The Minor Injury Guideline and Its Impact on Accident Victims
The Toronto Star recently published an article about the effect that the Minor Injury Guideline is having on Ontario accident victims. On September 1, 2010 drastic changes were implemented to the Statutory Accident Benefits Schedule. These changes reduce the amount of medical care payable by your auto insurer to $3,500 if you have suffered only a “minor injury”. In other words, if you suffer a sprain, strain, whiplash, contusion, abrasion, laceration or partial dislocation as a result of an accident, your insurance company is only obligated to pay for $3,500 of treatment. This is the sporting equivalent of a hard salary cap. For a MIG injury, you cannot purchase extra insurance coverage to help in the event you need additional treatment.
The definition of a “minor injury” is intentionally restrictive. The “Minor Injury Guideline” (the “MIG”) was implemented in 2010 by the Ontario government in an effort to stop insurance rates from rising. Insurance companies have claimed that the cap is necessary to help reduce fraud by eliminating unnecessary treatment requests. In the result, people who are legitimately injured are expected to reach their maximal recovery in what amounts to roughly 12 weeks or less.
Since these changes came into effect, up to 80 percent of all accident benefit claimants now find themselves under the MIG. Once the $3,500 cap is exhausted, your insurance company will only cover the cost of additional treatment is if there is “compelling evidence” from a health provider of a pre-existing condition that prevents you from achieving maximal recovery. The Guideline says this will only happen in “extremely limited instances”.
Not surprisingly, the instances of disputes between accident victims and their insurers have increased dramatically since the MIG came into force. The Financial Services Commission of Ontario, the government agency who adjudicates disputes between the public and their auto insurers, has become overwhelmed with applications for mediation. It is taking between 10-18 months for the mediation process to occur. In the meantime, the injured person who needs therapy is left twisting in the wind. If you have had your injuries unfairly categorized as “minor”, or if you feel as if are being treated as an adversary by your insurance company, a lawyer experienced in personal injury law may be able to assist you.
