Personal injury lawyers in British Columbia are always being asked to help get the Insurance Corporation of British Columbia, ICBC, to pay for medical expenses that are not covered by the Medical Services Plan. In this private medical cost car accident injury claim(Engqvist v. Doyle, 2011 BCSC 1585) Judge Rogers in Kelowna found that the injury claimant’s pain and the interference with her enjoyment of life was sufficient to merit compensating her for her private health care costs.
After being injured in two car accidents the claimant was recommended treatment that was not covered by MSP. The court found that private fee-for-service care offers the the possibility of alleviating the claimant’s symptoms more quickly than the public system.
In the first car accident the injury claimant was in her mini-van when another car pulled out into her path of travel. The right front corner of the claimant’s van collided with the left front corner of the other vehicle. The impact was of moderate force upon impact, the claimant’s head hit her steering wheel.
In the second car crash the claimant’s vehicle was rear ended. The second collision increased her stress level and aggravated her neck and back pain. She experienced a severe headache. The claimant however returned to her pre-second accident condition within a few months’ time.
Commenting on payment of private health care costs the court stated,
[45] The first point to address on this issue is that it does not concern the Canada Health Act. It does not require a philosophical discussion of the pros and cons of a general public health insurance scheme. Neither does the issue raise concerns about “queue jumping” by a well-resourced patient.
[46] Instead, the fundamental issue is whether a particular future treatment modality is reasonably necessary to promote the plaintiff’s mental and physical health: Milina v. Bartsch(1985), 49 B.C.L.R. (2d) 33 (S.C.). In the case of medial nerve blocks, the evidence at trial was clear that the plaintiff should undergo at least one set of medial nerve block injections. The evidence at trial was also clear that the plaintiff could access medial nerve block injections on a fee-for-service basis at a private health clinic pretty much at her convenience, while publicly funded medial nerve blocks require that the plaintiff go on a four- to six-month waiting list. Similar time frames apply to rhizotomy procedures if such are indicated by the nerve blocks…
[51] Reasonable in this context must be measured by an objective standard. What is reasonable in a given case must take into account not only the wait times involved, but also the degree of the plaintiff’s pain while sitting out those wait times and the effect that that pain will have on the plaintiff’s enjoyment of life. A minor ache in one’s little finger would be unlikely to be sufficient to underwrite expensive privately funded health care while a case of surgically curable paraplegia probably would.
[52] Accepting as I do the plaintiff’s evidence concerning the pain she has and its interference with her everyday life, I find that the plaintiff’s pain and its interference with her enjoyment of life is sufficient to merit acceleration of treatment via funding of private health care.
The judge awarded personal injury compensation as follows:
| Pain and suffering | $ | 70,000 |
| Past Income Loss | 2,150 | |
| Reduction of Earning Capacity | 5,000 | |
| Out of pocket expenses | 5,264 | |
| Future Care | 30,000 |
Posted by Mr. Renn A. Holness