Newmarket Catastrophic injury Lawyers
Sustaining catastrophic impairments in a motor vehicle collision can have negative consequences for an accident survivor’s physical well-being, psychological health, and financial security. The impacts of these severe, permanent injuries can have profound, lifelong effects on both accident survivors and their loved ones.
Many catastrophically impaired survivors of motor vehicle accidents incur substantial financial losses as a result of their newly acquired medical conditions. These often include lost wages, medical bills, home renovations, costs of personal support workers, and reduced future earning capabilities. Thankfully, all basic auto insurance plans should include provisions for no-fault accident benefits to help accident survivors offset the costs of their injury-related expenses.
The amount of accident benefits available to survivors is based on the severity of the injuries they have sustained. The province’s Statutory Accident Benefits Schedule (SABS) determines the mandatory minimum coverage amounts that must be included in all basic auto insurance plans throughout Ontario. These amounts are as follows:
- $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
In order to qualify for the highest level of accident benefits, the injuries sustained by a motor vehicle accident survivor must meet the threshold of catastrophic impairment. There are different factors considered by insurers when determining catastrophic impairment. The term “catastrophic impairment” is defined by the province’s SABS, and refers to injuries sustained in motor vehicle accidents resulting one or more of the following outcomes:
- 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
Catastrophically impaired motor vehicle accident victims are required to submit a claim to their insurers that includes an OCF-19 form, an application for determination of catastrophic impairment that must be completed by a physician familiar with the victim’s injuries.
Unfortunately, this already confusing and bureaucratic process can be even further complicated if an insurance provider disputes whether an applicant’s injuries meet the threshold of catastrophic impairment. There are several reasons why an insurer might question the severity of injuries. For example, they may argue that the injury is not severe enough to meet the threshold of catastrophic impairment, or they may argue that the injury was not directly caused by the accident. In some cases, they may also argue that the accident victim had a pre-existing condition that contributed to their injuries.
When insurers dispute the claims of catastrophically impaired accident survivors, they make life even more difficult for people who are already facing monumental challenges. Our Newmarket catastrophic injury lawyers are passionate about fighting on behalf of injured members of the local community to help them recover the coverage they are rightfully owed. To learn how our catastrophic injury lawyers serving Newmarket may be able to assist you, contact us today and receive a free initial consultation on your case.
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Our Newmarket catastrophic injury lawyers offer all prospective clients a free initial consultation. If you are unsure whether the settlement amount you have been offered is fair, call our catastrophic injury lawyers serving Newmarket and receive free, personalized legal feedback about your case.