British Columbia's Civil Resolution Tribunal has ruled ICBC cannot deny accident benefits it once confirmed, ordering the insurer to pay over $7,000 in expenses.
The dispute arose from a January 4, 2020 all-terrain vehicle accident near Princeton, British Columbia, in which the applicant was a passenger. The parties agreed the crash was caused by the driver's negligence; the driver has since died. The applicant sought Part 7 accident benefits from the Insurance Corporation of British Columbia under the Insurance (Vehicle) Act, covering medication costs, treatment expenses, and psychology sessions.
ICBC argued the accident occurred off-highway, a use for which the applicant's ATV was not insured, and that the claim was filed too late under the Insurance (Vehicle) Regulation's limitation rules. The tribunal disagreed on timing, finding ICBC had not proven it suffered prejudice from any delay - a requirement under the regulation before a late claim can be barred. ICBC had received the applicant's accident report and updates on his symptoms, and used the same employee to handle both his tort and benefits claims, the tribunal found.
The tribunal never had to resolve exactly where the accident happened. Despite knowing early on that the applicant's own account placed the crash off-road, ICBC confirmed by email on January 15, 2021 that he was entitled to accident benefits. Weeks later, it told the applicant's lender that benefits coverage existed, and on February 8, 2021, it confirmed to his lawyer that "part 7 benefits were open."
That series of assurances met the legal test for promissory estoppel, the tribunal found: a clear promise the applicant relied on to his detriment. Neither he nor his lawyer sought evidence from the driver about the accident's exact location before the driver died in September 2021, since both believed coverage was secure. That evidence, the tribunal found, would likely have been obtained had ICBC disclosed its coverage dispute earlier - and its absence left the applicant unable to counter ICBC's later denial. On that basis, the tribunal held ICBC was estopped from denying the claim.
On the specific benefits claimed, the tribunal awarded $360.19 for medication costs and $5,337 for treatment at a rehabilitation clinic, including physiotherapy, occupational therapy, and counselling, along with $414 for two psychology sessions - all within the regulation's per-treatment maximums. Requests for funding of neuropsychological testing, a physiatrist, and a further functional capacity evaluation were dismissed as unproven; the applicant had not shown a present need beyond care already underway.
Altogether, ICBC was ordered to pay $7,020.99 - $6,111.19 in health care expenses, $784.80 in pre-judgment interest, and $125 in tribunal fees. A separate claim for $20,000 in dispute-related expenses was dismissed for lack of supporting evidence. The decision is a validated order enforceable through the courts.
