Mississauga Catastrophic Injury Lawyers
If you were involved in a serious motor vehicle accident in Mississauga that caused you to sustain injuries meeting the threshold of catastrophic impairment, you should be entitled to accident benefits. No-fault accident benefits are available to anyone who has been injured in a motor vehicle accident, regardless of their level of responsibility for causing the collision. The amount of accident benefits available to individual accident victims is mandated by Ontario’s Statutory Accident Benefits Schedule (SABS), and is determined by evaluating the severity of the survivor’s injuries.
Accident benefits are intended to offset the costs of injury-related expenses incurred by survivors of motor vehicle accidents. All basic auto insurance plans in the province are required to include the following provisions:
- $3,500 in medical and rehabilitation benefits for accident victims who sustained minor injuries
- $65,000 over 5 years for the combined total costs of medical, rehabilitation, and attendant care benefits for accident victims who sustained non-minor, non-catastrophic injuries
- $1 million for life in combined medical, rehabilitation, and attendant care benefits for accident victims who sustained catastrophic injuries
Determining whether an injury meets the definition of catastrophic impairment can be a complex process. Insurance providers consider a number of factors when determining whether a claimant’s injuries meet the threshold of catastrophic impairment. The term “catastrophic impairment” is defined by the province’s SABS as injuries caused by a motor vehicle accident that result in at least one of the following conditions:
- 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
If your insurance provider disputes whether your injuries meet the definition of catastrophic impairment, they may require you to undergo an Independent Medical Examination (IME) with a medical professional of their choosing. This medical professional will evaluate your injuries and provide a report to your insurance provider. Iif the IME report disputes whether your injuries meet the definition, your insurance provider may deny your claim for higher amounts of accident benefits.
There are many reasons why an insurance adjustor may dispute your accident benefits claim. Frequently, claims submitted for catastrophic brain injuries are subject to additional (oftentimes, unnecessary) scrutiny. In order to meet the threshold of catastrophic impairment for a traumatic brain injury (TBI), claimants must show positive findings of a brain injury on a medically accepted brain imaging scan (such as CT scan or MRI). They must also be evaluated against the GOS-E – a widely-used tool to assess the outcomes of patients with TBIs – and meet the criteria for one of the following outcomes:
- Vegetative state (assessed at least 1 month following the date of injury)
- Upper or lower severe disability (assessed between 6-12 months following the date of injury)
- Lower moderate disability (assessed 12+ months following the date of injury)
If your insurance provider disputes whether your injuries meet the definition of catastrophic impairment, our Mississauga catastrophic injury lawyers may be able to help you navigate the claims process and advocate on your behalf. To learn more, contact us today.
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If you have been catastrophically injured in a motor vehicle accident in Mississauga, you may be entitled to higher amounts of accident benefits than collision survivors with less severe injuries. However, the claims process can be complex, and insurance providers may look for reasons to offer you settlement amounts that are unfairly low.
To review your case with our catastrophic injury lawyers serving Mississauga, call us to receive a free initial consultation. Our Mississauga catastrophic injury lawyers may be able to help you fight for the compensation you deserve.