By Sheila Marcantonio
By now, you all know that we in Ontario are paying the highest insurance costs for automobile insurance in Canada and apparently, we have the least amount of accidents. Ontario’s roads are among the safest in North America. According to a recent government report, Ontario’s 2013 auto-accident fatality rate was the second-lowest ever recorded in the province and the second-lowest in all of North America, behind only the District of Columbia. And Ontario’s auto-accident injury rate in 2013 was the lowest ever recorded in the province and among the lowest in Canada.
However, what most people in Ontario don’t realize, is that they are essentially self-insured for the first $40,000 of any pain and suffering injury claim. There is a deductible in Ontario and it currently is at $37,385.17, unless your injuries are worth more than $124,616.21. The deductible increases every year on January 1 according to inflation as does the maximum limit you must surpass. THIS is the Ontario Government’s way of getting rid of all soft tissue injury claims aka whiplash.
In addition to that, there is a threshold to meet and the wording for that threshold is as follows: permanent serious impairment of an important mental, physical or psychological function.
Essentially, what the threshold looks at is the permanent impairment that the injury causes and not the injury itself.
There are also regulations about how the evidence that a person’s claim meets the threshold and these regulations can be found here: https://www.ontario.ca/laws/regulation/960461
This is all meant to reduce the cost of Automobile Insurance in Ontario. It has NOT worked and most people are astonished to find out there is very minimal compensation for their pain and suffering.
By way of example, let’s imagine you are a nurse: if your arm is broken as a result of a car accident, you may require surgery to repair your injury and six months’ worth of physiotherapy thereafter. Since you work in a physical environment, your employment may be negatively affected as well. Most would agree that this constitutes a serious injury. At trial, let us assume that you are able to convince the jury that your pain and suffering amounts to $60,000. Once the statutory deductible is applied, your award is now only worth $22,600! Most would agree that there seems to be an inherent unfairness to the way this works – and they would not be wrong!
To illustrate the implications of the threshold, if we use the above noted example, we know that the $60,000 pain and suffering award given to the nurse is reduced to $22,600 by virtue of the statutory deductible. Following the jury verdict, the judge presiding over the trial will need to determine whether the injured party’s injuries meet the threshold definition of being permanent and serious. If the judge finds that the injuries do not meet the threshold, then the pain and suffering award is reduced to zero. Nothing!
A new study revealed that many Ontario drivers are unaware of the risks presented by changes to the Ontario auto insurance regulations – instituted seven years ago — and as a result, are not sufficiently protected in the event of a serious motor vehicle accident. Only 10% of the population purchased extra medical coverage. This is despite the fact that the costs of additional coverage add up to less than $100 in most cases.
This lack of information is putting people at grave risk. Unfortunately, in our daily practice, we encounter people all the time who have been seriously injured in a motor vehicle accident and find out, much too late, that they don’t have sufficient insurance to cover their medical and income needs. I appreciate that insurance is a provincial domain but it really has become too political.
Perhaps it is time to look at National Insurance Plan that attempt to fairly compensate people rather than insurance companies. However, in the meantime, you must contact your insurance broker and increase your optional no-fault benefits on your own insurance policy!!!
Sheila Marcantonio is senior Personal Injury lawyer at Lancaster, Brooks & Welch LLP. She offers track record of over 35 years’ experience successfully fighting for the rights of her clients.
She may be reached in St Catharines at 905-641-1551.