Tag: first party insurance

Let me begin by saying that when people talk about “ICBC claims” they typically refer to two different types of claims. The first has to do with ‘own insurance’ that is, you are insured with ICBC, something occurs that requires you take advantage of this insurance and you apply for your own insurance benefits. This is commonly referred to as a ‘first party claim’.
The second, and perhaps more frequently discussed, has to do with ‘third party insurance.’ That is, someone insured by ICBC injures you and you claim pain and suffering and other monies from that person, who in turn, is insured by ICBC and thus you deal with ICBC in that capacity.
The main focus of my blog has to do with ICBC third party claims, however, interesting reasons for judgment were released today by the BC Court of Appeal discussing limitation periods and ICBC first party claims.
The following facts are taken from the reasons for judgment based on the Plaintiff’s pleadings.
The Plaintiff was involved in a serious accident in 1995 when he was 6. His bicycle was involved in a collision with a motor vehicle. He suffered serious injuries including a head injury.
The Plaintiff was insured with ICBC and advanced a first party claim. In April 2003 ICBC refused to fund further services recommended for the Plaintiff’s brain injury ‘because Part 7 benefits were no longer available to the Plaintiff because legal action had not been commenced in a timely way‘.
This case focused on the Limitation Act (Which postpones certain limitation periods from running until a person’s 19th birthday in BC) vs. s. 103 of the Insurance (vehicle) Act which provides a 2 year limitation period in many circumstances to advance a claim against ICBC for first party insurance benefits.
I strongly recommend that this case be reviewed along with the applicable limitation periods for any parent involved in an ICBC claim on their children’s behalf. If you don’t have a lawyer for your child’s ICBC claim, it is vital that you are well aware of these potential limitation periods.
In this case the Plaintiff sued ICBC, not claiming his PArt 7 benefits, rather, claiming that ICBC was negligent ‘in adjusting the Plaintiff’s claim for PArt 7 benefits and that ICBC breached its duty to act in good faith‘.
ICBC brought an application to strike out portions of the Plaintiff’s statement of claim.  In other words, tried to dispose of the lawsuit even before it could go to trial.  The trial judge dismissed parts of ICBC’s application and ICBC appealed.
In this case the BC Court of Appeal held that “It is my view that section 103 does not apply to a non-contractual claim against ICBC as long as the claim is not an indirect attempt to enforce the contractual right to benefits. In this case, although ICBC’s alleged breach of duty resulted in the plaintiff failing to obtain Part 7 benefits, the loss of those benefits is not the damage claim being pursued by the Plaintiff. Rather, the plaintiff is seeking damages for his worsened condition as a result of his failure to obtain those Part 7 benefits.”
In terms of whether ICBC has to tell an injured ‘insured’ person about the limitation periods ICBC argued that ‘it is plain and obvious that (ICBC) did not owe a duty of care to the plaintiff to advise him or his mother regarding the coverage available to them under Part 7 of the Regulation (including advice about the kind of therapy and treatment that could be funded and the existence of the section 103 limitation period).”
Our BC Court of Appeal disagreed with ICBC and stated that “It is not plain and obvious that the present situation is not sufficiently analogous to Fletcher for the court to recognize the duty of care in the present case…..I would not give effect to ICBC’s submission that the court should strike out the allegation in the statement of claim that ICBC owed a duty of care to advise the Plaintiff or his mother of the plaintiff’s entitlement to benefits under Part 7 of the Regulation and of any limitations on his entitlement‘.
The Court of Appeal, however, did not go so far as to state that ICBC does owe a duty of care to tell it’s insured about limitation periods for first party claims. All that was decided was the Plaintiff was allowed to have his day in court to decide this issue.
The bottom line is that ICBC may not have to tell you your limitation periods (even if you are the parent of a brain injured child involved in an ICBC claim) and it is noteworthy that ICBC argued in court that ‘it is plain and obvious’ that ICBC does not have to advise this brain injured child’s parents of the limitation period. SO KNOW YOUR LIMITATION PERIODS OR GET LEGAL ADVICE!