SABS DENIED: The Three Mistakes That Tank Accident Claims
After a motor vehicle accident, the Statutory Accident Benefits Schedule (SABS) should be your safety net. But the truth is, the system is a maze of strict requirements, and a denial can halt your recovery.
The insurer’s job is to manage their liability. Your job is to comply perfectly. Here are the three most common pitfalls that lead to a denial of essential medical or income benefits:
1. Missing the Clock (The Deadline Trap)
The SABS process operates on an unforgiving timeline:
• 7 Days: You must notify your insurer of your intention to apply for benefits within 7 days of the accident.
• 30 Days: You must submit your completed OCF-1 Application for Accident Benefits within 30 days of receiving the forms from your insurer.
A minor delay or failure to provide notice can be used to legally bar your claim, regardless of how serious your injury is.
2. The “Reasonable and Necessary” Disagreement
The insurer is only obligated to pay for treatments they deem "reasonable and necessary." You and your doctor might agree that a new therapy is vital, but the insurer's medical consultant can disagree.
When an insurer issues a refusal to pay for a treatment plan (OCF-18), they are effectively denying your recovery plan. Without strong, objective medical evidence and clear advocacy, these denials are tough to overturn.
3. The Non-Compliance Red Flag
The SABS requires cooperation. If you refuse to attend an Insurer Examination (IE) or fail to provide requested records, the insurer can place you in a position of "non-compliance." This can result in a suspension or termination of your benefits.
Navigating these obligations—while you are injured and recovering—is the system's biggest challenge.
Protecting your SABS entitlement requires immediate attention to detail and a clear strategy to address potential denials.
If your SABS benefits have been delayed, denied, or challenged, time is critical. Seek informed guidance now.
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*This content is for general information, not legal advice
