claim in court in order to preserve a limitation period and protect an applicant’s right to claim for accident benefits. Ms. Mu submits that because the limitation period for accident benefits under the tribunal’s accident claims jurisdiction is the same as pre-April 1, 2019 claims for Part 7 benefits with the court (that is, 2 years), it follows that filing a pro forma Dispute Notice is within the tribunal’s mandate.
  4. I find an applicant, such as Ms. Mu, is entitled to file a Dispute Notice seeking accident benefits at any time, subject to the prescribed limitation period. Additionally, an applicant can include as much or as little detail in their Dispute Notice as they see fit, with the obvious risk that insufficient detail may mean they are unable to prove their claims. However, the tribunal’s mandate is to provide dispute resolution services accessibly, quickly, economically, informally, and flexibly.
  5. Once a Dispute Notice is filed, the dispute resolution process is started, and is not paused unless so ordered by the tribunal, on request by a party, and pursuant to tribunal rule 1.15. A request to pause a tribunal proceeding is not granted as of right.
  6. Tribunal rule 1.15 says that in considering a request to pause the tribunal process, the tribunal may consider:

a. The reason the party is requesting that the tribunal process be paused,

b. Whether all parties consent to pausing the tribunal process,

c. Any prejudice to the other parties if the tribunal process is paused,

d. Whether there have been previous delays, and the reason for those delays,

e. Whether the tribunal’s mandate supports a pause,

f. Any other legislation that may apply to the dispute or the request to pause,

g. Whether it is in the interests of justice and fairness to pause the tribunal process, and

h. Any other factors the tribunal considers appropriate.

24.In considering whether a dispute should be paused, the tribunal may determine that indefinitely pausing a proceeding, such as to allow a placeholder Dispute Notice filed to preserve a limitation period to sit dormant, is inconsistent with the tribunal’s mandate or with section 103 of the IVR. However, this issue is not before me, and would be determined by the tribunal if a party makes a request to pause the dispute.

25.Here, I find Ms. Mu’s Dispute Notice was properly filed within the limitation period and its subject-matter is within the tribunal’s jurisdiction. Therefore, the dispute resolution process has begun. In accordance with the tribunal’s mandate, the tribunal moves disputes through the dispute resolution process in a timely manner, subject to any requests to pause the process granted by a tribunal member. An applicant who files an application for dispute resolution must be prepared for the tribunal to resolve their dispute in a timely manner, consistent with the tribunal’s mandate.

26. As such, I find Ms. Mu’s claim for entitlement to accident benefits may continue as filed, and it will be up to the tribunal to decide any requests by the parties to pause the dispute resolution process, considering the factors in tribunal rule 1.15, discussed above.

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