The Insurance Act of Nova Scotia has adopted the Automobile Accident Diagnostic and Treatment Protocols Regulations (“the Regulations”). The Regulations apply to the examination, assessment and treatment or rehabilitation of strains, sprains and whiplash injuries suffered by an insured as a result of an accident in respect to which Section B benefits are payable. More specifically, the Regulations allow victims suffering from soft tissue injuries to receive immediate treatment after an accident by bypassing the need to obtain treatment approval from a physician. The Regulations allow for chiropractors and physiotherapists to fill out the necessary forms to begin treatment.
How many treatments will I receive if I choose to obtain treatments under those regulations?
The Regulations specify that one or more injuries resulting from an accident are authorized for treatments. That said, they allow for coverage of the initial assessment, as well as up to 10 or 21 additional treatments depending on the severity of the injury.
Below is a table demonstrating the number of visits generally authorized for treatment of an injury under the Regulations:
Injury Diagnosed | Total Number of Visits Authorized |
---|---|
1st or 2nd degree strain or sprain | combined total of 10 visits to a physiotherapist, chiropractor or adjunct therapist |
3rd degree strain or sprain | combined total of 21 visits to a physiotherapist, chiropractor or adjunct therapist |
whiplash I injury | combined total of 10 visits to a physiotherapist, chiropractor or adjunct therapist |
whiplash II injury | combined total of 21 visits to a physiotherapist, chiropractor or adjunct therapist |
How do I get more treatments?
You may be eligible to receive more treatments after your initial course of 10-21 treatments. The Regulations do not prevent or limit an individual or a health care practitioner from applying to the insurer for approval of additional treatments outside the limits specified by the Regulations. You will have to consult your health care practitioner as well as your insurer to determine which treatments they will cover.
I was told I must use my private insurance first. Is that true?
If your injuries do not fall within the scope of the Regulations, you must first use your private health insurance coverage to attend treatment. That said, your Section B benefits will only kick in when you exhaust your coverage provided under your private insurance plan. Your Section B adjuster will need documentation showing your private health coverage has been exhausted prior to beginning your benefits.
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