In Alberta, the standard auto insurance policy (SPF No. 1) includes Section B benefits, which provide up to $50,000 CAD per person for necessary medical treatments like physiotherapy, massage, and chiropractic care, regardless of who caused the accident.
Being involved in a motor vehicle collision in Calgary can leave you with painful injuries and unexpected medical bills. 🏥 Fortunately, Alberta operates under a “no-fault” accident benefits system for immediate medical care. This means that whether you caused the collision on Macleod Trail or were rear-ended at a red light, your own auto insurance company is responsible for funding your initial recovery through Section B benefits.
Understanding exactly what is covered under the Standard Policy Form No. 1 (SPF No. 1) is essential for your rehabilitation. Section B is designed to bridge the gap between the immediate aftermath of an accident and a potential future settlement. These benefits cover a wide array of health services that the standard Alberta Health Care Insurance Plan (AHCIP) may not fully cover.
Step-by-Step Process to Access Section B Benefits in Calgary
Step 1: Seek Immediate Medical Attention
Your health is the top priority. 🤕 Following an accident, visit an emergency room, such as the Foothills Medical Centre, or your family doctor within the first few days. A formal medical record documenting your injuries immediately after the crash is crucial for the insurance company to approve your Section B claim.
Step 2: Submit the Notice of Loss and Proof of Claim (Form AB-1)
To activate your coverage, you must notify your insurance company about the accident. You are required to submit the Form AB-1 (Notice of Loss and Proof of Claim) within 21 days of the accident. Concurrently, your primary healthcare practitioner (doctor, physiotherapist, or chiropractor) must complete and submit the Form AB-2 (Treatment Plan) to outline your required recovery path.
Step 3: Follow the Diagnostic and Treatment Protocols Regulation (DTPR)
For common soft tissue injuries like whiplash (WAD I or II), Alberta utilizes the DTPR system. 👸 This allows you to receive automatic pre-approval for up to 21 specialized treatment visits (such as physiotherapy or chiropractic care) within the first 90 days following the accident, without needing to wait for ongoing insurer approvals.
Step 4: Utilize Your Extended Health Benefits First
It is important to note that Section B is considered secondary coverage in Alberta. If you have extended health benefits through your employer (like Blue Cross or Sun Life), you must submit your receipts to them first. Section B will then cover any remaining balances or copays up to the policy limits.
What Treatments Are Specifically Covered in Alberta?
Section B provides a maximum total coverage of $50,000 CAD per person. However, specific treatments have sub-limits. Here is a breakdown of what you can expect:
| Treatment Type | Coverage Details under Section B |
|---|---|
| Physiotherapy | Covered up to the $50,000 limit, often billed directly within the initial 90-day protocol. |
| Chiropractic Care | Covered up to a maximum of $1,000 CAD unless otherwise approved. |
| Massage Therapy | Covered up to a maximum of $350 CAD (requires a doctor’s referral). |
| Dental Work | Covers repair or replacement of natural teeth damaged directly by the collision. |
| Ambulance Services | Fully covered to transport you from the Calgary accident scene to the hospital. |
How Long Does Section B Coverage Last?
Your Section B medical benefits are available for up to two years from the date of the accident or until the $50,000 CAD limit is exhausted, whichever comes first. ⏱ Additionally, Section B provides a modest weekly income replacement benefit (up to $400 CAD per week for a maximum of 104 weeks) if you are completely disabled from working due to the accident.
Frequently Asked Questions (FAQ)
Do I have to pay out-of-pocket for my physiotherapy?
In most cases, if you treat within the DTPR (first 90 days), the clinic will bill your auto insurance directly, meaning no out-of-pocket costs for you.
What happens if I need more than $350 in massage therapy?
Once you exhaust the Section B limit of $350 for massage, you will either need to pay out-of-pocket or claim these additional expenses in a lawsuit against the at-fault driver.
Can I claim Section B if I was the at-fault driver?
Yes. Section B benefits are standard “no-fault” benefits, meaning every driver, passenger, and pedestrian involved has access to them regardless of liability.
Are prescription medications covered?
Yes, necessary prescription medications related to your accident injuries (such as painkillers or muscle relaxants) are covered under the $50,000 medical limit.
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