Understanding your Accident Benefits Following Changes to the Ontario Statutory Accident Benefits Schedule
Catastrophic Injury Victim Beware ! In an effort to make insurance more affordable for all Ontarians, the Ministry of Transportation made some large scale changes to accident benefits coverage last June. These changes have reduced, changed and, in some cases, eliminated coverage. In particular those impacted by a catastrophic injury are most at risk.
As many drivers do not regularly review the their policies, they may not be aware of the impact of the new lowered benefits. Many will find out only when an accident happens. Then it is too late.
Want to be covered in the event of a catastrophic injury ? Always best to check with your insurance company
Our Ottawa injury lawyers wrote about the changes when the new legislation took effect. At that time, we encouraged readers to make a thorough review of their existing policies and encouraged them to purchase additional coverage.
Our lawyers have received many questions about Insurance coverage since the changes took effect in June. While the outlines provided by the Ministry give a fair rundown of what is covered and what is not covered under the new standard policy, many drivers remain confused about the definition of catastrophic injuries. The term catastrophic determines the type of benefit available, but its definition is not clear in the material provided with the standard insurance policy.
What is considered a catastrophic injury ?
If an injury will have a lifelong impact on the victim’s quality of life, it can be deemed catastrophic. If the victim is left a paraplegic or quadriplegic or requires the amputation of an arm or leg, if the injury causes serious traumatic brain injury or if the victim suffers loss of vision the injury would most likely be classified as a catastrophic injury. Sadly, people with these catastrophic injuries are the ones who need insurance coverage the most and now, with the changes, they are losing many of their accident benefits.
Once someone’s impairments are considered a catastrophic injury the victim may be eligible for the additional benefits including:
- $1,000,000.00 for Medical Rehabilitation and Attendant Care combined (up to $6,000 per month)
- Housekeeping (up to $100 per week for life)
- Income Replacement Benefit (to a max of $400 per week for life)
- Non-Earner Benefit (up to 104 weeks after the accident up to $185 per week)
- Visitor Expenses
- Entitlement to a Case Manager
- Lost Educational Expenses (up to $15,000)
- Payment for clothing, prescription eyewear, dentures, hearing aids, prosthetics and other medical or dental devices damaged as a result of the car accident
- Reimbursement for travel to and from medical appointments
- Caregiver Benefits
These definitions may be difficult to interpret and it is always advisable to consult a personal injury lawyer as soon as possible after a serious accident.
Ontario Catastrophic Injury Lawyer David Hollingsworth, Brain Injury Lawyer, Spinal Cord Injury Lawyer in Ottawa , Ontario, Catastrophic Injury Lawyer
What is a Catastrophic Injury ? Ontario Accident Benefits
Catastrophic Impairment means:
a) spinal cord injury: paraplegia or quadriplegia;
b) the amputation or impairment causing the total and permanent loss of use of one or both arms or legs
c) the total loss of vision in both eyes
e) brain impairment that, in respect of an accident, results in,
(i) a score of 9 or less on the Glasgow Coma Scale; or
(ii) a score of 2 (vegetative) or 3 (severe disability) on the Glasgow Outcome Scale
f) any impairment or combination of impairments that results in a 55 percent or more impairment of the whole person, in accordance with A.M.A. Guide’ or
g) any impairment that results in a class 4 impairment (marked impairment) or class 5 impairment (extreme impairment) due to mental or behavioural disorder, in accordance with the A.M.A Guide.
Differences in benefits for Catastrophic Injury vs Non Catastrophic Injury:
1) Attendant Care payable at $6,000 per month (up to a maximum of $1,000,000) if you are insured, instead of $3,000 if you aren’t
2) Those who are insured receive a maximum of $1,000,000 for life in Medical and Rehabilitation Benefits,
3) Housekeeping benefit for life
4) Case management services are covered.
A catastrophic injury is a life altering injury for not only the person involved in the accident, but also their friends and family. These injuries are so severe that a new “life-plan” needs to be put in place. Our Ottawa personal injury lawyers understand that there is more that just getting maximum compensation for our clients at stake. We work with our clients medical and support staff so that when our clients are able to leave the hospital they are not “on their own”. No one should be expected to navigate that process on their own. It’s important for our clients recovery that a realistic plan and the proper supports are put in place. A catastrophic injury is life-changing and we can only help to change lives as best as possible, following a tragic accident.