Cambridge Catastrophic Injury Lawyer

Life can change in an instant. When unexpected and traumatic motor vehicle collisions occur, a person’s life can be suddenly and permanently altered.

Those who sustain catastrophic impairments as a result of motor vehicle accidents often face immense challenges. Frequently, these are physical, mental, and financial in nature. The financial burden of coping with severe, permanent injuries can be overwhelming for people who have survived motor vehicle collisions, with medical expenses, attendant care services, home renovations, and other necessary costs adding up quickly. Those who are unable to continue working because of their catastrophic impairments may face additional financial losses in the form of lost income and a reduced future earning capability.

In Ontario, all basic auto insurance plans are required to include no-fault accident benefits coverage as per the Statutory Accident Benefits Schedule (SABS). Regardless of fault, anyone injured in a motor vehicle accident should be eligible to receive accident benefits to help offset their injury-related financial losses.

The amount of accident benefits an accident victim is entitled to depends on the severity of their injuries. The SABS outlines the coverage amounts required in all basic auto insurance plans in Ontario, with catastrophic injuries warranting the highest amount of benefits. In accordance with the SABS, all basic auto insurance plans provincewide must include the following 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

On top of mandating the amount of accident benefits that should be made available to survivors of motor vehicle collisions, the SABS also provides a specific definition of “catastrophic impairment.” This is intended to clarify which injuries qualify for this designation, and by extension, for higher amounts of accident benefits. According to the SABS, a motor vehicle collision survivor could be considered catastrophically impaired if their accident resulted in one or more of the following 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

When applying for accident benefits, those with catastrophic impairments should consult with a qualified physician who can provide an opinion on their prognosis and complete the necessary OCF-19 form to support their claim. However, insurance providers may not always agree with the physician’s findings and may insist upon the applicant undergoing independent medical evaluations. Insurers may find reasons to dispute the severity or validity of an applicant’s injuries, or even deny their claim for benefits.

Dealing with insurance companies in the aftermath of a catastrophic injury can be complicated and overwhelming. If an insurance company denies an accident benefits claim, seeking legal assistance from catastrophic injury lawyers may help victims recover the benefits they rightfully deserve. To learn more, call our Cambridge catastrophic injury lawyers today to receive a free initial consultation on your case.

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Our catastrophic injury lawyers serving Cambridge understand the frustrations and challenges faced by accident victims and strive to make the process of fighting for fair coverage as simple and straightforward as possible. Contact us today for a free initial consultation to learn about your options.