Not many people know this, but my family used to own a farm in Brockville, ON. Brockville is east of Kingston, near the Ontario/Quebec border. My grandparents owned a large farm with hundreds of cows, some chickens and large vegetable garden. I still have memories of the farm. On occasion, my grandfather would threaten me if I didn’t listen by saying he would take my toys away and give them to the cows. I sure listened after that.
As Goldfinger legend has it, the farm house burned down on account of a spontaneous hey fire. The only things that were saved were the family photo albums. And if you ask around, there are a few epic shots of yours truly hanging out with the cows we had.
The reason I’m bringing up Brockville is because it reminds me of a special client our law firm worked with. This client was involved in a single car motor vehicle accident just outside of Brockville. Years went by and this person never thought of retaining a lawyer. She was at fault for the single car accident, so there was nobody to sue (you can’t sue yourself for your own negligence). The person was scared to consult with a lawyer for these reasons. S/he didn’t know where to turn, what to do, or how the system worked. She was lost, and just went along with whatever the insurer suggested.
The person sustained multiple orthopaedic injuries and a brain injury in the car accident. This was by no means a minor collision, and the injuries were significant. I’ll talk more about the significance of those injuries later on in this Toronto Injury Lawyer Blog Post.
The injured accident victim was getting help from an occupational therapist who had been referred to him/her through their insurance company. NOTE: whenever the insurer recommends that you go to a certain physio or rehab clinic, or see a certain therapist run as fast as you can in the opposite direction. There is a very good reason why the insurer is insisting or recommending that you attend at a certain clinic or see a certain clinician. More often than note, these people aren’t on your side. They’ve been referred to help you via the insurer. The insurer is their client. They are on the insurer’s “preferred list” of vendors. How do you think they get there in the first place?
Quick legal tip: As the insured, you can go to any clinic you wish to attend. You can pick any therapist you wish to see. You are NOT at the mercy of the insurer’s “preferred vendor list“. You are the injured accident victim. You paid insurance premiums. You get to chose.
Back to the injured accident victim in Brockville. S/he was unable to return to work following the car accident. S/he needed attendant care. The house was a mess. S/he could no longer concentrate or retain information like they used to. His/her life had turned upsidown in a very bad way.
Years went by and the person was NOT getting the help they needed. There was no attendant care. There was no physiotherapy. There was no counselling to deal with the depression, anxiety, fear of driving. There was no speech language pathologist to deal with the memory issues and concentration problems. The family doctor’s resources were stretched to the limits. OHIP did NOT cover these types of things. CCAC was fully booked and would not deal with a car accident case like this one. Something needed to be done, but nothing was getting done.
The occupational therapist who had been dealing with this person did not seem to care. So long as the OT’s treatment plans were getting approved by the insurer (which they were), that OT was happy to stay the course.
I’m not sure what tipped the scales to have this person call our law firm. But enough was enough and it was time for a change. This person could simply not continue living life to this low standard. If things kept progressing as they were without any real meaningful change, this person may have likely been on the streets or worse.
Within 7 months of getting retained, our law firm made real positive changes in this person’s life. As it turns out, this person’s injuries were so bad, that the insurer agreed that they met the definition of catastrophic. It was only on our lawyers suggestion that such an application was made. The OT who had been working with the accident victim for over 4 years had never even considered the notion of applying for the catastrophic designation by way of OCF-19. The family doctor certainly didn’t know how things worked so they could not be to blame. Having said that, upon speaking with the family doctor, they were relieved that something was getting done for the mutual client/patient. Referrals were made for case management, physiotherapy, speech language pathology and counselling. The old OT who did little on the file was relieved of their duties and replaced with a more pro-active and patient centred OT.
The economic reality of this situation is that the person’s scope of accident benefits increased from an available $172,000 to $2,100,000. This is a significant increase by any account.
A few lessons from this story:
- It never hurts to call a lawyer who is focused on the well being of the injured accident victim. You never know what you’re entitled to if you don’t inquire about your rights
- Don’t trust the insurer, or their preferred vendors to look after you. Question everything and lawyer up.
- At the end of the day, you’re the boss. If you’re not getting the results or treatment you feel you deserve, or if that treatment is not up to standard, then you are free to switch service providers.
- Don’t be afraid to ask questions, even if you were responsible for the car accident. That’s what no fault insurance is all about in Ontario
- If you’re ever in Brockville, let me know and I’ll give you directions to my old family farm. The old Courthouse with the statue of Sir Isaac Brock in front of it is also a great site! I think this is a monument all Canadians can agree is great…