Algoma Catastrophic injury Lawyers
The days, weeks, and even months following a serious, injury-causing motor vehicle collision can be confusing. This is especially true for accident survivors who sustained catastrophic impairments as a result of the collisions. These permanently injured accident victims may find it overwhelming to try readjusting to regular life, undergoing physical rehabilitation, coping with financial losses, and dealing with insurance companies.
Catastrophically impaired survivors of motor vehicle collisions often incur substantial financial losses as a result of their injuries. These financial losses are often mitigated by the no-fault accident benefits available to all injured survivors of motor vehicle accidents.
In accordance with the province of Ontario’s Statutory Accident Benefits Schedule (SABS), all basic auto insurance plans must include a mandatory minimum amount of accident benefits. Individual policyholders may choose to pay for additional coverage.
The amount of accident benefits available through basic auto insurance plans are dependent on the severity of the injuries sustained by the claimant. The mandatory minimum amounts are as follows:
- Minor injuries: $3,500 in medical and rehabilitation benefits
- Non-minor, non-catastrophic injuries: $65,000 for the combined total costs of medical, rehabilitation, and attendant care benefits for 5 years
- Catastrophic injuries: $1 million in combined medical, rehabilitation, and attendant care benefits for life
According to the SABS, in order to meet the threshold of catastrophic impairment, a motor vehicle accident victim must have sustained at least one of the following as a result of their collision:
- Paraplegia or Tetraplegia
- Severe impairment of ambulatory mobility or use of an arm; or Amputation
- Loss of Vision of Both Eyes
- Traumatic Brain Injury (TBI) meeting the Glasgow Outcome Scale-Extended (GOS-E) criteria
- Physical Impairment or Combination of Physical Impairments (which results in 55% or more of whole person)
- Mental or Behavioural Impairment (excluding Traumatic Brain Injury) Combined with a Physical Impairment (which results 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 behavioural disorder
A physician familiar with the accident survivor’s injuries and prognosis must submit a recommendation to insurers attesting that they believe their patient’s accident-related injuries meet the threshold of catastrophic impairment. They do so by completing an OCF-19 form which must be included in the applicant’s accident benefits claim.
Unfortunately, a physician’s completed application for a determination of catastrophic impairment does not automatically grant their patient access to higher accident benefits coverage. As it happens, insurers frequently dispute the claims of catastrophically impaired accident survivors. This can occur for a variety of reasons, such as insufficient medical documentation, conflicting medical opinions, or concerns about the validity of the claim.
Insurers may require an injured accident survivor to submit to an independent medical examination to confirm their original physician’s findings, offer unfairly low settlement amounts, or deny their claim for benefits outright.
In these situations, the assistance of an Algoma catastrophic injury lawyer can prove beneficial. Our catastrophic injury lawyers serving Algoma are familiar with the unfair tactics used by insurance providers to give injured accident victims less than what they are rightfully owed. To learn more, schedule a free initial consultation with Preszler Injury Lawyers today.
How We May Be Able to Help
Our Algoma catastrophic injury lawyers have combined decades of experience helping deserving clients in the local community receive the fair treatment and compensation to which they should be entitled. With our assistance, you may be able to easily resolve your dispute with your insurer and get the coverage you need to get your life back on track.
If you were involved in a motor vehicle collision and sustained injuries as a result, do not hesitate to contact us today to receive a free initial consultation on your case.
