Goodman Halioua LLP is proud to announce that it has joined FAIR (Fair Association of Victims for Accident Insurance Reform). FAIR is a not-for-profit organization of car accident victims struggling with the current automobile insurance system in Ontario. FAIR seeks the reform of automobile insurance legislation in Ontario so that all car accident victims receive the treatment they require.
The current legislation and the often inappropriate use of the Minor Injury Guidelines (MIG) classification provides insurers with broad powers. These powers allow insurers to limit claimants’ rights to the benefits they need and their ability to discover the extent of their injuries and impairments by denying claimants the ability to have an assessment performed by the health care practitioner of their choice. Assessments are required so that medical evidence can be provided to support the injured person’s entitlement to a variety of benefits including medical and rehabilitation, income replacement and attendant care benefits.
Often, an adjuster without any medical specialty will arbitrarily classify a claimant’s injuries as “minor”, thereby severely limiting the benefits available to the injured person. Where an injured person is placed in the MIG, their medical and rehabilitation benefits are limited to a maximum of $3,500.00. To overturn the insurer’s decision, a claimant will often require an assessment to be paid out of his/her own pocket to prove that he/she requires care exceeding the MIG limits and should not be placed in the MIG.
Even where a claimant is not classified in the MIG, or has been removed from the MIG, the insurer will often deny reasonable assessment requests sought by the claimant to substantiate his/her entitlement to benefits on the basis that they are not reasonable or necessary. In our experience, the insurer will require that the claimant attend the exact same assessment that he/she initially requested, but with a health care practitioner chosen by the insurer. In some cases, the claimant will self-fund the assessment(s). The insurer will then demand the same assessment with its own health care practitioner, despite initially responding that such assessment was not reasonable and necessary (and will continue to refuse to pay for it).
The car accident lawyers at Goodman Halioua LLP are equipped to assist car accident victims in obtaining the best treatment possible in this difficult environment and are ready to protect their rights. Our car accident lawyers are well versed in the tactics employed by insurance companies and advocate on behalf of clients for their rightful benefits. In appropriate cases, we will pay for the claimant’s reasonable and necessary assessment(s) to ensure their entitlement to benefits is realized.
We frequently attend mediations before the Financial Services Commission of Ontario (FSCO) on the above issues and are prepared, where necessary, to bring these matters before a FSCO Arbitrator or Judge.
We applaud FAIR for their work in supporting the rights of car accident victims and ensuring that the health care professionals who conduct Insurer’s Examinations do so objectively. Please visit the FAIR website at www.fairassociation.ca to learn more about this organization that we proudly support.
