Crisis Centre of BC Presents at Special Committee to Review ICBC’s Enhanced Care Model

On September 21, 2026, Stacy Ashton appeared before the Special Committee to Review Provisions of the Insurance (Vehicle) Act on behalf of the Crisis Centre. Below is a transcript of our presentation and the questions and answers that followed.

Stacy’s Presentation

I’ve spent time reviewing the many submissions made to this committee, and what I’m seeing, and perhaps what you’re seeing too, is that Enhanced Care should work in principle. But it is not working because the practical and cultural changes needed to move ICBC from an adversarial system to a care-based system have not yet been fully made.

The concerns raised by many injured people can be summarized as follows:

• Early access to treatment is valuable, but if recovery takes longer than four months, many people encounter delays, denials, and administrative barriers that interfere with rehabilitation and create significant stress.
• Income replacement benefits are helpful, but often do not cover the full costs associated with an injury. They may not adequately reflect the realities of self-employment, future earning losses, or long-term financial impacts.
• Collaboration between ICBC and disability organizations is positive, but if outside intervention is required for people to access benefits they are already entitled to, something has gone wrong within the system.
• Appeal processes exist, but individuals must often bear the cost of gathering evidence and navigating complex procedures, while facing a process that many perceive as difficult to challenge successfully.

The committee has heard that ICBC is retraining adjusters and introducing navigators to help people access benefits and navigate the claims process. On the surface, this sounds promising. But I would encourage you to consider what it means that ICBC has concluded navigators and advocates are necessary.

It suggests that ICBC recognizes there are cases where legitimate benefits are not reaching injured people. It suggests that the problem is significant enough that internal management alone has not resolved it. It suggests that some staff continue to approach claims through the lens of an adversarial system, even though they are now dealing with injured people seeking care, not opposing lawyers.

When an advocate or navigator successfully helps someone access benefits, that person was entitled to those benefits all along. Those benefits should not have been withheld in the first place.

Under Enhanced Care, ICBC’s role is no longer to deny care or minimize benefits. Its role is to ensure that people injured in motor vehicle crashes receive the support and treatment they are entitled to.

In 2020, Premier David Eby acknowledged the challenge of this transition, stating that ICBC had “operated for decades within a system designed to defend claims through legal processes, and that one of the greatest challenges would be shifting that culture toward a care-based approach.”

This is turning out to be very, very true.

You, members of this committee, are being called on to help ICBC make the transition to a care-based system.

If ICBC is truly to become a care-based system, wrongfully withholding benefits must become one of the most serious failures within the organization. The greatest concern should not be approving a treatment that later proves unnecessary. The greater concern should be denying or delaying care that an injured person genuinely needs.

I am here on behalf of the Crisis Intervention and Suicide Prevention Centre of BC because a parent, Susannah Devitt, reach out to me to share the story of her son, Matthew, and his experience recovering after being hit by a car while cycling.

When you hear Matthew’s story, I want you to hear the profound loss that Matthew felt on losing his health, his hopes, his dreams for the future to a car accident. Then, I want you to think about how it feels to have to fight ICBC while grappling with these losses. I want you to hear the sense of betrayal that Matthew felt and the humiliation of having treatments denied that his medical care team thought would help him.

I want you to think about the despair and hopelessness of giving up on getting better and giving up on the fight and deciding you’ll just live, or not live, with the cards you’ve been dealt. The level of despair and suffering can be quite profound. For Matthew, that despair took his life.

I want you to understand that any one of us could find ourselves in a similar situation after a serious collision. A system that creates unnecessary barriers to care is a system of despair: it generates anger, sadness, hopelessness, and helplessness rather than healing and recovery.

It does not have to be this way.

It will, though, take some pretty concerted efforts, in the legislation and by government, to encourage and force a change that ICBC has not been able to make by itself. Thank you.

Q&A

Brennan Day (Deputy Chair):
Just reading over your submission, you make a great point, and it’s one I’ve raised a few times today: the people with the greatest support needs are often the least able to advocate for themselves.

Under a system that limits access to legal representation, what would effective victim advocacy look like? If we are not returning to a tort-based system, how do we ensure injured people still have a meaningful seat at the table?

Stacy Ashton:
I think what we’re seeing is that ICBC is creating a lot of its own work.

The more benefits are denied or delayed, the more people end up making complaints, seeking reviews, accessing tribunals, and looking for external support. If the threshold for denying care were much higher, you would likely see fewer disputes and less need for intervention.

If ICBC is telling you that people need navigators to access legitimate benefits, then it already knows those benefits should be provided. The question is: why is the process so difficult? Why does it require so much paperwork? Why isn’t a note from a physician enough?

When governments implemented freedom-of-information legislation, they were dealing with bureaucracies that had long defaulted to withholding information. The legislation had to be very clear in shifting that culture toward disclosure. In the same way, ICBC needs a cultural shift from “withhold” to “get those benefits out the door as quickly as possible.”

Brennan Day:
What has been your experience with freedom-of-information processes in relation to ICBC claims?

Stacy Ashton:
It seems strange that someone receiving medical care would not have full access to their own ICBC file at any time and without cost.

Why shouldn’t people be able to see every document that has been added to their claim file? We’ve heard examples of individuals having to challenge information they didn’t know had been included and that was not accurate.

I believe people should have straightforward access to all records related to their claim. If ICBC required fewer records to approve treatments in the first place, there would also be less paperwork to dispute later.

Stephanie Higginson (Chair):
I’d like to explore your recommendation on ensuring access to independent advisers who can help people navigate Enhanced Care.
We’ve heard a lot about the complexity of the system and the inequities that can result when people don’t have the capacity to navigate it effectively. What would an independent adviser model look like from your perspective?

Stacy Ashton:
I think there are really two options.

Either you make the maze significantly easier to navigate, or you provide independent advocates with enough authority to help people overcome unnecessary barriers.

Ultimately, we’re talking about changing a system. You can do that through external accountability, with advocates who have meaningful power to challenge decisions, or by making it much more difficult for legitimate claims to be denied in the first place.

If the current structure remains, then there will continue to be a need for strong external advocates capable of holding ICBC accountable. The alternative is to substantially reduce ICBC’s ability to deny claims improperly.

Brennan Day:
We’ve heard concerns about the current dispute-resolution process. What would an independent complaint body need to do differently to intervene earlier and prevent unnecessary delays in treatment?

Stacy Ashton:
A system becomes a “system of despair” when an individual has far less power than the organization they depend on. Their choices are constrained, their access to justice is limited, and they can experience harm without any effective recourse.

In this case, people are often dealing with significant injuries, and failing to receive appropriate care can have profound consequences.

If there is going to be a tribunal process, it needs to restore balance. It needs to empower injured people so that they are on more equal footing with ICBC representatives who are determining whether benefits will be approved.

At the moment, the burden of proof appears to rest primarily on the injured person. That seems backwards. If ICBC is withholding benefits, perhaps ICBC should be required to demonstrate why it is justified in doing so.

Brennan Day:
One of your recommendations is that ICBC needs better transparency and measurement. What should ICBC be measuring and publicly reporting so that we can better understand whether the system is working?

Stacy Ashton:
That’s a difficult question because delay and denial can distort the data. Many people simply give up. They don’t complain because they don’t believe it will make a difference.

I would like to see transparency around how many claims are denied, how many are delayed, and how long people are waiting for decisions.

In crisis services, we measure service standards. For example, we track how long callers wait before their call is answered. We have a target that 90 percent of calls should be answered within one minute.

A similar approach could be applied here. For example, ICBC could set clear service-level expectations around how quickly benefits are approved or continued. If someone requests ongoing treatment, there should be a defined timeline for a decision, and if that standard isn’t met, then the organization has not met its service obligation.

These targets should be designed around the needs of injured people and should be publicly reported so there is accountability.

Brennan Day:
That’s a helpful framework and something we can explore further with ICBC.

Stacy Ashton:
The concept of service-level standards is common across customer-facing organizations. Crisis lines use them. Help desks use them. They’re a basic accountability tool.

George Chow:
In your view, is there anything that could be done at the board level of ICBC to address some of the issues you’ve raised?

Stacy Ashton:
This type of change has to come from both the top and the bottom of an organization.

The board needs to be measuring success differently. If savings are seen as the primary indicator of success, rather than asking whether a portion of those savings might reflect legitimate claims that were never paid, then the board will interpret performance very differently.

Ultimately, incentives matter. The culture and priorities set at the top of the organization influence how decisions are made throughout the system. Meaningful change requires aligning those incentives with the goal of delivering care and meeting the needs of injured people.

 

These comments have been lightly edited for clarity. To see the unedited transcript and access presentations from many other speakers, visit the parliamentary committee website.

Get Support

If you’re having thoughts of suicide, please call or text 9-8-8.

If you’re experiencing a mental health crisis, please call 310-6789.

 

Media Contact

Stacy Ashton

Executive Director, Crisis Centre of BC

sashton@crisiscentre.bc.ca

604-872-1811 x224

 

Jeffrey Preiss

Director, Development & Communications

jpreiss@crisiscentre.bc.ca

604-872-1811 x222