Some motor vehicle accidents result in injuries that permanently change a person’s life. In Ontario, the most serious injuries may qualify as a catastrophic impairment under the province’s automobile insurance system. A catastrophic designation is important because it significantly increases the level of accident benefits available to an injured person and can provide access to the long-term treatment and care that serious injuries often require.
What is a Catastrophic Impairment?
Catastrophic impairment claims are governed by Ontario’s Statutory Accident Benefits Schedule, which sets out the rules for accident benefits following a motor vehicle accident. These benefits are available through your own automobile insurance policy and are generally available regardless of who caused the accident.
Accident Benefits for Catastrophic Injuries in Ontario
Under Ontario’s accident benefits system, the amount of medical and care funding available depends on how an injury is classified. For individuals with non-catastrophic injuries, the combined limit for medical, rehabilitation, and attendant care benefits is typically $65,000. However, if a person is found to have sustained a catastrophic impairment, the available funding increases dramatically to up to $1,000,000 for medical, rehabilitation, and attendant care benefits.
This increased funding reflects the reality that catastrophic injuries often require extensive medical treatment, rehabilitation services, and long-term assistance with daily activities. Many individuals with catastrophic injuries require ongoing therapy, mobility equipment, home modifications, or personal care assistance for the rest of their lives.
Criteria for Catastrophic Impairments
Ontario law sets out specific criteria that determine whether an injury qualifies as catastrophic. Some injuries are automatically considered catastrophic because of their severity. These can include spinal cord injuries that cause paralysis, amputations of limbs, severe burns covering a significant portion of the body, and certain forms of blindness.
Traumatic brain injuries may also qualify as catastrophic where the injury results in significant and permanent impairment of cognitive functioning. In some cases, catastrophic status may also be determined based on a combination of physical and psychological impairments that together meet the legal threshold.
How Catastrophic Impairments Are Determined
Determining whether an injury meets the catastrophic definition is often a complex medical and legal process. Insurance companies typically require detailed medical documentation and may request specialized assessments from medical experts. These assessments may evaluate the extent of a person’s physical impairments, cognitive limitations, psychological condition, and ability to perform daily activities.
Impact on Tort Claims and Compensation
In addition to increasing the level of accident benefits available, catastrophic injuries may also significantly affect a person’s tort claim against the at-fault driver. Individuals who suffer catastrophic injuries often experience long-term loss of income, reduced ability to work, and substantial future care needs. These losses may be addressed through a civil lawsuit seeking compensation for damages such as pain and suffering, income loss, and the future cost of care.
Legal Assistance for Catastrophic Impairment Claims
If you or a loved one has suffered serious injuries in a motor vehicle accident, it may be important to obtain legal advice about whether a catastrophic impairment claim should be pursued. Don’t hesitate to book a consultation with an experienced lawyer.
