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Auto insurance in Ontario remains a touch issue for many. If you have been catastrophically injured on the road recently, you might be one of the unlucky few who was burned by Ontario’s injury benefits guidelines.
Just a few years ago, benefits were sliced without premiums being cut proportionately. Five years ago, if you were catastrophically injured in a car accident, your benefits could get you whatever you needed to properly recover. Now, though still capped at $1 million, the definition of “catastrophically injured” has changed allowing about 30 per cent less people to qualify for these benefits. Slashing didn’t stop there. Serious injuries get you $50,000 (down from $100,000) and minor injuries are awarded $3,500. If you fall slightly outside the guidelines of what it means to be catastrophically injured, you’re missing out on a lot of money that would have aided your recovery.
What are the guidelines? To be catastrophically injured, you must now be paraplegic or quadriplegic, had a leg or arm amputation as a result of your accident, lost your eyesight or had severe brain or spine injuries. The definition was supposedly meant to foster fairness for motor vehicle accident victims giving the most benefits to the people who need it the most.
That’s fantastic for the people who qualify for benefits, but for accident victims who have very severe injuries that narrowly miss being considered “catastrophic,” they miss out on a sizeable chunk of benefits that they also need.
There has been about a 30 per cent reduction in the number of patients who qualify for the big benefits. Severe or chronic pain does not qualify as catastrophic and neither do psychological impairments when combined with your physical injuries, no matter how serious. The justification for this was that two injuries that do not individually meet the CAT requirements should not meet the requirements when combined.
These changes were made because hospitalization for motor vehicle accidents dropped 12 per cent in Ontario, but insurance companies were presented with more claims. The number of large claims more than doubled. These changes were also placed to prevent fraud, such as staged accidents or medical or rehab clinics milking the system by sending patients for too many assessments. (Each assessment is now capped at $2,000.) In a nutshell, less people who are undeserving of the medical benefits can find loopholes to earn themselves some money, but fewer people who actually need large benefits can access them too.
Insurance companies have found a way to prevent getting ripped off and are saving themselves money. They are making money too. In 2010, they paid an average of $764 in injury benefits for each car on the road. In 2012, that number whittled down to $300. That would be well and good if your insurance costs were whittled down too, but they were not. It’s a system of you paying them, so they can pay you less.
The personal injury and accident lawyers at Neinstein Personal Injury Lawyers have been handling motor vehicle accident injuries for clients throughout Ontario for more than 45 years. We know how to get you the compensation you need. Call us at 416-920-4242 to set up a free consultation. Come chat with us!
Greg Neinstein
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