A spinal cord injury has the potential to profoundly impact every aspect of an individual’s life and that of their family. Beyond the physical pain, surgeries, and disruptions to daily living, it’s crucial to recognize the substantial financial burden these injuries can impose. Medical treatment, rehabilitation, and ongoing care costs alone can grow quickly. In these situations, it is important that victims collaborate with a legal team that is well-versed in these catastrophic injuries and adept in both the legal and medical aspects of the case.
Brain injuries, particularly traumatic brain injuries, rank among the most severe injuries victims endure. Although brain injuries can occur in various accidents involving head trauma, falls and motor vehicle accidents stand out as two of the most prevalent causes.
These catastrophic injuries often bring about profound and lasting consequences for both the victims and their families, frequently necessitating lifelong care. If you or a loved one has experienced a brain injury, it is crucial to seek guidance from a personal injury attorney who possesses the expertise to anticipate and assess all of the future expenses over many years. This approach ensures you receive the highest possible compensation available to cope with the traumatic injury.
Individuals who suffer catastrophic impairments in motor vehicle accidents can experience lasting repercussions from their injuries. These severe injuries can lead to significant physical and mental impairments, impacting an accident victim’s ability to carry out daily tasks, work, or partake in recreational activities.
In Ontario, according to the Statutory Accident Benefits Schedule (SABS), anyone injured in a motor vehicle collision is generally entitled to no-fault accident benefits. These benefits are designed to provide insurance coverage to help offset the financial burdens caused by an accident victim’s injury-related expenses.
The level of coverage an accident victim may receive depends on the severity of their injuries. Given the profound and wide-ranging effects of catastrophic impairments, individuals who sustain such severe and permanent injuries are eligible for the highest amounts of accident benefits.
While some motorists may opt for additional insurance coverage, all standard auto insurance policies in Ontario offer the following benefits to injured accident survivors:
- $3,500 in medical and rehabilitation benefits for those with minor injuries
- $65,000 over a span of 5 years for combined medical, rehabilitation, and attendant care benefits for individuals with non-minor, non-catastrophic injuries
- $1 million for life in combined medical, rehabilitation, and attendant care benefits for accident victims with catastrophic injuries
The SABS framework outlines both the amount of coverage available to catastrophically impaired motor vehicle accident survivors and the definition of “catastrophic impairment” in the context of accident benefits claims. An accident survivor from a motor vehicle collision is considered to be catastrophically impaired if they meet at least one of the following criteria:
- Paraplegia or Tetraplegia
- Severe impairment of ambulatory mobility or use of an arm; or Amputation
- Loss of vision in both eyes
- Traumatic Brain Injury (TBI) meeting the Glasgow Outcome Scale-Extended (GOS-E) criteria
- Physical Impairment or Combination of Physical Impairments (resulting in 55% or more impairment of the whole person)
- Mental or Behavioral Impairment (excluding Traumatic Brain Injury) Combined with a Physical Impairment (resulting in 55% or more impairment of the whole person)
- Marked impairment in three or more areas of function that precludes useful functioning; or an Extreme impairment in one or more areas of functioning due to mental or behavioral disorder
When determining the benefits owed to injured accident survivors, insurance providers evaluate all the documentation provided in a claimant’s application. If the accident victim has sustained a catastrophic injury, specific documents are required from their physician. However, insurance companies are not obligated to agree with a physician’s recommendations, and they may not always provide accident survivors with the full number of benefits they rightfully deserve based on the severity of their injuries. If an insurance company denies an accident survivor’s claim or offers an unfairly low settlement, the catastrophically impaired individual may struggle to cover the costs of necessary medical care, treatment, and support.
If you’ve been injured in a motor vehicle accident and your insurance provider disputes your accident benefits claim, our catastrophic injury lawyers may be able to assist you in securing the coverage you deserve. To explore your options further, please don’t hesitate to book a free phone consultation.