Benefits Recently Cut FURTHER

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Benefits Recently Cut FURTHER

As part of the 2015 budget, the Government of Ontario announced that they will be making changes to the Insurance Act.  By changes, they mean cuts to minimum coverage levels.  These cuts will leave those who are seriously injured in a motor vehicle accident at risk of being under protected.

The changes described on the Ministry of Finance website1 are set out in the following table along with our comments highlighting the real impact of these changes

You can’t always get what you want, and now you just might find, you CAN’T get what you need
Change Impact
Change the standard benefit level for medical and rehabilitation benefits will be $65,000 (from $50,000) and include attendant care services under this benefit. Consumers will also have an option to increase that coverage up to $1 million. Although described as an increase, this is actually a cut of $21,000 to the standard benefit. The current regime provides for $50,000 in medical and rehabilitation benefits and $36,000 of attendant care benefits, for a total of $86,000.
Include attendant care services with the $1 million medical and rehabilitation benefit for catastrophic impairments, and provide the option for additional coverage of $1 million, for $2 million in total coverage. Another cut. This time by $1 million. The current regime provides benefits of $1 million for attendant care and $1 million for rehabilitation benefits.
Reduce the duration of medical and rehabilitation benefits from 10 years to 5 years, for all claimants except children. You now have to get better in 5 years. If you remain injured after 5 years you won’t have medical and rehabilitation benefits to help you.
Eliminate the six-month waiting period for non-earner benefits and limit the duration of non-earner benefits to two years after the accident Another cut. This benefit is typically claimed by those who aren’t working when injured, such as students. The change is a massive cut for someone who is seriously injured as a student and who can no longer work. Under the current regime a person could recover $185/week after a 6 month waiting period up to two years, and then after 2 years $320/week. That benefit would continue provided they had a complete inability to carry on a normal life. Doesn’t sound like a lot, but over a 25 year period this would total about $416,000. Now that same person would be limited to $185/week for 2 years, or about $19,420, total. Ever.
Require goods and services not explicitly listed in the Statutory Accident Benefits Schedule (SABS) to be “essential” and agreed upon by the insurer. If goods or services are needed for your recovery and they aren’t in the SABS you know how to convince your insurer they are essential. What is “essential” is not currently defined in the SABS. And yes, the government actually has that in quotes.

These changes are reportedly being made to reduce auto insurance premiums but, in fact, auto insurers have no obligation or requirement to reduce their premiums. These changes are a reduction in services with no guarantee of reduction in premiums.

These changes to the Insurance Act affect the minimum amounts of coverage an insurance company must provide. You will be able to pay more if you want better benefits. So, now you’ll have to pay more to get what you used to get.

Ontario Ministry of Finance, 2015 Ontario Budget, Chapter I: Implementing the Plan, available online at: <http://www.fin.gov.on.ca/en/budget/ontariobudgets/2015/ch1f.html>