They know how the system works... do you?
ICBC won't pay for medical-rehab treatment my doctor recommends. Should I still undergo the treatment - and if so, how can I get them to pay for it?
It's important for your health and well-being for you to follow your doctor's recommendations. It's also crucial for your insurance claim. If you ignore your doctor's suggestions, ICBC may claim that you haven't made a sufficient effort to recover, so you're not entitled to accident benefits or compensation. The fact that ICBC won't pay for your treatment upfront isn't a valid excuse for not doing it, even when covering this cost yourself might place you in financial hardship.
One reason ICBC often won't pay for necessary treatment is to place a financial strain on claimants and their families. If you're struggling financially, you're more apt to accept a quick settlement, which might not be fair to you nor fully compensate you for your injuries. While Canadian courts have ruled that a corporation can't knowingly place a financial burden on a party with “significantly weaker resources” than them, ICBC does this all the time.
If you win your case at trial, your lawyer can argue that you're entitled to “special costs” because ICBC took unfair advantage of you by not paying for needed treatment. This could substantially increase the money you end up with. (Your lawyer can't charge a contingency fee on awarded costs.)
If you weren't at fault in your accident, as part of your damages you should get back any money you spend on medical-rehab treatment recommended by your doctors. You may also get money to pay for future treatment.
Even if you were at fault, when you settle your claim you should get back money for treatment that's normally covered as a Part 7 (no-fault) accident benefit. ICBC prefers not to keep claims open indefinitely. You can refuse to sign off on your claim – which would terminate your right to future Part 7 benefits - unless you're reimbursed for all your out-of-pocket medical-rehab expenses.
You can sue ICBC for no-fault benefits by initiating a Part 7 legal action against them. Depending on how much money is involved, the case may be heard in Small Claims Court or the BC Supreme Court.
If ICBC provides you with some accident benefits but won't pay for specific treatment, you can take them to arbitration. You'll have to show that the recommended treatment is necessary; your need for it is a direct result of your accident; and the cost of the treatment is reasonable.
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If you don’t get treatment your doctor recommends, you won’t be awarded money for this treatment in the future.
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If you're entitled to WorkSafeBC benefits or you have extended healthcare or other insurance coverage they'll have to cover your medical-rehab costs. The insurer may be reimbursed later through your claim for damages.