Personal Injury Insurance Coverage Was Reduced -- Are You Protected?

October 20, 2016, Kitchener, Ontario

Posted by: Robert Deutschmann, Personal Injury Lawyer

Effective June 1, 2016, coverage under Ontario auto insurance policies was reduced significantly in the event of personal injury. Simply put, if you are injured in a car accident you may not have enough benefits to see you through recovery now. The changes were in response to decreases in premiums required by the provincial government to help make them more affordable.

The most significant changes include serious reductions of accident benefits. While the new benefit amounts seem to be large at first glance, anyone who has been unfortunate enough to be in a car accident will tell you that the amounts of coverage may well be inadequate. Consider if you are injured seriously and you need physio, OT, and personal care 3 times a week for a few months at $1000 a week then onward for many more months. Consider the cost of assistive devices (canes, beds, wheelchairs etc), the cost of medications, and the cost of the many other therapies and medical assessments that may be required. Many costs of an accident extend over a lifetime as well. If you have serious injuries, you may require assistance/physio for the rest of your life.

The Financial Services Commission of Ontario which overseas auto insurance in Ontario released a fact sheet regarding the changes. I’ve cut and pasted the important parts here. You can check out the website for all the details. Look at your policy renewal this cycle and ensure that you have the coverage that is adequate in case of an accident. The insurance premium increase may not be as great as you fear.

Most significant changes

 
Whether you are buying a new policy or renewing an existing one, you should be aware of the most significant changes to statutory accident benefits:

 

Benefit

Current Policy

New Policy

Medical and Rehabilitation for non-catastrophic injuries

$50,000

 

These benefits have been combined and reduced to $65,000 total

Attendant Care for non-catastrophic injuries

$36,000

Medical and Rehabilitation for catastrophic injuries

$1,000,000

 

 

These benefits have been combined and reduced to $1,000,000 total

Attendant Care for catastrophic injuries

$1,000,000

 
Some important things to remember about these benefits:


 

  • If you have previously chosen to purchase optional benefits to increase these amounts, check your policy – they may have changed to reflect amounts available in new options.
  • Medical, Rehabilitation and Attendant Care benefits for minor injuries are fixed at a maximum limit of $3,500.

The optional benefits available for Medical, Rehabilitation and Attendant Care have also changed:

 

Current Optional Benefit

Optional Benefit available on or after 
June 1, 2016

 

Non-catastrophic injuries

 

Medical and Rehabilitation for non-catastrophic injuries $100,000

$72,000 and $100,000 options have been eliminated.

 

New: Combined Medical, Rehabilitation and Attendant Care of $130,000** for non-catastrophic injuries.

 

If you have previously chosen to purchase these optional benefits check your policy or contact your agent or broker – they may have changed to reflect the amount available in this new option. 

 
 

Attendant Care for non-catastrophic injuries

$72,000

 
 

​ ​Catastrophic injuries

 

Not available

New: Combined Medical, Rehabilitation and Attendant Care of $1,000,000 for catastrophic injuries only.

 

 

The $1,000,000 Medical, Rehabilitation and Attendant Care optional benefit for all injuries (non-catastrophic and catastrophic) remains unchanged. If you have previously chosen to purchase this optional benefit it will appear on your new policy.

 

The chart below illustrates the overall benefit limits available depending on which optional benefit or combination of optional benefits you purchase, if any:

 

Options:
Medical, Rehabilitation and Attendant Care

Maximum for 
Non-catastrophic injuries

Maximum for
catastrophic injuries

Standard: No options purchased

$65,000**

$1 million

$130,000 combined (non-catastrophic injuries)*

$130,000**

$1 million

$1 million (all injuries)*

$1 million

$2 million

$1 million (catastrophic injuries)

$65,000**

$2 million

Combinations:

$130,000 combined (non-catastrophic injuries) 
+ $1 million (catastrophic injuries)

$130,000**

$2 million

$1 million (all injuries) + $1 million (catastrophic injuries)

$1 million

$3 million

*$130,000 optional combined (non-catastrophic injuries) and $1 million optional (all injuries) cannot be purchased together.
** Duration of benefit is five (5) years for adults.

Other Optional Benefits

 
There are many other options available to purchase additional or increased benefits and coverages. The following chart lists some but not all of those and indicates if those options changed on June 1. You can also choose not to increase any benefit or coverage. If you have previously purchased any optional benefits, you should review your renewal documents as they may have changed.

Benefit/Coverage

Current Policy

New Policy

You can choose

Income Replacement benefit

70 per cent of gross income up to $400 per week.

No change

To increase the weekly limit to $600, $800 or $1,000 per week.

Caregiver benefit

Available only for catastrophic injuries: Up to $250 per week for the first dependant plus $50 for each additional dependant.

No change

To make the same amounts available in current policy for catastrophic injuries available for all injuries.

Housekeeping and Home Maintenance expenses

Available only for catastrophic injuries: Up to $100 per week.

No change 

To make the same amounts available in current policy for catastrophic injuries available for all injuries.

Death and Funeral benefits

$25,000 lump sum to an eligible spouse; $10,000 lump sum to each dependant; maximum $6,000 funeral benefits.

No change

$50,000 lump sum to an eligible spouse; $20,000 lump sum to each dependant; maximum $8,000 funeral benefits.

Dependant Care benefit

Not provided

Not provided

To purchase this benefit and add up to $75 per week for the first dependant and $25 per week for each additional dependant to a maximum of $150 per week.

Indexation benefit

Not provided

Not provided

To add an annual adjustment for inflation for many benefits according to the Consumer Price Index for Canada to your policy.

Third Party Liability

$200,000 minimum for claims as a result of lawsuits against you.

No change

Options exist to increase the minimum amount.

Tort Deductible

$36,905.40 deductible for court awarded compensation for pain and suffering (Jan 1-Dec 31, 2016).

No change

Reduce deductible by $10,000 regardless of annual indexation percentage increases.

 

 
Other key changes include:

Minor Accident

 

 

Insurers can no longer use a minor at-fault accident that occurs on or after June 1, 2016 meeting certain criteria to increase your premiums.  The criteria include that no payment has been made by any insurer, that there are no injuries, and that damages to each car and property were less than $2,000 per car and were paid by the at-fault driver. This provision is limited to one minor accident every three years.

Interest Rate for Monthly Payment Plans  

The maximum interest rate that insurers can charge if you make monthly premium payments has been lowered from 3% to 1.3% for one year policies, with corresponding reductions for shorter terms.

Comprehensive Deductible

The standard deductible for Comprehensive coverage has been increased from $300 to $500. 
 

Non-Earner benefit

The six-month waiting period for people who are not working to receive benefits has been reduced to four weeks. Conversely, benefits can now only be received for up to two years after the accident.

Duration of Medical, Rehabilitation and Attendant Care benefits

For all claimants except children, the amount of time that you can receive this standard benefit is now five years for non-catastrophic injuries, and it will be paid only as long as you remain medically eligible.

 

Posted under Brain Injury, Catastrophic Injury, Paraplegia, Personal Injury, Quadriplegia, Spinal Cord Injury

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About Deutschmann Law

Deutschmann Law serves South-Western Ontario with offices in Kitchener-Waterloo, Cambridge, Woodstock, Brantford, Stratford and Ayr. The law practice of Robert Deutschmann focuses almost exclusively in personal injury and disability insurance matters. For more information, please visit www.deutschmannlaw.com or call us toll-free at 1-866-414-4878.

The opinions expressed here, while intended to provide useful information, should not be interpreted as legal recommendations or advice.

Practice Areas

  1. Car accidents
  2. Motorcycle accidents
  3. Automobile accident benefits
  4. Catastrophic injury
  5. Brain injury
  6. Paraplegia and Quadriplegia
  7. Spinal cord injury
  8. Drunk driving accidents
  9. Concussion syndrome
  1. Wrongful death
  2. Bicycle accidents
  3. Disability insurance claims
  4. Slip and fall injury
  5. Fractures or broken bone injury
  6. Pedestrian accidents
  7. Chronic pain
  8. Truck accidents
  9. Amputation and disfigurement

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