The Ontario Provincial Government has legislated more reductions to the no-fault accident benefits available to Ontario motor vehicle accident victims. One of the most significant changes is that medical, rehabilitation and attendant care benefits will be slashed by up to fifty percent.
Reductions to Catastrophic Injury Benefits
Those who will suffer most from these changes are the people who have been most seriously injured. Prior to June 1, 2016, if an accident victim suffered injuries that are determined to be catastrophic (the most serious classification of injury), he or she was entitled to medical and rehabilitative benefits of one million dollars and attendant care benefits of one million dollars. In other words, two million dollars of coverage for treatment and care, for catastrophically injured victims. These sums have remained constant over the years, without increases for inflation.
Effective June 1, 2016, these benefits will be “combined” and slashed in half. Where before there was a combined total coverage of two million dollars, for policies purchased or renewed on or after June 1, 2016 there will only one million dollars, for all medical, rehabilitation and attendant care.
One million dollars may seem like a lot. However, when dealing with a catastrophic injury such as a brain injury or a spinal cord injury, one million dollars is not enough. I have been involved in car accident cases where the future costs of care beyond OHIP funded treatment have been valued at several million dollars. I have seen cases involving catastrophically injured children where even the old limit of two million dollars of funding was far from enough. With only one million dollars of available treatment, catastrophically injured victims will be left with inadequate treatment or simply run out of funding.
Reductions to Non-Catastrophic Injury Benefits
The news is almost as bad for those people who suffer serious but not quite catastrophic injuries. The Ontario Government has taken three steps to decrease coverage for these seriously injured people. First, the test to be considered catastrophically impaired has been revised so that fewer people will obtain a catastrophic impairment designation. If you do not get a catastrophic designation, you have less funding available for medical, rehabilitative and attendant care treatment.
Second, is that the benefits for non-catastrophically injured victims are being cut yet again. Prior to September 1, 2010, non-catastrophically impaired victims had up to $100,000 for medical and rehabilitative treatment and $100,000 for attendant care treatment. This funding was available only for treatment that was both reasonable and necessary. Effective September 1, 2010, the government reduced the funding for medical and rehabilitative care to $50,000.00 and attendant care to $36,000.00, for a total of $86,000.00 (down from $200,000). Effective June 1, 2016, these two benefits are being reduced even more. The two coverages (med/rehab and attendant care) will be combined, with a maximum benefit coverage of $65,000.00. In other words, in 2009, a seriously injured accident victim had up to $200,000.00 of coverage available for reasonable and necessary treatment. Now, instead of increasing to reflect inflation, the coverage has been reduced to less than 35% of what it used to be.
The third step taken to reduce coverage for people who are seriously but not quite catastrophically injured is that funding after June 1, 2016 will only be available for a maximum of 5 years (down from 10 years). If you are not fully recovered and require more treatment or care after five years, effective June 1, 2016, you are out of luck.
So what can you do about this? One suggestion is to obtain additional “optional” no-fault accident benefits insurance at an increased cost. Yes, that means you will have to pay the insurance company even more money, to obtain the same benefits you had in the past.
For more information about the changes to accident benefits on June 1, 2016 and the available optional benefits, visit the Ontario Financial Services Commission of Ontario website:
If you have been seriously injured in a car or other motor vehicle accident in Ottawa or anywhere else in Eastern Ontario, contact our personal injury lawyers for a free consultation: