Finding Solutions to Key Challenges: Part 1 Incurred Expenses – A Challenge for New Accident Victims

On September 1, 2010, the interpretation of “incurred expense” changed dramatically and created new challenges for the families of innocent accident victims.

From 1991 to 1995 the definition of “incurred expense” to obtain attendant care required families to retain professional caregivers in order to qualify for reimbursement under the SABS.  In subsequent revisions of the SABS, the requirement to use professional caregivers was removed and the Courts interpreted the word “incurred” in a manner that was more favourable to the insured.

The changes to the regulation which came into effect on September 1, 2010 take us back to the situation which existed prior to 1994 and which proved to be so unfair to accident victims. Under this new regulation the application of the regulatory definition of ‘incurred’ requires that the insured have received the goods and services or have paid the expense or promised to pay the expense before they can be reimbursed by the insurers.

This of course, puts a highly unfair burden on the family of the accident victim to cover costs out of pocket before they can be reimbursed. In many cases this can result in a family member having to quit their job to provide attendant care to quality for reimbursement under SABS.

This is the tip of a very deep iceberg that can have a profoundly negative financial impact on accident victims and their families at a time when they are quite likely to already be struggling financially.

Click here to read the full version of Craig’s paper

Your Comments Are Always Welcome

If you have any comments to pass along to us, please feel free to make them here. We would appreciate your feedback and are very interested in the details of any particular challenges these changes in the law have presented for you.