THE MINOR INJURY GUIDELINE (MIG) & CATASTROPHIC INJURY IN ONTARIO MOTOR VEHICLE ACCIDENTS

A Primer on the Minor Injury Guideline (MIG) and Catastrophic Impairment Designation in Accident Benefits

Daria Kagan
Personal Injury Lawyer in Toronto, Ontario

In 1990, the Ontario Motorist Protection Plan (Bill 68) created no -fault auto insurance in Ontario. With the passage of this law, car accident victims were no longer able to sue for minor injuries but would instead recover Accident Benefits(a.k.a. no-fault benefits) from their own auto insurers. Since then, through various legal developments, a framework was established to streamline howauto insurers process Accident Benefits claims. The most recent updates to this framework are the Minor Injury Guideline (MIG), released in 2010, followed by a revised MIG that took effect in November of 2011. The MIG created asimplified, cookiecutter system of classifying many kinds of injuries as minor injuries and it drastically reduced the Accident Benefits available to those people whose injuries fall within the MIGs broad definition of minor injury. What benefits are available from Accident Benefits? What Accident Benefits are available to you, and how much, depends on: whether your auto insurance policy is a standard policy or contains optional, additional coverage for extra Accident Benefits whether you meet the various tests for each type of benefit

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 how severe your injuries are, specifically: whether your injuries are so severe that you to meet the test of Catastrophic Impairment, in which your access to benefits increases in amount and type of benefits available whether your injuries fall under the MIGs definition of

Minor Injury, in which case your access to benefits is

drastically reduced Non-Minor Injury: If your injuries neither fall under the MIG, nor are they catastrophic, then your injuries would be classified as non-minor injury and the Accident Benefits available to you from your auto insurer would include: Medical-Rehabilitation Benefits up to a limit of$50,000 (optional coverage limit is $100,000) Attendant Care Benefits up to a limit of$36,000 (optional coverage limit is $72,000) Income Replacement Benefits up to $400/week(70 % of net weekly income up to a limit of $400; increased coverages of up to $600, $800 and $1000 per week are optional) Caregiver Benefits are not available unless you have optional coverage, in which case this is limited to $250/week for the first

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person in need of a caregiver and $50/week for each additional person Housekeeping& Home Maintenance Benefits are not available unless you have optional coverage, in which case this is limited to $100/week

Minor Injury Guideline (MIG): If your injuries fall under the MIGs definition of minor injury, the Accident Benefits available to you (listed above under Non-Minor Injury) will be reduced as follows: Medical-Rehabilitation Benefits reduced to a limit of $3,500 No access to Attendant Care Benefits Catastrophic Impairment: If your injuries are severe enough to meet the test of Catastrophic Impairment, the Accident Benefits available to you will increase as follows: $1 million in Medical-Rehabilitation Benefits $1 million in Attendant Care Benefits Caregiving Benefits of $250 per week for the first person in need of a caregiver and $50 for each additional person Housekeeping Benefits of $100 per week

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What determines if I fall within the MIG and how can I get out of the MIG? A minor injury is defined by the MIG to include: strain or sprain of muscles, tendons, ligaments, including partial but not total tearing whiplash (except if this includes spinal dislocations or signs of nerve damage) cuts, bruises, lacerations partial but not total joint dislocation If your auto insurer decides that your injuries fall within the MIG, and you disagree, you need to:

Convincing your auto insurer that your injuries do not fall under MIG can be challenging if you dont have an experienced personal injury lawyer by your side.

1. provide your auto insurer with medical documents supporting that your injuries do not fall within the minor injury definition,

or
2. provide compelling evidence from a healthcare provider that you are excluded from the MIG because of a pre-existing injury or

illness that prevents healing within a normal time frame.

Convincing your auto insurer that your injuries do not fall under MIG can be challenging if you dont have an experienced personal injury lawyer by your side. It is your lawyers job to assist you with this and to get you out of MIG where appropriate.

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How is a Catastrophic Impairment determined? The definition of Catastrophic Impairment includes: amputation permanent loss of the use of a limb paraplegia quadriplegia blindness in both eyes certain types of brain impairment severe impairment due to mental or behavioral disorders a combination of impairments that result in at least 55 percent impairment of the whole person

What happens if the Accident Benefits insurance company refuses to pay my benefits? If youve been seriously injured in a car accident and your Accident Benefits insurer refuses to pay benefits to which you are entitled, you need an experienced personal injury lawyer on your side. One of our lawyers would be happy to speak with you, free of charge, to assess the benefits you may be entitled to.

The Threshold and Deductible in Motor Vehicle Accident Cases in Ontario

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At Kagan Law Firm P.C., we have an Accident Benefits team dedicated to ensuring our clients take full advantage of the benefits available to them. When an Accident Benefits insurer cuts-off or denies benefits, we fight to enforce our clients rights and make the insurer pay. The different types of Accident Benefits are described below:

Income Replacement Benefit: to compensate for lost income after

an accident

Non-Earner Benefit: available if you do not qualify for Income

Replacement Benefit but suffer a complete inability to carry on a normal life

Medical & Rehabilitation Benefit: for costs of drugs and non-OHIP

funded health care such as physiotherapy, massage, chiropractic care, etc.

Attendant Care Benefit: for costs of an aide or attendant to assist

you or costs of a long-term care facility

Housekeeping & Home Maintenance Benefit: to replace the

home care tasks which you used to perform before the accident but are unable to resume after the accident

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Caregiver Benefits: if you used to be a caregiver to someone you

live with but are unable to resume that role due to your catastrophic injuries from an accident

Expenses Benefit: to reimburse you certain expenses incurred due

to an accident, such as the costs of buying a back or neck brace, or to reimburse you for clothing or eye glasses damaged in the accident

Death and Funeral Benefits: for a family member fatally injured in

an accident

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About the Author

Daria Kagan Daria has spent her career representing injured and disabled people. Her practice is dedicated exclusively to securing assistance, resources and compensation for injured and disabled people and their families. Daria has successfully argued and enforced her clients rights at the Superior Court of Justice, the Ontario Court of Justice, the appellate courts of the Divisional Court and the Ontario Court of Appeal as well as a variety of administrative tribunals, including The Financial Services Commission of Ontario. Daria is a member of the Law Society of Upper Canada, the Ontario Trial Lawyers Association, the Toronto Lawyers Association, the Halton County Law Association and the Halton Hills Chamber of Commerce. She has spoken and organized presentations at conferences sponsored by these and other organizations, most recently, those of The Advocates Society and the Canadian Institute. Daria enjoys volunteering with the Ontario Justice Education Network and she routinely provides mentorship and training to health care and rehabilitation clinics in order to equip them with the tools and up-to-date information they need to better assist their patients in accessing the benefits they need. Kagan Law Firm PC www.kaganlaw.ca Toll Free: 1 855 734 0007 Telephone: 416 734 0007 Fax: 416 734 0008 Email: info@kaganlaw.ca 3300 Bloor St. W. (Sun Life Financial Centre) Centre Tower 10th Floor, Suite 3080 Toronto, ON M8X 2X3

The Threshold and Deductible in Motor Vehicle Accident Cases in Ontario

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