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What Will the Common Traffic Injury Guideline Mean for Ontario Auto Insurance?

In late 2010, the Financial Services Regulatory Authority of Ontario (FSRA), which regulates auto insurance, released the Minor Injury Guideline (MIG), updating it in 2011. MIG provided detailed rules for the treatment of “minor injuries” resulting from auto accidents.

It also set a limit of $3,500 on the amount of benefits available for medical and rehabilitation expenses paid for such injuries. This was a dramatic cut from the previous limit of $100,000.

But MIG was always intended to be a placeholder. In 2012, the Ministry of Finance and FSRA awarded a contract to researchers to develop an evidence-based framework for the treatment of traffic injuries. That framework was released in 2015 as the Common Traffic Injury Guideline (CTI).

What were the proposed changes under the CTI Guideline?

The proposed CTI Guideline makes several significant changes to the existing rules. Regular readers won’t be surprised to learn that many of the changes are negative for injured Ontario drivers. Below are three:

1. Benefits are Decreased (Again)

Before the MIG Guideline was introduced in 2010, injured Ontarians could access up to $100,000 in benefits for medical and rehabilitation services. MIG reduced this to a paltry $3,500, but apparently even that isn’t low enough. According to the Ontario Trial Lawyers Association (OTLA), the CTI Guideline will result in this benefit falling to $1,000 per person.

If you’ve been following our blog for the last month, you’re probably beginning to see a trend here. Ontario has been trying to cut auto insurance premiums for decades, and its go-to tactic in this regard has long been to simply cut benefits. The proposed replacement of MIG with CTI will be yet another entry in that sad history.

2. Benefits Won’t Last Long Enough

The CTI Guideline places a six-month time limit on treatment. Why? Because studies have shown that among individuals suffering with a CTI from a car accident, 50% will have recovered within six months after the accident.

Of course, that means that half of all drivers who sustain a CTI will receive inadequate care. The OTLA estimates that this corresponds to nearly 30,000 Ontarians each year.

But it gets worse. As we explain below, injuries can be classified under CTI as either “recent” (within the last three months) or “persistent” (between four and six months old), and that classification determines what care is available. What happens if someone waits for treatment until three months have passed after an accident?

In that case, only the treatments permitted during the “persistent” phase are available. In other words, what treatment is available depends on how long ago an injury was sustained, not how long ago treatment for the injury began. This will deprive even more injured drivers of the full benefits they should receive.

3. CTI Reaches More Injuries than MIG

Under MIG, a “minor injury” is a “sprain, strain, whiplash-associated disorder, contusion, abrasion, laceration, or subluxation and any clinically associated sequelae.” This definition is further fleshed out in the MIG Guideline.

CTI involves a much more detailed framework for what it calls “common traffic injuries.” First, it divides traffic injuries into three “types,” the first of which roughly corresponds to what were previously called “minor injuries”:

  • Type I injuries are injuries that have a recovery time ranging from a matter of days to a few months. They include neck pain and associated disorders, sprains and strains of the spine and limbs, traumatic radiculopathies, mild traumatic brain injuries, and post-traumatic psychological issues, like anxiety or stress.
  • Type II injuries involve a “substantial loss of anatomical alignment, structural integrity, [or] psychological, cognitive, and/or physiological functioning.” Recovery generally requires significant medical attention. These injuries include hip, shoulder, or facial fractures, depression, and post-traumatic stress disorder.
  • Type III injuries are Type II injuries that involve permanent catastrophic impairment or disability.

Injuries are further classified under CTI by “phase.” An injury within the last three months is “recent,” and an injury within the last four to six months is “persistent.” These phases determine what care is to be provided to patients.

Of particular note: Type I injuries include “mild” traumatic brain injuries (TBIs). This is troubling, because even “mild” TBIs can have a lasting impact well beyond the six-month window for which the CTI Guideline provides care.

See also: What is the Difference Between an Acquired Brain Injury and Traumatic Brain Injury?

Conclusion: Changes are Concerning to All Ontario Drivers

As with other recently proposed changes to the Ontario auto insurance system, the changes being considered as part of the CTI Guideline should concern all Ontario drivers. These proposals are part of a longer-term trend to reduce the benefits of auto insurance for those injured in car accidents. We hope the FSRA thinks carefully about the changes CTI makes before finalizing it.

Have you been in an accident? The personal injury lawyers of Preszler Injury Lawyers may be able to help. Contact us today for a free case evaluation.

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