The Ontario government and the insurance companies are at it again. Once more, there are changes to the benefits a victim of a car accident is entitled to, and once more, these changes are in favour of insurance companies.
The following changes will be implemented on June 1, 2016:
Medical and Rehabilitation Benefits and Attendant Care Benefits:
Medical and Rehabilitation Benefits are for treatment, medication, and other medically related expenses.
Attendant Care Benefits are for services provided to help with a victim’s care, such as dressing, undressing, bathing, etc.
These two benefits have now been combined and entitlement has been reduced to a maximum amount of $65,000.00. This calculates to a $21,000.00 discount to insurance companies.
The duration to use these benefits has also been decreased. You must use these benefits within five years. Prior to June 1, 2016, the duration was 10 years.
For Attendant Care Benefits, the only manner in which to obtain monies for the help a victim receives is if the loss of income incurred by the individual who is helping the victim amounts to the exact same sum that an occupational therapist has deemed reasonable for the month. For example, if an occupational therapist deems that the attendant care a victim receives is $3,000.00 per month, this means that the service provider must also lose $3,000.00 per month in income. If the service provider helps with attendant care before or after work, or on the weekends, and has not lost income, the victim does NOT receive an attendant care benefit from the insurance company.
If you choose to purchase optional benefits, your entitlement is $130,000.00, however, the maximum has also been decreased from the prior regime.
Catastrophic Impairment Benefits:
If a victim is catastrophically impaired, Medical and Rehabilitation Benefits and Attendant Care Benefits have been decreased to $1 million. This amounts to millions of dollars in savings to insurance companies. This has significant consequences to a young victim of a car accident, who is paralyzed and only has $1 million dollars in treatment and attendant care for the rest of his/her life. The costs of health care and self-care is substantial for such a victim, and those monies would be used in a couple of years.
The definition of a Catastrophic Impairment has also changed so that it has become very restrictive and thus significantly more difficult to deem a victim as catastrophically impaired. This change in the law has been made, after catastrophically injured victims of car accidents have won decisions in the courts which clarify the definition of Catastrophic Impairment in their favour. After these decisions were rendered in the Court of Appeal, insurance companies lobbied to the Ontario government to make the changes to the definition in their favour.
If a victim is elderly, unemployed at the time of the accident, and/or is a student, Non-Earner Benefits have been decreased substantially from a victim’s lifetime to a mere two years. The waiting period to receive this benefit has been decreased, however, from six months, to four weeks.
Cancellation or Refusal to Renew an Insurance Policy:
Ontario’s insurance regime is no fault insurance. This means that your insurance premiums do not increase if you claim for a not at fault car accident. This used to mean that an insurance company cannot cancel or refuse to renew your insurance policy if you make a claim as a result of a car accident. This is no longer the case as of June 1, 2016. There are only a few exceptions where the insurance company does not have this liberty.
As the years pass, it is clear that a victim’s right to accident benefits will diminish with each change in the law. In the end, unless the public complains to their local MPP’s, victims of car accidents will be left with no protection at all.