Ottawa Injury Lawyers provide a brief summary of some of the most important upcoming changes to Ontario Accident Benefits and the License Appeals Tribunal (LAT).
Ontario drivers and residents will continue to see an erosion in insurance coverage and Accident Benefits. Here is what you need to know:
As of April 1, 2016, accident benefit arbitration applications are to be sent to the Licence Appeals Tribunal (“the LAT”) instead of the Financial Services Commission of Ontario (FSCO). Further changes were made in relation to Ontario’s Statutory Accident Benefits Schedule (SABS) for accidents that occur on or after June 1, 2016 which include the following:
· Catastrophic limits changed to $1 million combined for medical/rehabilitation and Attendant Care (reduced from $2 million to $1 million)
· Medical/rehabilitation and Attendant Care benefits for non-Catastrophic injuries are to be combined totaling $65,000 (reduced from $86,000 to $65,000)
· Medical/rehabilitation benefits for non-Catastrophic injuries limited to 5 years instead of 10 years
· The 6 month waiting period for non-earner benefits is eliminated, but the non-earner benefits will only be available for 2 years
· An update to the ‘catastrophic impairment’ definition consistent with more up-to-date medical information and knowledge to reflect modern medicine
LAT Dispute Resolution System
The Ontario Government maintains that the new LAT dispute resolution system is more streamlined than its predecessor. Additionally, FSCO mandatory mediations have been eliminated, and applicants are now expected to apply for arbitration as soon as a benefit is denied or terminated. The arbitration process will be as follows:
· Applicant will file Arbitration with LAT via a new form.
· The insurer will file a response and a case conference will be scheduled.
· Prior to the case conference each respective party will file a case conference brief/summary.
· A case conference will then take place. This will be similar to the FSCO pre-hearing.
· If the matter doesn’t settle, a hearing will occur by way of written, electronic, or in person hearings.
· Appeal – either party may request the Chair to reconsider the matter. Or, the matter can be appealed to the Divisional Court.
The transition to LAT from FSCO is not going to be easy. We are expecting backlogs. Moreover, the majority of FSCO mediators who developed an expertise in this very specific area of law did not transfer over to the LAT. In other words, knowledge and expertise will be lost in the transition. Further, appealing to the Divisional Court may be a difficult hurdle for applicants since courts are often hesitant to overturn arbitrators. With all that being said, it appears as though applicants suffering from catastrophic impairments will be impacted the most by this legislation.
Personal Injury Lawyer Ottawa, David Hollingsworth…The Financial Services Commission of Ontario has again made some changes to Ontario accident benefits and unfortunately, in my opinion as an Ottawa personal injury lawyer, these changes do not favour Ontario drivers, should they become injured in an accident and need to access their accident benefits. One of the recent changes in accident benefits has to do with the MIG (Minor Injury Guideline) and it requires a pre-existing condition to have been included in a medical note by a health professional to get out of the Minor Injury Guideline.
As of February 1, 2014, the Government of Ontario has decided that Ontario drivers who are accessing their accident benefits and who fall under the Minor Injury Guideline are limited to the cap of $3,500.00 UNLESS they have a pre-existing medical condition and this pre-existing medical condition must have been documented by a health practitioner prior to the accident. This is a new requirement. Before February 1, 2014, pre-existing medical conditions did not need to be documented. Essentially , what this means is that if you were injured before but had perhaps not sought out medical treatment that was documented, then you will not be considered for the exclusion of minor injury guidelines and most likely your treatment will be limited to the $3,500.00 cap.
This change in accident benefits highlights why it is critical to treat any injury as serious. Most people think things will heal naturally over time and often can’t find the time to get to the hospital or doctor. With wait times the way they are, it is understandable; however these types of changes highly why Ontario drivers need to make this a priority. Unfortunately, once an accident has occurred, you can’t turn back the clock.
If you have been in an accident and are injured, it is imperative you speak with an experienced personal injury lawyer. It’s important you know your rights and leave no stone unturned in the event that weeks, months or years later your injuries prevent you from a quality of life you once had. If you have a question or would like more information about the recent changes to Ontario Accident Benefits, contact us at www.ottawainjury.ca . We would be happy to sit down with you free of charge .