Our previous reader, an Ontario driver asked what insurance coverage’s and limits are there for personal injury from a car accident?
My answer is twofold as the coverage’s Ontario drivers have now will be greatly reduced when the new Auto Insurance Policy comes into effect.
Presently, Ontario has “Superior” coverages as opposed to every other province.
After September 2010, the Ontario Auto Insurance Policy coverages will be “Inferior” to every other province when it comes to the treatment of minor injuries resulting from a car accident.
The Ontario driver’s coverage for Medical and Rehabilitation limits will be cut in half, from $100,000 to $50,000.
But that’s not the “BOMB” which is about to be dropped.
The BOMB is in the “CAP of $3,500” that’s being placed on the treatment of minor injuries. Even if you need further medical treatment to get you healed, you will NOT have access to the remaining $46,500 of coverage you paid for.
The reason for the insurance companies lowering this coverage from $100,000 to $50,000 was to give Ontario drivers a ‘break’ in their premium. But this cap is actually reducing your coverage for minor injuries from $100,000 to $3,500. So how much premium is exactly being saved by the Ontario driver, and at what consequence?
This cap may be the ‘breaking point’ for the Ontario driver’s confidence in the government, and insurance industry, about their level of concern for providing adequate medical coverage for driver’s injured in car accidents.
Both the government, and insurance industry, are well aware that $3,500 is insufficient coverage for treating minor injuries. The average claim was $42,217 made by Ontario drivers for rehabilitation in 2008, as reported by the Insurance Bureau of Canada. Although this number is inclusive of all injuries from mild to serious, including catastrophic, it’s safe to conclude that most injuries fall into the “minor category.”
Given the average claim exceeds $40,000, capping the treatment for a minor injury at $3,500 appears to be a “savings” for the insurance industry, and a serious “handicap” for the Ontario driver.
A “Minor Injury” will be defined as a sprain, strain, whiplash disorder, contusion, abrasion, laceration, partial dislocation of a joint or organ, and any pathological condition resulting from an injury, or trauma. Additionally, the age factor isn’t addressed.A minor injury to a 25 year old is not so minor to a 70 year old.
Further, a “Major Injury” can initially appear minor, like whiplash, muscle or a ligament tear, leaving the injured subjected to an arbitrary limit of $3,500 for their rehabilitation, regardless of whether or not they require the full limit of the $50,000 that they have already paid for to get better.
Adding insult to injury, there’s no formal process in place for a person to qualify for the additional $46,500 of coverage if their “so called” minor injury is actually serious, other than perusing legal action.
Ontario drivers have the option of buying back their coverage to $100,000, but the cap of $3,500 for treating minor injuries remains in force.
Coverage’s vary from province to province. Alberta and New Brunswick have a $50,000 limit for Accident Benefits, but with no cap for minor injuries. PEI, NWT and Nova Scotia have $25,000. Newfoundland and Labrador have the option to purchase $25,000 in coverage, while the coverage in Yukon is at $10,000. However, nowhere are there “Caps for Minor Injuries” in any of these provinces.
Ontario drivers are about to have the poorest coverage for the treatment of minor injuries from auto accidents in Canada.
Jeremy Diamond, a personal injury lawyer from the firm Diamond and Diamond states that; “These caps will be devastating. Those that require treatment will be subject to the insurance's definition of minor and may not be able to receive all the treatment they require.Furthermore, if the insurance company's doctor pegs your injury as "minor" an excessive amount of expense and litigation will be needed to extract you from that category.If you require immediate treatment after your $3,500 cap is exhausted and cannot afford out of pocket expenses, you will be left waiting for treatment which often makes the injury worse.Basically the average person that gets injured will suffer waiting for their claims to be reviewed as the lawyers spend years trying to figure out the new definitions and guidelines.”
If you’d like to add your comments as to why you feel this arbitrary cap of $3,500 should be eliminated you can go to; www.RomanovReport.com and I’ll attach your comments to my letter of concern about this cap to the government.
Other coverage’s being affected this September are:
- Attendant Care, for non-catastrophic injuries, is being reduced to $36,000 from $72,000 in coverage.
- House Keeping and Caregiver Expenses are all gone, unless the injuries are deemed to be catastrophic.
These benefits will only be provided if you pay extra for them. The question is; will they be sold back for the amount equal to what you’re paying now?
Although still the “most explosive” fact remains that the Ontario driver has not been given the option of buying back “No Cap” coverage for minor injuries. If this is all about the insurance company “saving you money” then why have you been blocked from buying this coverage back?
This new insurance policy, offers nothing new, and is a “Ticking Time Bomb” for Ontario drivers when they will need their medical coverage the most.
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