Vaughan Catastrophic Injury Lawyer

No one should be forced to fight their insurance provider for fair coverage, especially after sustaining debilitating, permanent, catastrophic impairments in a motor vehicle accident. Unfortunately, the process of recovering accident benefits commensurate with the severity of their injuries can be frustrating and complicated for catastrophically impaired accident survivors in Vaughan.

The term “catastrophic impairment” is defined by the Ontario Statutory Accident Benefits Schedule (SABS) as an accident-related injury causing one or more of the following medical 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

The amount of accident benefits available to survivors of motor vehicle accidents differ based on the severity of injuries sustained. In accordance with the province’s SABS, those who have been catastrophically impaired are entitled to higher levels of compensation.

All basic auto insurance plans in Ontario must include provisions for the following mandatory minimum amounts of coverage:

• $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

The benefits amounts listed above reflect the mandatory minimums included in all basic auto insurance plans in Ontario. Some policyholders may elect to purchase additional coverage from their insurance providers.

Catastrophically impaired collisions survivors applying for accident benefits must include an OCF-19 form along with their claim. This application for determination of catastrophic impairment must be completed by a physician familiar with the claimant’s injuries and the impacts they have on their daily life. However, just because an applicant’s physician believes their patient should be entitled to accident benefits commensurate with catastrophic impairment does not necessarily mean their claim will be approved by their insurer.

Insurance companies weigh multiple factors when considering a determination of catastrophic impairment. Insurers may look for reasons to dispute a claimant’s reported symptoms or argue that they do not meet the threshold for catastrophic impairment in an attempt to offer the injured claimant an unfairly low settlement amount. They may also decide to deny an applicant’s claim for accident benefits altogether.

If you have suffered a catastrophic injury as a result of a motor vehicle accident, the process of applying for and accessing an appropriate amount of insurance coverage can be a stressful, emotionally taxing experience. Our Vaughan catastrophic injury lawyers may be able to help you formally appeal their decision and fight the insurance provider on your behalf so that you can get the accident benefits you deserve. To learn more about working with our catastrophic injury lawyers serving Vaughan, contact us today.

How A Lawyer May Be Able To Help

Our Vaughan catastrophic injury lawyers offer all prospective clients a free initial consultation on their case. If you are unsure about options for financial recovery that might be available to you in the aftermath of a severe, injury-causing accident, do not hesitate to call us today. By taking advantage of your free initial consultation, you can receive personalized, case-specific legal advice from our catastrophic injury lawyers serving Vaughan.

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