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ACCIDENT BENEFIT CLAIMS
If you have been injured in an accident in Ontario and you have automobile insurance, you’re entitled to no-fault benefits.
It’s that simple: it doesn’t matter if you were driving a automobile, a passenger, a pedestrian, or even on a bicycle.
But while your right to benefits is simple, obtaining them may not be. For those in an automobile collision, the legal process in Ontario can be confusing, long, and traumatic.
And even though your injuries are documented, your insurance provider may not pay these benefits, or may only pay a portion of the full amount. At Rotondo Law, our team of legal experts will work with you to get the benefits you’re entitled to after an accident to help aid in your recovery.
The benefit claims typically cover lost wages - up to 70% of your gross income - and these benefits can last up to two years after the accident. Your caregiver is also entitled to benefits. Rotondo Law will carefully look at your case and work hard to see that you receive the full no-fault benefits that you are entitled to. Best of all, we do not collect our fee until your case is closed.
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SINCE JUNE 2016 ...
Changes to the Statutory Accident Benefits Schedule, Effective June 1, 2016.
The Statutory Accident Benefits Schedule has undergone a significant changes. The changes are both substantive and procedural. Substantively, notable changes relate to the definitions of catastrophic impairment, and to non – earner and medical and rehabilitation benefits. These changes apply to existing insurance contracts that are terminated or renewed as of June 1, 2016, and to new insurance contracts made on or after June 1, 2016. For the most part, the amendments apply only to policies issued or renewed on or after June 1, 2016. Existing contracts will remain subject to the current limits until the contract is terminated or renewed.
The definitions of catastrophic impairment have been given a legislative overhaul, with different definitions of catastrophic impairment specific to adults as well as to children. For brain injuries, the reference to the Glasgow Coma Scale has been removed, and instead, the definitions refer to diagnostic imaging tests, the Glasgow Outcome Scale, the Extended Glasgow Outcome Scale, and for children under the age of 18, the King’s Outcome Scale for Childhood Head Injury, as well as other important changes. The new definitions also change the definitions of catastrophic impairment in respect to amputations, loss of vision, ambulatory mobility, and psychological impairments. For psychological impairments, a claimant must be assessed to have sustained a marked impairment in three of the four aspects of function, or extreme impairment in one aspect, and a loss of useful function. The changes do permit combining physical and psychological impairments, but the combination must be performed in accordance with the American Medical Association’s Guides to the Evaluation of Permanent Impairment, 6th edition, which provides a specified methodology for determining Whole Person Impairments.
Catastrophic LimitsLimits for catastrophic impairments have been drastically reduced from $1 million for medical rehabilitation benefits in addition to $1 for attendant care benefits, to a combined limit of $1 million dollars for medical and rehabilitation benefits and attendant care benefits.
In accordance with the changes to the Statutory Accident Benefits Schedule, there is no longer a six-month waiting period after the accident. Also, prior to the changes to the Statutory Accident Benefits Schedule, a claimant would receive $185.00 per week, which could under some circumstances be increased to $320.00 per week, and be paid beyond two years. As of June 1, 2016, there will be a four-week waiting period, and weekly benefits in the sum of $185.00 will cease at the two year juncture.
Medical / Rehab and Attendant Care Benefits
The changes to the Statutory Accident Benefits Schedule significantly reduce medical and rehabilitation benefits and attendant care benefits. The changes provide for combined medical and rehabilitation and attendant care benefits in the amount of $65, 000, which is reduced from $50, 000 for medical and rehabilitation benefits along with an additional $36, 000 for attendant care benefits. Significantly, the duration of eligibility for medical and rehabilitation benefits has been reduced from 10 years to 5 years post - accident, with an exception for claimants under the age of 18 years old as of the time of the accident.
The changes to the Statutory Accident Benefit Schedule create challenges. Various benefits that are not recoverable through a Statutory Accident Benefits claim are potentially recoverable in tort. To maximize your compensation, an experienced personal injury lawyer recognizes the interplay between the Statutory Accident Benefits Schedule and the tort system. If you have suffered injuries in a motor vehicle accident, you are entitled to various statutory accident benefits. Our experienced lawyers at Rotondo Law can help you. Call us for a free consultation.