Over the last couple of years there has been much talk in the media about the changes in the Ontario automobile insurance system.  On September 1, 2010, the entire system underwent a significant overhaul.  For many, the significance of these changes is not fully understood until such time as they or a loved one has been injured in an accident. 

 

The most significant changes were to the accident benefits system, a bundle of benefits that is available to individuals who have been injured in a motor vehicle accident.  Over the next few months, I hope to more fully explain what the changes to the accident benefit system have been.   

 

Of all the changes to the accident benefit system, the most dramatic has to be the introduction of the Minor Injury Guideline because it captures the vast majority of accident claims.  The Minor Injury Guideline limits the amount of money that is available from your automobile insurer to pay for medical treatment and rehabilitation for injuries that are predominantly considered minor.  The maximum amount payable under the Guideline is $3,500.00.[1]  By contrast, if an injury is not considered minor, medical and rehabilitation benefits are available up to $50,000.00 for up to ten years after the accident (or up to $100,000.00 if optional coverage has been purchased). 

 

What is a Minor Injury? 

 

The Minor Injury Guideline, defines a minor injury as:

 

(a)         Sprain – an injury to one or more tendons or ligaments, including a partial but not a complete tear;

 

(b)         Strain – an injury to one or more muscles, including a partial but not a complete tear;

 

(c)         Whiplash associated disorder – a whiplash injury that does not exhibit objective, demonstrable, definable and clinically relevant neurological signs AND does not exhibit a fracture in or dislocation of the spine;

 

(d)         Contusion;

 

(e)         Abrasion;

 

(f)          Laceration; or

 

(g)         Subluxation (a partial but not a complete dislocation of a joint);

 

(h)         and any associated sequelae (any condition or complication that arises from any of the above injuries).[2] 

 

 

Not all Minor Injuries are Considered Minor

 

If your injury is predominantly a minor injury but there is compelling medical evidence that you  have a pre-existing condition that will prevent you from reaching maximum medical recovery if you are limited to the $3,500 cap, then the Guideline will not apply.  As a result of this, it is important that you provide a complete medical history to your treatment providers so they can properly assess whether your injury should be treated within the Guideline or if it would be more appropriate to treat in the ordinary medical and rehabilitation benefit stream.

 

If you have been injured in a motor vehicle accident and have any questions about the Minor Injury Guideline, or your rights in general, please contact Sandra DiMeo. 



[1] Insurance Act, R.S.O. 1990, c.I.8,  O.Reg. 34/10, s.18

[2] Financial Services Commission of Ontario, Superintendent’s Guideline No. 02/11