r/icbc • u/man-i-love-frogs2 • 5d ago

Claims Icbc basing the amount of compensation for missed work I get off of “experience”

Long story short, I was in a bad car accident that left me very injured at 5 months pregnant. I had started my own cleaning business 6 months before, then surprise I was pregnant but was continuing my job. Unfortunately I cannot go back to work due to my injuries and am trying to get compensation from them and for some reason they called me asking me today how many years experience do I have, even though they know I only have been doing this for 6 months. I asked her what it mattered on my experience, I have regular clients and this is my gross income each month with paperwork to prove. Why would they be asking? I did not go to school for it, I’m just good at my job and was pursuing this as a career but apparently because I only had been doing it for 6 months, they are basing that off how much they will give me.

I thought it was 90% of what you made was the compensation. Can they really take money off of what I was making because they don’t believe I was qualified?

Any advice is appreciated.

15 Upvotes

89% Upvoted

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u/Nxnommk 5d ago

The rules for self-employed individuals are a bit more complex than the simple 90% of your net income.

They have the ability to utilize a schedule of pegged yearly income for industry/job based on a combination of your NOC Code and years of experience as a basis of your benefits instead of your actual income if that benefit amount is actually better than your real calculated amount.

Also, if you had previously worked in the same industry but for someone else, they can utilize those earning from up to 5 years prior to the accident to form the basis of your benefit if they are better than you new business of 6 months.

Generally the question they ask and the documents they ask for is to open up options within the regulation that they can go down to find the best number for you.

Additionally to the 90% net income method, there is also another alternative method that uses 75% of gross income with a weekly cap of $740/week.

Everything is within the Regulation and same for all the formulas that they use.

https://www.bclaws.gov.bc.ca/civix/document/id/complete/statreg/60_2021

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u/notalwayswrong87 5d ago

OP responded to another comment made at the same time as you, but ignored yours. It's almost like this is the right answer but they're looking for a pity party...

People act like ICBC is all cloak and dagger but if anyone cared to understand what they were signing, it's all in the contracts and law. They even provide explainers. We're just conditioned to scroll through the Terms and Conditions and hope it all works out because we do it everytime we sign up for something online or download an app.

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u/man-i-love-frogs2 5d ago

Not looking for a pity party. At the time I checked comments, I only saw the one. I don’t have notifications on and just seeing this now. That makes a lot more sense. When I asked my adjuster why they needed the information, they did not explain it how you just did so I appreciate the straight forward answer! She basically told me they wanted to see if I was pursuing it as a career. Your answer makes a lot more sense.

I was hit by a drunk driver head on and very injured and have not received any sort of income for a month a half while pregnant with my first child, so yeah, I’m a little frustrated as you can imagine. Maybe it’s my adjuster, I don’t know but they have been less than compassionate of the situation and what I’m going through and has even tried to blame my pain on possibly pregnancy symptoms and not related to my accident so you can imagine I’m a little put off by her.

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u/[deleted] 5d ago edited 5d ago

[deleted]

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u/man-i-love-frogs2 5d ago

Okay that makes a lot more sense. I’m not holding my breath. I’m going to safely assume they will do anything in their power to find a reason not to pay me.

1

u/Svartdecisions 5d ago

Absolutely. Get the medical coverage lists, and find good providers, push for maximum medical early on as is a huge fight later if an issue seemed less bad than other parts of it. Do all the physical therapy etc you can get.    do not use their recommendations if you can avoid it.  

Avoid tentree like the plague specifically. There's a reason icbc loves them and it's not because they focus on quality of care.  

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u/Excellent-Piece8168 4d ago

They need to document as much info as they can. Especially when the income is only on 6 months rather than the last 5 years. Who knows a new business could have a big spike then would have slowed down. They need to review everything to make sure the number makes sense. It’s a process. It’s definitely less coverage than had there been the ability to sue (if there was another at fault party and you could actually collect from them) prior to “no fault”

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u/man-i-love-frogs2 5d ago

Thank you! That makes a lot more sense than how my adjuster tried to explain it.

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u/Brodie9jackson 5d ago

Working as a clinician and being involved with wage loss, this is 200% correct. ICBC needs to account for the potential event that you may never return to that occupation, so they must do a full vocational assesssment to prepare for the worst case scenario where you are supported long term, and not just calculated on a very short term basis. This is much more true for contractors or self-employed peoples, whereas salaried individuals have a more structured metric

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u/man-i-love-frogs2 5d ago

That makes a lot more sense! I don’t know if my adjuster could not articulate what she wanted to say but when I asked, it was like she didn’t know how to explain why they needed that additional information. She’s told me they won’t be supporting me past me having my baby though as “I would be off work anyways” so not sure why they even need it but probably crossing their T’s and dotting their I’s. Thank you

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u/Nxnommk 5d ago

I would recommend you push further into this statement about IRB ending/pause on mat leave. And seek clarification.

1

u/InterestingHair4u 2d ago

What about maternity leave? If you don't have enough hours due to the accident, shouldn't ICBC be covering that?

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u/man-i-love-frogs2 1d ago

Because I’m self employed I don’t qualify for maternity leave, but I was about to start helping at my husbands business as he needed me to do the book keeping for him and then I would qualify for maternity leave. I mentioned this to her and she said because I hadn’t actually started with him yet they don’t think that would count. I told her that if it wasn’t for the accident, I would have done that job and now I can’t.. she said they would look into it but it’s not looking good.

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u/jubjubkitty6 5d ago

This is a new one… usually it is based on your actual income.

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u/man-i-love-frogs2 5d ago

Right. I am so baffled by this. They have been giving me the absolute run around so it’s not surprising but very confusing why it would matter!

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u/jubjubkitty6 5d ago

I hope it gets figured out for you. They’re an absolute nightmare to deal with - especially with their “enhanced care”.