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No surgery date in sight for North Delta man who wants to warn others of ICBC’s no-fault model

Dennis Hoy points to the province’s no-fault insurance model and refusal to pay for individuals to access faster medical and rehabilitation services through the private health care system
Dennis Hoy
Dennis Hoy (pictured) wants to return to his active lifestyle after being rear-ended and tearing a muscle in his shoulder, but nearly five months later, he’s still not sure when he’ll be able to get the recommended surgery.

North Delta resident Dennis Hoy feels the province moving to no-fault insurance puts car-accident victims at the mercy of ICBC and the public health system – both of which have presented him with long wait times to get the care he needs.

Hoy was rear-ended at the end of October last year, which left him with a torn supraspinatus muscle in his shoulder and excruciating pain in his neck and back. Nearly five months later, he still doesn’t know when he’ll be able to get the recommended surgery to repair the tear.

All of his life, Hoy was a physically active athlete. Pre-accident, he would rock climb, ski, and fish regularly. But now, the retired teacher can no longer lift his right arm.

Even with his prescribed medication, Hoy is still suffering from chronic pain as he waits for the surgery to repair his shoulder through the public health care system.

“I have to take pain pills and sleeping pills – opioids. The B.C. government totes how dangerous opioids are, but ICBC does not care one bit if I get hooked on opioids. I can’t sleep or get through the day without taking pills,” says Hoy.

Though ICBC declined an interview with the Optimist, they wrote in an emailed statement that they make “every effort to help injured British Columbians get access to the care they need, as soon as possible after a crash.”

Hoy points to the province’s move to a no-fault car insurance model called Enhanced Care, which means that individuals can no longer sue the person who caused the accident and then use that money to access medical services through the private health care system.

According to the ICBC website, people are only able to sue if the at-fault driver is convicted of certain Criminal Code offences that led to the accident, like impaired driving.

Going through the private system – as opposed to the public system with notoriously long wait times – could mean more streamlined care for individuals like Hoy who need these services as soon as possible to recover and move forward after the accident.

In their statement to the Optimist, ICBC said they cannot privately pay for imaging or surgeries that are medically-required services provided under the province’s Medical Services Plan due to the Insurance (Vehicle) Act and its Enhanced Accident Benefit Regulation.

“ICBC follows up with health care providers leading customers’ care plans to determine treatment options, taking into consideration wait times. In some cases, customers may benefit from treatments like physiotherapy, massage therapy and pain management, to name a few, that would be paid for under Enhanced Care coverage,” said ICBC in their emailed response.

These types of rehabilitation treatments or interventions are pre-approved for injured individuals within the first 12 weeks after their accident, but from there, they must demonstrate that further treatments are necessary for their recovery, ICBC added.

This process of demonstrating a continued need for treatments, which includes hours of waiting on hold with ICBC, is time-consuming and exhausting, says Hoy. If he wasn’t already retired, he says he wouldn’t have the time for all the back-and-forth it involves.

“I’ve kept myself out of the healthcare system because of my physical fitness my whole life, and how many good years have I got left?” he says. “I want fair treatment for people, especially people that have been injured at no fault of their own, like myself.”

B.C. moved to Enhanced Care model in May of 2021 with the reasoning of decreasing insurance costs and improving care, recovery and wage loss benefits.

According to ICBC, moving to this system removes the “adversarial approach” of suing drivers and “the hundreds of millions of dollars that was being spent on legal costs under the former system.”

“Under the previous insurance system, care and recovery benefits were capped at $300,000 and only those not responsible for causing a crash could sue an at-fault driver for additional compensation. Now, with Enhanced Care, there is no overall limit to the care and recovery benefits available to British Columbians injured in a crash – they get all the care they need, when they need it, for as long as they need it,” said ICBC in their emailed response.