(Photo credit: Nickobec/SXC)
If you have been injured in a car accident on or after September 1, 2010, you have probably become familiar with Ontario’s Minor Injury Guidelines (MIG).
The MIG is the set of rules around how much someone can claim in injury benefits from their insurance company if they have received a minor injury from a car accident. When referring to this set of guidelines, a “minor” injury has been defined as a sprain, strain, laceration, or whiplash. Insured drivers who have suffered any of these impairments can claim up to $3,500 from their insurance company (this has been drastically cut from the amount you could claim prior to the MIG). If they had a medical condition prior to the accident, which makes the “minor” injury more severe, they are considered to be exempt from the MIG because this condition combined with the newly added minor injury prevents them from being able to recover 100 per cent. Part of why the MIG was started is to improve the way health care resources are used.
Changes that started at the beginning of November 2011 dealt with the billing from practitioners. The MIG designs treatment to be in three, four-week blocks. Prior to the changes, practitioners were charging for the full block at the beginning. So if a patient wanted to switch practitioners, they had little money left over because they were already charged the full amount. Now, medical professionals are only allowed to charge 25 per cent of the total price for up to the last week which they provided services for.
Before treatment starts, the injured person will be sent to get an assessment where their injuries are diagnosed and a rehab plan is decided upon. There have been complaints that medical professionals charge absurd amounts for assessments and that they favour the insurance companies so that these companies would continue sending patients to them to get these biased assessments. Now, apparently, the first visit will cost a maximum amount of $215, which is inclusive of the assessments and services.
So how do the three treatment blocks work?
Each block is four weeks. At the end of each block, the doctor will assess you and decide based on the treatment received and how much you have recovered, if you will be discharged from the program or if you will continue on for the next four-week block. The practitioner can charge $775 for treatment for the first block, $500 for the second, and $225 for the third. If they don’t offer treatment but instead provide a “monitoring” service, they can charge $200 for each block. They cannot combine the monitoring and treatment fees. Monitoring means that they will give you guidance, advice, coaching, and counselling. If after the third block you are still in need of care, you submit a Treatment and Assessment Plan with a medical report to your insurance company.
Though this may seem reasonable and organized, there has been much complaint that this $3,500 cap is a measly total compared to the injuries gotten while out on the road. As discussed in a Toronto Star story, this sum of money provided by insurance companies is easily drained and the insured and injured driver if left to deal with their injuries alone. To add to this, while claims have been dramatically slashed, premiums collected by insurance companies have increased. It’s like you are losing out double.
The personal injury and accident lawyers at Neinstein Personal Injury Lawyers have been handling accident injuries for clients throughout Ontario for over 45 years. We understand the impacts injuries can have on your life and know how to help you. Call us at 416-920-4242. Set up a free consultation and come talk with us.
Greg Neinstein
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