On September 1st, 2015 there were important changes to Ontario’s Statutory Accident Benefits Schedule. These changes significantly lowered the benefits available to Ontarians who are injured in a motor vehicle accident. This article looks at the changes and discusses how they impact accident victims.
There are 3 categories of accident benefits available to people injured in a motor vehicle accident in Ontario:
- Minor Injury Guideline,
- Non-Catastrophic, and
(1) Minor Injury Guideline (“MIG”)
MIG funding is for medical and rehabilitation benefits for minor injuries and is limited to $3,500. The Insurance Act defines minor injuries as “one or more of a sprain, strain, whiplash associated disorder, contusion, abrasion, laceration or subluxation and includes any clinically associated sequelae to such an injury”. The $3,500 limit is often far short of what is needed to get victims access to the medical and rehabilitation services they need to make a full recovery.
(2) Non catastrophic (“Non-CAT”)
If injuries are more severe than MIG, or are not within the definition of MIG injuries (e.g. psychological injuries, a muscle tear, fracture or concussion) and not considered catastrophic, accident victims were eligible for $50,000 in medical-rehabilitation benefits and $36,000 in attendant care in benefits. These limits have now changed.
(3) Catastrophic (“CAT”)
A catastrophic injury means someone has suffered a horrible injury, such as amputation, blindness in both eyes, severe brain injury, mental or behavioural disorders, or paraplegia/quadriplegia. If injuries fall within this category, accident victims were entitled to $1,000,000 in medical-rehabilitation benefits and $1,000,000 in attendant care benefits. This has changed.
Changes to SABS, effective September 1, 2015
Several key changes that have been made to SABS that leave accident victims with far less than was available.
First, many injuries that were considered a catastrophic injury no longer qualify. The new, narrower definition will be used to determine if you qualify for this category. Therefore, fewer accidents victims will be considered catastrophic, meaning fewer people will be entitled to the level of funding that is necessary for proper rehabilitation and attendant care needs. In addition, attendant care services must now be paid out of the $1,000,000, whereas previously attendant care services were provided for by a separate $1,000,000 in funding.
For non-catastrophic injuries, the funding limit will be $65,000 for all services. This means that it also includes attendant care services. Previously, non-catastrophic injured clients received $50,000 of medical and rehabilitation benefits and $36,000 for attendant care. Now these benefits are lumped in to $65,000 for all of these services.
This chart summarizes the upcoming changes:
|Non-CAT Medical and Rehabilitation Benefits
|Less medical and rehabilitation services and less attendant care
|CAT Impairment Definition
|Significantly narrower definition
|Less medical and rehabilitation services
|Catastrophic Attendant Care Services
|Additional $1,000,000 for attendant care
|Now, part and parcel of a $1,000,000
|Less attendant care
|Claimants can either sue in court, or through private arbitration
|Claimants can only sue through arbitration – taking away access to justice through the court.
|Claimants will have less choice on how to resolve their claim
|Six month waiting period for benefits, but can receive benefits for ten years or longer
|No more waiting, but benefits are reduced to two years.
|Less in the long term
|Standard Collision Deductible
|Higher deductible means insurers cover less
|Duration of Medical and Rehabilitation Benefits
|Standard Time: 10 years
|Standard Time: 5 years
|Less time to get better
|Pain and Suffering Compensation
|Current prejudgement interest of 5%
|Prejudgment interest decreased to 1.3%
|Less money reaches victims for pain and suffering
The Ontario Government has made changes that will affect and limit the funding that accident victims need on their path to recovery. The erosion of these accident benefits make it even more important that accident victims consult with a personal injury lawyer who can properly advocate for them against the negligent party that caused the accident.
Motor vehicle accidents can cause permanent, life changing injuries to individuals that affect not only their lives, but the lives of their family, friends and co-workers. You should be aware of how this decrease in your accident benefits may affect you, or someone you love. It is important that you have a lawyer that understands the complexities of this ever-changing area of law to maximize your claim and ensure just compensation.