Alberta’s roads are changing, and so is the auto insurance system that protects you on them. For years, drivers have navigated a complex, often contentious system for handling accident claims. Now, the Government of Alberta is introducing a seismic shift set to take effect on January 1, 2027: the Care-First automobile insurance system. This new model promises to prioritize medical recovery over legal battles, aiming for faster care and more stable insurance premiums.
But what does this mean for you, the everyday driver? How will your benefits, your claims process, and your right to sue be affected? This article breaks down everything you need to know about the Care-First model, providing a clear roadmap for navigating this new era of auto insurance in Alberta.
Introduction: Navigating Alberta’s New Care-First Auto Insurance System
A New Era for Alberta Auto Insurance
The move to a Care-First system represents the most significant overhaul of the province’s automobile insurance system in decades. It shifts the focus for bodily injury claims from determining who was at fault to ensuring every injured person receives immediate access to medical care and recovery support. For many Albertans frustrated by rising premiums and lengthy disputes, this change is designed to offer a more streamlined and supportive alternative. This new framework, established under the province’s Automobile Insurance Act, aims to fundamentally alter how injured Albertans interact with their insurance provider after a motor vehicle accident.
Understanding Alberta’s Care-First Model: The What and Why Behind the Change
What is Care-First Automobile Insurance?
At its core, the Care-First model is a “no-fault” system specifically for injury claims. This doesn’t mean fault is irrelevant for things like traffic tickets or determining your future premiums; it means that if you are injured in a vehicle collision, you will claim benefits directly from your own insurance company, regardless of who caused the accident.
The primary goal is to remove the often lengthy and adversarial process of suing the at-fault driver’s insurer to get compensation for medical treatments and lost income. Instead, the focus is placed squarely on “maximum medical recovery.” Your insurer becomes your primary partner in rehabilitation, providing immediate access to a comprehensive suite of benefits designed to get you back on your feet as quickly and completely as possible.
Why the Change? The Goals of the Alberta Government
The transition to a Care-First system is driven by several key objectives aimed at fixing perceived flaws in the current auto insurance system. For years, Albertans have faced some of the highest auto insurance premiums in the country. Alberta drivers spent 3.1% of their after-tax income on auto insurance premiums in 2023, a figure higher than the Canadian average. The Government of Alberta takes the position that a significant driver of these costs has been litigation.
The Alberta government, supported by organizations like the Insurance Bureau of Canada, believes that by reducing the reliance on lawsuits for most injury claims, the system can redirect funds from legal fees toward enhanced care for injured Albertans and, ultimately, create a more stable and affordable insurance market.
Your Accident Benefits Under Care-First: Comprehensive Coverage for Recovery
Under the Care-First system, the suite of Accident Benefits available to an injured person is significantly enhanced and becomes the primary source of support following a crash.
Immediate Medical and Rehabilitation Benefits
This is the cornerstone of the Care-First model. After a vehicle collision, you should have immediate access to a wide range of medical benefits to support your recovery. This includes funding for treatments like physiotherapy, chiropractic care, massage therapy, psychological counselling, dental work, and ambulance services. The system is designed to provide all necessary medical care and rehabilitation support to help you achieve maximum medical recovery without out-of-pocket expenses or long waits for legal settlements.
Income Replacement Benefits for Lost Wages
If your injuries prevent you from working, the Care-First system provides income replacement benefits. This coverage ensures you continue to receive a portion of your regular earnings while you recover. The goal is to provide financial stability, allowing you to focus on your health without the added stress of lost income. Specific amounts and durations will be detailed in your policy, representing a crucial safety net for working Albertans.
Enhanced Support for Serious and Catastrophic Injuries
The system makes special provisions for those who suffer the most severe outcomes. For catastrophic injuries that result in long-term or permanent disability, the medical benefits are extensive and designed to cover lifelong care needs. Furthermore, the introduction of a permanent impairment benefit provides a lump-sum payment for non-economic losses, such as the loss of a limb or a permanent serious disfigurement, acknowledging the profound impact these injuries have on a person’s life.
Death Benefits and Funeral Expenses
In the tragic event of a fatal accident, the Care-First system provides a death benefit to surviving spouses or dependents to offer financial support during an incredibly difficult time. The policy also includes coverage for a portion of funeral expenses, helping to alleviate the immediate financial burdens on the family.
Navigating the New Claims Process: What to Expect After an Accident
What to Do Immediately After a Vehicle Collision
Your first steps after an accident remain largely the same:
- Ensure Safety: Check for injuries and move to a safe location if possible.
- Call for Help: Dial 911 if there are injuries, significant damage, or if the situation is unsafe.
- Call the Police: Police attending the scene of the accident can have a significant impact on whether you are able to sue later for additional damages since Care-First requires that the at fault driver is convicted before you are able to sue for damages.
- Exchange Information: Get the name, contact details, driver’s license number, and insurance information from all other drivers involved.
- Document the Scene: Take photos of the vehicles, damage, and the surrounding area.
- Report the Accident: Notify your insurance company as soon as possible to start the claims process.
Working with Your Insurance Company Under Care-First
This is where the process fundamentally changes for bodily injury claims. You will report the accident and your injuries directly to your own insurer. They will open a claim file and assign an adjuster who will be your main point of contact. This adjuster’s role is to guide you through the process of accessing your medical and income replacement benefits, coordinating with healthcare providers to approve treatments and ensure you receive the care you need promptly.
Understanding Your Rights and Insurer Demands
Under Care-First, you have a right to receive all reasonable and necessary medical care to aid in your recovery. Your insurer may require you to be assessed by specific medical professionals to confirm the nature of your injuries and the required treatment plan. It is crucial to cooperate with these requests, provide accurate information, and maintain open communication with your adjuster to ensure your benefits are processed smoothly.
Resolving Disputes: The Care-First Tribunal and Appeals Process
If you disagree with a decision made by your insurance company—for instance, a denial of a specific treatment or a dispute over income benefits—you are no longer required to file a lawsuit in court for most matters. Instead, you will take your case to the newly established Care-First Tribunal. This independent, expert tribunal is designed to be a faster, more accessible, and less costly venue for resolving disputes between injured Albertans and their insurers, ensuring fair adjudication of claims.
Your Right to Sue for Injuries: What Has Truly Changed?
Significant Limitations on Lawsuits for Most Injuries
One of the most profound changes under the Care-First model is the significant restriction on the right to sue the at-fault driver for compensation for pain and suffering for most common vehicle collision injuries. The traditional tort system, where an injured person sues another party for damages, is being largely replaced by the comprehensive Accident Benefits provided by your own insurer. This is the central mechanism through which the government hopes to reduce legal costs within the automobile insurance system.
Exceptions to the Rule: When Can You Still Sue?
The right to sue is not entirely eliminated. Lawsuits will still be permitted in specific, limited circumstances. These exceptions typically include cases where:
• The at-fault driver is convicted of a serious criminal offense, such as impaired driving causing bodily harm.
• The at-fault party is, for example, a vehicle manufacturer responsible for a defect that caused the accident.
The Care-First Tribunal: Your Primary Avenue for Justice
For the vast majority of disputes regarding benefits, treatment plans, or compensation amounts under the policy, the Care-First Tribunal will be the primary venue for seeking justice. This shift moves disputes out of the traditional court system and into a specialized administrative body, which is intended to provide quicker resolutions based on expert evidence rather than lengthy legal arguments.
Impact on Your Insurance Premiums and Coverage Options
The Promise of More Affordable Premiums
A key promise of the Care-First system is its potential to stabilize and reduce Alberta’s high auto insurance premiums. With auto insurance premiums in Q3 2024 jumping 12.9% over the previous year, the pressure for relief is immense. By curbing legal costs, the government projects that the savings will be passed on to consumers. However, some analyses raise questions. A report from MNP found that maintaining certain rights to sue could add up to $136 annually to premiums, suggesting the final details of the legislation will be critical.
Understanding “Good Driver Protection” in the New System
The Government of Alberta has emphasized protecting good drivers from unfair premium hikes. Existing regulations, such as rate caps for those with good driving records, are expected to continue. The broader goal of the Care-First system is to create a more predictable cost environment for insurers, which should, in theory, lead to less volatility in premiums for all drivers.
Reviewing Your Optional Coverage Needs
While the standard policy will provide comprehensive benefits, it’s a good time to review your optional coverage. You may want to consider increasing your third-party liability limits or purchasing additional income replacement or medical benefits beyond the standard offering to ensure you have the level of protection that best suits your personal and financial situation.
Essential Practical Tips for Every Alberta Driver Under Care-First
Before an Accident: Proactive Preparation
- Review Your Policy: Understand the limits and coverages of your current auto insurance policy. When renewal comes, ask your broker or agent how the new system will affect your options.
- Install a Dashcam: A camera can provide objective evidence of how an accident occurred, which is still important for determining fault for premium purposes and in cases where a lawsuit is permitted.
- Keep Documents Accessible: Have a digital or physical copy of your insurance and registration in your vehicle at all times.
During and After an Accident: Smart Steps to Take
- Prioritize Health: Seek medical attention immediately, even for seemingly minor injuries. Your health is the top priority, and early diagnosis is key to recovery.
- Be Thorough: When reporting your claim, provide your insurer with as much detail as possible about the accident and your injuries.
- Follow Your Treatment Plan: Adhere to the medical advice and rehabilitation plan prescribed by your healthcare providers to maximize your recovery.
Conclusion: Driving Forward with Confidence in Alberta
The transition to a Care-First automobile insurance system is a monumental change for every driver in Alberta. By prioritizing medical care and recovery, the new model aims to create a more supportive, efficient, and affordable system for all. While the promise of lower insurance premiums remains a key benchmark for success, the immediate benefit for injured Albertans, if the system operates as intended will be faster access to comprehensive medical care without the need for a protracted legal fight.
As January 1, 2027, approaches, your most powerful tool is knowledge. By understanding how the claims process works, what benefits you are entitled to, and what your rights are under this new framework, you can navigate the road ahead with confidence. Review your policy, ask questions, and stay informed to ensure you are fully prepared for this new chapter in Alberta auto insurance.
Watchmaker Law is an Alberta based personal injury law firm that can assist you with your Care-First benefits claim when it is implemented in 2027. The firm is led by David Sowemimo, one of Canada’s Top 25 Most Influential Lawyers. He has handled cases in both no-fault and fault jurisdictions. Our firm can be reached at 825-203-9801, or you can chat with us in the chat box below.
