Ontario Government’s $1 million course correction!

Contained in the 2019 Ontario Budget, Protecting What Matters Most, the government announced that it will be restoring the ‘missing million’ in auto insurance coverage for the most seriously injured, or “catastrophically impaired”, that was slashed in 2016.

What happened in 2016?

Well, in 2016, the former government introduced major changes to how those with the most serious of injuries are treated under the no-fault accident benefits system in Ontario. All of these changes resulted in benefits being reduced, making recovery for accident victims more difficult.

Prior to this change, a person who sustained a catastrophic impairment could receive up to $1 million in attendant care benefits and $1 million in medical and rehabilitation benefits, for a total of $2 million.

These benefits were reduced to $1 million. This means that $1 million of treatment and care funding was unilaterally eliminated for those who are most seriously injured – with no reduction in insurance premiums.

Who are the most seriously impaired?

The definition of “catastrophic” impairment also underwent some major overhaul in 2016. It typically refers to those who have suffered the most debilitating injuries, including amputations, blindness, traumatic brain injuries, or paralysis.

Why was this reduction a problem?

This reduction translated into serious issues for the catastrophically impaired person and their families. With the reduction, most victims ran out of funding for their recovery and treatment long before achieving any meaningful rehabilitation.

When a victim runs out of funding but continues to have medical needs, they are forced to incur theses costs on their own. This in turn causes serious financial hardships for injured persons and their families.

This cut to accident benefits for those who are catastrophically impaired impacted everyone. It impacted the injured party and their families by causing financial strain and restricting the care they can receive; it impacted the at-fault driver who could be underinsured if such an injury is caused by their negligence, it placed their home and financial survival at risk; and it impacted the general public: many of these expenses to fall to taxpayers through the victims’ reliance on social assistance and publicly funded healthcare providers.

Real life example

An accident victim who has sustained a traumatic brain injury may require 24/7 attendant care, however the legislative cap on these benefits is only $6,000 per month. It may, and often does, cost more in lost wages or to hire someone to provide the care, however those extra costs cannot be recovered through your car insurance. In such a case, an injured person would run out of benefits – all benefits – in under 15 years without even taking into consideration any of the victim’s treatment needs. In addition to attendant care this victim would also require extensive rehabilitation, costing thousands of dollars per year. It is not uncommon to see all funding for such a person exhausted within 10 years of the accident, or sooner, for benefits that were supposed to last for the injured person’s lifetime.

In some cases, an injured person can sue an at-fault driver the catastrophically impaired person can sue to access more coverage through that person’s insurance company. But for seriously injured people, it has become a growing problem that the at-fault driver may not have enough insurance themselves to cover the rest of the injured person’s losses.

We are hopeful that $2 million in coverage will be restored very soon as the default minimum for all drivers in the event they are catastrophically impaired.