Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

C14 - 2017, Automobile Insurance - Part 1 BC > 3 - Accident Benefits > Flashcards

3 - Accident Benefits Flashcards

1
Q
  1. Why are Accident Benefits necessary?
A

Accident Benefits are necessary to provide immediate financial assistance for insured’s, vehicle passenger or both who are injured or killed in an automobile accident.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q
  1. What does the term “no-fault” mean in the realm of automobile insurance?
A

The term “no-fault” means:
That claims are settled with an insured without regard to fault.
That an insured looks to his/her own insurer to recover after suffering a loss.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q
  1. Briefly trace the evolution of no-fault Accident Benefits in Canada
A

In Canada, Accident Benefits evolved from medical expenses coverage which was offered as an optional coverage in the late 1940’s.
In the 1960’s Universal Medicare was established in Canada which ONLY provides coverages for medical expenses.
Rehabilitation cost and required treatments are not covered under Medicare.
In the early stages, Accident Benefits were quite similar in all provinces. Modest limits were immediately available to everyone injured in an automobile accident.
Over time, provinces have taken different directions:
In some provinces the right to sue have been removed or limited to specified circumstances and coverages have been greatly enhanced.
In other provinces, coverage remains nominal and innocent parties are still permitted to sue those who are at fault for full compensation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q
  1. In Automobile insurance, what is threshold?
A

The degree of injury a claimant must sustain before being allowed to commence a legal action against the negligent party.
The dollar amount or verbal injury’s nature and severity description that must be suffered to pursue the right of action.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q
  1. Which provinces have banned lawsuits by motorist/passengers injured in automobile accidents?
A

Quebec and Manitoba

Injured parties are fully compensated by the Accident Benefits coverage in these two provinces.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q
  1. How are Accident Benefits provided?
A

Benefits for at-fault drivers:
Accident Benefits payments are always provided on a no-fault basis.
Accident Benefits provides coverage to:
At fault or partially at fault drivers. This is the only benefit the at fault party receive.
At fault driver’s dependants who are injured in an automobile accident

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q
  1. Does a person injured in an auto accident in BC have the right to commence a legal action against the responsible motorist?
A

Yes, they must first accept or waive the Accident Benefits that they are entitled to receive under basic Autoplan.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q
  1. What legislation defines the scope and breadth of Accident Benefits coverage?
A
  1. Part 7 of the Regulations under the Insurance (Vehicle) Act defines the scope and breadth of Accident Benefits coverage.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q
  1. List the 4 main areas of coverage under Autoplan Accident Benefits
A

Medical and Rehabilitation Expenses, such as: physio, chiropractor, message, ambulance and dental.
Disability Benefits (Wage Loss)–> AGWE(Average Gross Weekly Earning) upto $300/week.
Benefits for Employed Persons: EI, treated as Primary –> ICBC treated as Excess.
Benefits for Homemakers
Death Benefits
Funeral Expenses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q
  1. What types of medical and rehabilitation expenses are covered?
A 
10. Autoplan Accident Benefits reimburse up to $150,000/injured person for expenses: 
Medical
Dental
Ambulance
Chiropractic
Physiotherapy
Occupational therapy
Speech therapy
Prosthetics
Medication
Medical supply or equipment
Attendant care
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q
  1. What are some of the limitations with respect to reimbursement of certain rehabilitation expenses?
A
  1. Autoplan does not cover expenses that may be claimed under other insurance policies, medical or hospital plans.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q
  1. Briefly outline the disability benefits available under Autoplan to employed persons who have been injured in an automobile accident?
A

DISABILITY BENEFITS FOR EMPLOYED PERSONS
Employed persons (someone who had a job or worked 6/12 months at DOL ):
the amount paid is limited to 75% of AGWE - weekly wage loss payment from other benefits or
Maximum amount of $300/week, whichever is less.
EI benefits is treated as primary but takes 2 weeks for benefits to start
Autoplan wage loss begins on the 8th day to cover the 2nd week
No benefits are payable for the first 7 days of TOTAL disability.
EI amount will be deducted from any Autoplan entitlement.
ICBC is not liable to pay benefit for injury or death where an insured is covered under Workers’ Compensation Act.
ICBC is not liable to pay for injury or death even if the insured has elected not claim or forfeited his/her claim under Workers’ Compensation Act.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q
  1. Briefly outline the disability benefits available under Autoplan for homemakers?
A

DISABILITY BENEFITS FOR HOMEMAKERS:
Autoplan will pay up to a maximum amount of $145/week for expenses to hire a person to perform the household tasks on the injured’s behalf.
To be eligible, the insured must be disabled w/in 20 days after the MVA.
No benefits are payable when a family member performs the household tasks on the homemaker’s behalf.
No benefits are payable for the first 7 days of TOTAL disability.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q
  1. What is the waiting period for disability benefits?
A
  1. The waiting period for disability benefits is 7 days. Payments commence on the 8th day.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q
  1. What is the duration of payments under disability benefits for employed persons?
A

The duration of payments under disability benefits for employed persons:
Benefits are available for the duration of the disability if the insured continues to be totally disabled at the end of 104 weeks or until the insured reaches age 65, whichever comes first.
Benefits are reduced by any benefits received from Canada Pension Plan or Quebec Pension Plan after the first 104 weeks of payment.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q
  1. Are funeral expenses covered under Accident Benefits?
A
  1. Yes. If the insured is killed in a MVA, burial and funeral expenses will be reimbursed up to a maximum dollar amount specified in the schedule.
17
Q
  1. What types of payments are made under death benefits?
A

Two types of payments made under death benefits:
- Initial lump sum of payment,
- Weekly payment for 104 weeks.
Children age 19 or older (because of mental&physical infirmity) who receive financial support and reside with the deceased person, are eligible to receive weekly payments for a maximum of 104 weeks.
- Death Benefits are payable to the insured’s spouse, dependant or both if the insured killed in MVA.
- If the insured provided the primary or higher income source, the death benefits to the survivor will be higher than if the insured provided less or no income.
- Higher death benefits are paid if the insured was considered the head of the household.
- The number of surviving dependants will also affect the amount that will be paid.

18
Q
  1. Who is an “insured” under Autoplan Accident Benefits, for accidents that occur in the USA/Canada?
A

The following persons are insured under Autoplan AB for accidents that occur in Canada/USA:

  • The named insured.
  • Members of the household of a person named in an Owner’s Certificate.
  • Members of the household of a person named in a Driver’s Certificate.
  • Occupants of vehicles licensed and insured in BC with ICBC.
  • Occupants of vehicles not required to be licensed in BC operated by persons with a valid BC Driver’s Certificate.
  • Cyclists or pedestrians involved in a collision with an insured vehicle.
  • A resident of BC who is entitled to bring an action for injury or death under Insurance (Vehicle) Act in cases involving uninsured vehicles or hit and run situations.
19
Q
  1. Outline the exclusions to AB coverage that are included in the Insurance (Vehicle) Regulation as “Restrictions on Benefits”.
A

Accident Benefits are NOT paid in respect to person’s injury or death who at the time of the accident was:

  • Resident outside of the province and is the occupant of a vehicle not insured by Autoplan - a visitor from California injured in BC by a motorist from Alberta is not eligible for Autoplan benefits.
  • An occupant of or is struck by a vehicle that cannot be licensed under the Motor Vehicle Act or Commercial Transport Act or an out of province vehicle that would fall into same category such as a snowmobile or ATV.
  • An occupant of a vehicle that is of such design that it could be licensed under Motor Vehicle Act, the Commercial Transport Act or similar legislation of another jurisdiction but is not licensed - Unless the occupant had reasonable grounds to believe that the vehicle was licensed.
  • An occupant of vehicles that are exempted from Autoplan.
  • Accident Benefits are NOT payable for a person’s injury or death resulting from:
  • Suicide or attempted suicide.
  • Involvement in illicit or prohibited trade.
  • Sickness or disease unless the sickness or disease is a direct result of the accident.
20
Q
  1. How will a breach of coverage conditions by an insured affect coverage under Accident Benefits?
A

Breaches of coverage conditions will result in loss of benefits including Accident Benefits such as:

  • The insured doesn’t have a valid DL.
  • Illicit or prohibited trade or transportation.
  • Escape or avoid arrest.
  • Race or speed test.
21
Q

Lawsuits for motorists/injured passengers are banned in:

a) Alberta
b) BC
c) PEI
d) Quebec

A

d) Quebec

22
Q

In BC injured persons can pursue legal action against at-fault parties if:

a) they waive their AB provided under Autoplan
b) they waive their WCB benefits
c) they waive their EI
d) they waive the right to sue their insurer

A

a) In BC, injured persons or spouses/dependants of insureds who have been killed in auto accident still have the right to commence a legal action against responsible motorists. However, they must first accept or waive the AB hey they are entitled under basic Autoplan, or any other contract or pan of auto insurance

23
Q

One of the AB benefits that Autoplan provides is:

a) funeral expenses
b) tax benefits
c) legal expenses
d) life benefits

A

a) funeral expenses

24
Q

In which of the following situations would AB be provided by Autoplan:

a) Suicide
b) Attempted suicide
c) Cyclists injured in MVA
d) Vehicle involved in race/speed test

A

c) Cyclists or pedestrians involved in collision with an insured vehicle are considered to be persons insured under Autoplan AB.

25
Q

Accident Benefits will be paid to an injured:

a) cyclist in Alaska who is not named in owner’s certificate
b) cyclist in Alaska on their way via ferry to Canada who is not named in an owner’s certificate
c) pedestrian in Alaska who is not named in an owner’s certificate
d) pedestrian on their way via ferry to Canada who is named in an owner’s certificate

A

d) When an accident occurs in USA or on a vessel travelling between Canada & USA, no benefits are payable under Autoplan AB to a cyclist/pedestrian, unless he is named in an owners/drivers certificate, or is a member of the household of a person named in such a certificate

C14 - 2017, Automobile Insurance - Part 1 BC (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions