ICBC Not Entitled To Unlimited Information in Processing Claims
ICBC has a lot of power when processing claims. But it is not unlimited. This week reasons for judgement were published by the Civil Resolution Tribunal reigning in some of the power ICBC thought they had.
In the recent case (Nawa v. ICBC) the Applicant was involved in two collisions. A benefits dispute arose with ICBC with the Applicant claiming, among other things, that ICBC wrongfully suspended the payment of his income replacement benefits.
ICBC argued they were entitled to do so because he did not comply with section 11 of the Insurance (Vehicle) Act. This section requires an insured to give ICBC “the content required by the corporation” and further to “comply with any other method of making and proving claims that is established by the corporation.“.
ICBC argued that the insured failed to provide them all the financial information they wanted including his tax records from up to two years prior to his crash.
The CRT found ICBC was wrong to suspend the benefits and noted that while the legislation is broad and gives ICBC the power to request a lot of information they can’t get everything just because they want it. They are restrained to information that is “necessary and material” for the insured to make or prove their claim.
In ordering ICBC to reinstate the benefit and finding their powers for information do have limits Tribunal Member Alison Wake provided the following reasons:
46. In a letter dated June 14, 2023, ICBC informed Mr. Nawa that it had suspended his income replacement benefits. ICBC then requested that Mr. Nawa provide further financial information, this time dating back to 2018, within 10 business days in order to determine his eligibility for income replacement benefits.
47. I note the document request in ICBC’s June 14, 2023 letter is significantly broader than its February 21, 2023 and March 7, 2023 requests. ICBC did not explain, in this letter or in submissions, why it expanded on its previous requests and why the additional information was required to determine Mr. Nawa’s entitlement to income replacement benefits.
48. ICBC relies on section 121(1)(d) of the IVA, which allows ICBC to reduce, suspend, or cancel benefits where an insured fails to comply with section 11. Section 11 allows ICBC to require an insured to provide certain information to it. While ICBC does not specify which subsection it relies on, I infer it relies on section 11(4), which allows ICBC to require an insured to provide documents including “the content required by the corporation”, and to “comply with any other method of making and proving claims” that is established by ICBC. While this provision grants ICBC broad authority to request information from its insureds, I find it necessarily implies that the information ICBC requires must be sufficiently related to the insured’s claim. In other words, I find that to suspend or cancel benefits based on an insured’s failure to provide requested information, ICBC must establish that the requested information is necessary and material for the insured to make or prove their claim.
49. As noted, ICBC did not explain in any of its correspondence or submissions why it required the requested additional information to consider Mr. Nawa’s claims. While I find there is no evidence to support Mr. Nawa’s argument that ICBC was “fishing” for information to use against Mr. Nawa’s employer, in the absence of any further explanation from ICBC, I find it is not clear that the requested information was material to Mr. Nawa’s claim for income replacement benefits. So, I find ICBC was not entitled to suspend Mr. Nawa’s income replacement benefits on this basis.