New Alberta Standard Automobile Policy S.P.F. No. 1

The new Alberta Standard Automobile Policy S.P.F. No. 1 was recently issued, replacing the S.P.F. No. 1 issued in 1998. The new Policy incorporates changes brought about by amendments to the Insurance Act, R.S.A. 2000, c. I-3, and accompanying Regulations 121/04 and 259/06.

There are no changes to Section A (Third Party Liability), Section C (Loss or Damage to Insured Automobile), or the Statutory Conditions. The action is in Section B, the Accident Benefits.

Alberta Regulation 121/04 took effect on October 1, 2004, and with it came the following changes:

1. Medical services covered now include the following:
   • massage therapy, to a limit of $250
   • physical therapy, to a limit of $250
   • acupuncture services, to a limit of $250
   The monetary limit for all insured medical expenses is increased from $10,000 to $50,000;
2. The limit on charges for chiropractic services is increased from $500 to $750, and the limit on psychological, physical, and occupational therapy services is $600 each;
3. It affirms that the Section B benefits are secondary to any hospitalization plan or other insurance contract, with a new exception for expenses payable for an injury to which the Diagnostic and Treatment Protocols apply. If expenses are incurred for care or treatment prescribed under the Protocols, the Section B benefits become primary, subject only to expenses payable under any law;
4. Death benefits, as provided in Subsection 2, are payable not only to "spouses" but also to an "adult interdependent partner". Indeed, the definition of an "insured person" now extends beyond the named insured and their spouse to include an adult interdependent partner. Adult interdependent partners are mentioned in Section B's "Special Provisions, Definitions and Exclusions";
5. It provides a benefit of $400 per family for grief counselling, payable to the spouse, or the adult interdependent partner, or other immediate family member of the deceased;
6. It provides increased death benefits upon the death of the head of the household. If there is a surviving spouse or adult interdependent partner living in the household, the benefit is increased by $15,000 for the spouse or adult interdependent partner, and by a subsequent $4,000 for each remaining survivor. Where there are 2+ survivors who are a spouse or adult interdependent partner, and 1+ dependent relatives, the benefit is increased by 20% for each survivor other then the 'first';
7. The definition of a "dependent relative" now includes those who are 18 and over, and live in the same home as the head of the household and who are principally dependent on the head of the household for financial support due to mental or physical disability. Previously, it appeared that the financial dependence had to be total to allow a person to fall within this definition. Further, "dependent relative" now includes those who depend for financial support on the head of the household, or on the spouse or the adult interdependent partner of the head of the household.
8. An interesting amendment is in paragraph 2.1 which clarifies the situation with respect to a head of household who has both a spouse and an adult interdependent partner. In such a situation, the person living with the head of the household trumps the non-resident;
9. The benefits for the unemployed are broadened under Part II, which provides that an insured who was not working at the time of the accident, but whose injuries prevent them from doing housekeeping duties can claim benefits of $100/week for up to 26 weeks. Previously, only spouses could make this claim;
10. "Average gross weekly earnings" is now defined as the greater of the average weekly earnings in the last month pre-accident or in the last 12 months pre-accident;
11. Details and forms are prescribed for the administration of claims which fall under the Protocols.
12. A "properly completed prescribed claim form" may be submitted by mail, personal delivery, fax or by e-mail if both parties previously agreed to this method of communication, within 30 days of the accident or as soon as is practicable.

Alberta Regulation 259/06, applicable to motor vehicle accidents that occurred on or after March 1, 2007, provides for the following changes:

1. The limit for funeral expenses is increased from $2,000 to $5,000;
2. The weekly indemnity payment for income loss is increased to a maximum of $400/week;
3. The Policy gives and the Policy takes away. Although the benefit payable to the unemployed for loss of housekeeping capacity now applies only to those who are 18 and older, the benefit is increased from $100/week to $135/week.

For more information on these changes, please contact James Neilson, Insurance Litigation Practice Group Leader at (780) 423-8552 (jneilson@parlee.com).