Once you are in a car accident, your car insurance policy will provide you with Accident Benefits. Everyone is eligible for treatment for minor injuries sustained during a car accident. The insurer does not need to approve the treatment for minor injuries. The maximum amount of money an insurance company will give for minor injuries is $3,500. This is given in three block treatments of four weeks, each for twelve weeks. This money is to help you get treatment to be able to get back to your pre-accident self. A minor injury is a strain, sprain, whiplash, contusion, abrasion, and subluxation (dislocation).
Challenging Minor Injury Classification
However, $3,500 may not be enough to help you receive the treatment you need to return to being your pre-accident self. This means you can always challenge the classification your insurance provider has placed on you.
Injuries Excluded from Minor Injury Guidelines
A way to get out of Minor Injury Guidelines is to show that the injuries sustained do not fall within the minor injury guideline. These injuries include fractures, concussions, injuries that require further care such as surgery, amputations, chronic pain, and psychological symptoms.
Pre-Existing Conditions
Based on section 18(2) of the Statutory Accident Benefits Schedule, getting out of minor injury guidelines for a pre-existing injury can be done if there was a pre-existing condition that was documented before the accident and if the pre-existing condition will prevent the recovery from injuries if you are confined within the $3,500 limit of minor injury guidelines. In Scarlett v Belair Insurance, 2015 ONSC 3635, it was decided that the decision is based on compelling evidence and refers to sufficient evidence based on a standard of reasonableness. The evidence must show that the condition was pre-accident and would prevent recovery under minimal injury guidelines, as stated in 16-004272 v Continental Casualty Insurance Company, 2017 CanLII 63661.
Chronic Pain
Another way to get out of minor injury guidelines is to show that the injury is causing chronic pain. P.L. and Aviva Insurance Canada, 2019 CanLII 22223 (ON LAT) stated that chronic pain could get you out of minor injury guidelines. A chronic injury persists longer than the indicated timeframe for healing for the original disorder. Chronic pain can get you out of minor injury guidelines if the chronic pain results in a functional impairment and causes suffering and distress to a certain level.
Psychological Impairment
Another way to get out of minor injury guidelines is when a car accident causes psychological impairment. This can include post-traumatic stress disorder, depression, and adjustment disorder. If you have an injury, even a minor one, but it is linked to psychological impairments, then it can be a way to get out of the minor injury guidelines.
Concussions
Another way to get out of minor injuries is to show that the car accident resulted in a concussion. This would not be considered a minor injury, and you would qualify to get out of minor injury guidelines.
Benefits of Exceeding Minor Injury Guidelines
If you get out of minor injury guidelines, you will be eligible for up to $65,000 for medical, rehabilitation, and attendant care. You should consult a personal injury lawyer to help you get the money you deserve after your car accident. Remember that you suffered a loss, so you better call Ross.