» Alberta Accident Benefits Initial Claims Process

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Alberta Accident Benefits Initial Claims Process

Alberta Accident Benefits - Initial Claims Process


If you have been injured in an automobile accident in Alberta, you are entitled to accident benefits coverage
regardless of whether you were at fault for the accident. The benefits you receive depend on the type of injury
you have:

• If your injury is a sprain, strain or a whiplash associated with disorder I or II, your primary health care
practitioner (chiropractor, medical doctor or physical therapist) does not have to seek approval of the
insurer for payment for treatment of these injuries if you provide notice of your claim. Your primary
health care practitioner will be able to bill the automobile insurer for all treatment services outlined in
the “Diagnostic and Treatment Protocols” that are not covered by Alberta Health Care Insurance.
These protocols have been developed in consultation with primary health care practitioners and are
based on the best research and evidence currently available.

• For all other injuries, if you choose not to follow the diagnostic and treatment protocols, you will need to
pay the health service provider for any services not covered by Alberta Health Care Insurance. You will
be reimbursed for eligible expenses from your extended health care benefits (e.g., Blue Cross or similar
employee benefits plan) and then by your automobile insurer.

What to do if you are injured in an Automobile Accident:

1. See a Primary Health Care Practitioner (chiropractor, medical doctor, physical therapist) as soon as
possible for an assessment of your injury and, if needed, treatment advice.
2. File an injury accident report with the police.
3. Complete the attached Notice of Loss and Proof of Claim Form (AB-1), retain a copy for your
records and send the original signed form(s) to the insurance company. If you are unable to send the
form within the following timeframes, submit it to your insurance company as soon as practicable and
explain the reason for the delay.

• If your injury is diagnosed as a sprain, strain or whiplash associated disorder I or II, submit this
form within 10 days of the accident so that you can access accident benefits described as the
“Diagnostic and Treatment Protocols.”

• If you have other types of injuries, or you choose not to access the accident benefits described
as the “Diagnostic and Treatment Protocols”, submit the form within 30 days of the accident.

• If a family member is fatally injured in the collision, you can access funeral, grief counselling and
death benefits. This form should be submitted within 30 days of the accident.

4. You will be contacted about the benefits you are entitled to receive after the insurance company
reviews your completed form. If your insurance company needs any additional information in order to
process your application, they will contact you.

If you have further questions about this form, the process, or your benefits, please contact your claims
adjuster. If you do not know who your claims adjuster is, contact your insurer or the Insurance Bureau
of Canada at 1-800-377-6378.

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