You told me my claim would remain open!
|Authority||Insurance Corporation of British Columbia|
Cara was injured in a car accident when she was a young child. The accident resulted in the amputation of one of her arms. She received an award for no-fault benefits.
Now an adult, Cara believed that her benefits claim would remain open until the award amount had been depleted. However, when she applied to ICBC for assistance with the cost of a new prosthetic arm, ICBC denied her claim because it had been inactive for more than two years. With the help of a lawyer, she had been trying to resolve this issue. After 13 months without resolution, Cara came to us.
Our investigation began with a review of the Insurance (Vehicle) Act Regulations. Section 103 states that a claim for benefits under Part 7 can only be made within two years of the date of the last benefit payment made. However, we also reviewed the other documents that were available and identified one in particular that made a difference. Cara had a letter from ICBC written to her parents’ lawyer in 2000 that said her claim would remain open indefinitely as part of the settlement reached on her behalf.
Given the assurance provided in the letter we questioned whether ICBC followed a reasonable procedure in closing Cara’s claim and denying her application for Part 7 benefits.
ICBC was initially unable to locate any documents related to Cara’s claim. In order to further the investigation we provided ICBC a copy of the letter they gave Cara’s family in 2000 and discussed its consequence. After consulting with its legal department, ICBC agreed to reconsider its decision. Cara’s file was reopened and ICBC assured her that, as promised, she could access the part 7 benefits until the award amount was depleted.
|Category||Driving and Transportation|