Basic coverage/
Lawsuit ban
Lawsuit ban
Basic Vehicle Damage coverage only applies to off-highway crashes when at least two licensed standard vehicles are involved. True or False?
True
An Income Replacement benefit is available for customers based on their earner classification. Name all 6.
- full-time earner
- part-time
- temporary earner
- non-earner
- student
- minor
How is a milestone different than a recovery goal?
A milestone evaluates progress towards a recovery goal
When must an insured provide receipt for expenses incurred that will be paid or reimbursed as benefits?
Sec 57 ….no later than 180 days from the date that those expenses are incurred.
A student or minor cannot qualify for both reimbursement of non-refundable tuition fees and loss of studies benefit- True or false?
True, technically, it’s the same benefit. The insured is entitled to the greater of the LOS amount or the cost of non-refundable tuition expenses
Basic vehicle damage coverage shifts settlement of specific vehicle damage claims from third party to?
1st Party
A CL-22 claims application form is not required to pay for income replacement benefits. True or False.
False
Where in ClaimCenter, will specialist track progress of the goals, milestones, and functional abilities and limitations
In the Functional Limitation screen
What is the minimum permanent impairment compensation if the insured sustains a non-catastrophic injury?
$836
How many hours per week qualifies an employed person as a part time earner?
Less than 28hr
Who identifies lawsuit ban exceptions?
non-injury adjuster or recovery specialist
If the responsible driver is convicted of a criminal code offence, will the IRB benefit be affected and how?
Yes it may be reduced, depending on percentage of responsibility and number of dependants. Also some criminal convictions will not be subject to a reduction
Customer’s job requirement is lifting up to 50lb, they are able to lift 20lb compared to 5lb the previous month, this is a recovery goal. True or False?
False. This is a milestone.
How often is a caregiver benefit payable under section 152 of the Act?
Every 14 days
Covers treatment or services which lessen an injured customer's disability, facilitate their recovery, or prevent a decline in function
Medical and Paramedical benefit
Starting May 1, 2021, statutory uninsured/unidentified motorist provision will only respond to claims for what type of damage?
non-vehicle property damage
As part of this benefit, all earners are eligible to receive up to what % of their net income, & what is maximum yearly insurable income for the period of May 1, 2021 to March 31, 2022?
90% & $100,000
What are the 5 steps to our case management model?
1. Establish relationships, gather and provide info
2. Establish care plan with goals and milestones 3. Maximize treatment impact
4. Manage case plan
5. Conclude case plan and close claim
Under the Recreation Benefit, for an injured customer with a permanent impairment rating of 35%, what is the sub-limit of benefits available under this benefit, every 2 years?
Sec 36.7, $500
Name 3 circumstances under which a non-BC resident would be eligible for EAB?
-They are named registered owner or lessee
-They are the driver or occupant of the BC plated vehicle involved in the crash
-They are a pedestrian or cyclist struck by the BC plated vehicle
For vehicle related loss, which 4 losses are subject to the lawsuit ban?
-Vehicle to vehicle dmg in an on-highway crash in BC
-Loss of use
-Accelerated depreciation
-Two or more standard vehicles involved in an off-hwy crash in BC
What section of the Regulations discusses the events that end or suspend entitlement to IRB?
Part 2, Sec 11 of the Income Replacement & Retirement benefits and benefits for students and minors Regulations
Name 5 guiding principles for our medical strategy
1. Evidence based and best practice care,
2. Function based outcomes
3.Timely access to care
4.Customized customer-centered care
5.Collaborative design and delivery
What is the timeline for the corporation to commence an action on recovery of benefits and what section covers it?
Sec 67, within 2 years after the date on which the benefits were paid, and (b) may commence an action to recover benefits, if fraud is involved, at any time
Which three EAB are reduced if responsible driver is convicted of a Criminal Code offence?
- Income Replacement
- Permanent Impairment
- Death Benefits, if the responsible driver is a beneficiary of the deceased person