Articles Posted in Catastrophic Accident (CAT)

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The most serious types of motor vehicle accidents in Ontario are referred to as “catastrophic“, or “CAT” cases.

Just because the accident is bad, doesn’t necessarily make that the accident is “catastrophic“.

Just because the injuries are serious, also doesn’t make the accident “catastrophic“.

The term “catastrophic” carries a very specific medico-legal definition. It’s a term of art. This definition has been tinkered with throughout the years, over and over again. That’s how important it is for any car accident case.

Currently, in Ontario, in order for your car accident case to be defined as “catastrophic“, your doctor or specialist must find on an OCF-19 Application for Determination of Catastrophic Benefits Form which certifies that your injuries meet one of the following criteria:

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First and foremost, I would like to thank all those loyal readers of the Toronto Injury Lawyer Blog. Your readership, positive feedback and comments are all encouraging. We are glad and proud of keeping you informed and up to speed with the ever changing legal environment for personal injury claims in Ontario.

The focus of the Toronto Injury Lawyer Blog this week will be on Catastrophic motor vehicle accident claims, or CAT claims as they`re known in the industry.

CAT claims are in the category of the most serious cases we see at our law firm. Not just any run of the mill car accident case will qualify as catastrophic. There is an ever changing medico-legal definition of that it takes for injuries from a car accident to be categorised as catastrophic. The medico-legal definition changed very recently (June 1, 2016 to be exact). Any accident after June 1, 2016 will be tested based on the new CAT test, which is itemised in the OCF-19 Application For Catastrophic Impairment Form as follows:

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Did you know that your car insurance coverage for accident claims is changing effective June 1, 2016?

If you’re answer is “NO“, then you’re not alone.

To be frank, the only reason I know about these changes is because I’m a personal injury lawyer and it’s my job to do so. But if you’re reading this Toronto Injury Lawyer Blog Post, chances are you’re not a personal injury lawyer like me, and these changes are new to you.

Why are these changes being introduced in the first place?Good question!

I didn’t ask for them…. You didn’t ask for them…..

The only people who asked for these changes were the car insurance companies and their lobbyist group in order to save them MONEY. These changes aren’t about you ,the consumer. They aren’t about protecting the public. They’re about making MONEY for those large, multi-national corporations who provide insurance services in Ontario.

The logic is that the savings for large, deep pocketed insurers are supposed to be passed along to the average, every day, Ontario motorist. These changes have been coming fast and furious to save insurers money.

Yet, in Goldfinger Personal Injury Law’s informal poll of 10 drivers asked in Toronto; 10 drivers asked in Peterborough; 10 drivers asked in London; 10 drivers asked in Kitchener; and 10 drivers asked in Vaughan; NONE OF THEM REPORTED ANY SAVINGS ON THEIR CAR INSURANCE IN THE PAST 3 YEARS!! The only savings that were reported were from those motorists who stopped driving, or instead of insuring 2 vehicles, they new only insured 1 vehicle. Conducting these polls was very easy for our law firm because we have offices in all of these Cities, with the exception of the City of Vaughan.

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The winds of change aren’t just blowing for car insurance in Ontario. They’re howling! Over the past 8 months, Ontario’s government has announced a major overhaul to how personal injury disputes arising from the use or operation of a motor vehicle are dealt with.

Why is this important to you?

For starters, if you drive a car, or a passenger in a car and sustain any sort of injury, then these changes will impact you. Secondly, it’s the LAW if you drive a car or motorcycle to have insurance. If you drive a motorized vehicle without insurance, then you’re breaking the law and you don’t want to do that. Because car insurance is a requirement, then it ought to be GOOD, and not a hollow policy.

In Ontario, we have a no fault system of accident benefits. These accident benefits are there to protect policy holders, like you and me. The intent of the accident benefit system and the surrounding legislation is CONSUMER PROTECTION LEGISLATION. We are getting away from that “Consumer Protection” part as each day goes by.

Here are some of the highlights from the drastic changes which will kick in effective April 1, 2016 and June 1, 2016:

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Happy New Year to all of the readers of the Toronto Injury Lawyer Blog! We hope that the upcoming new year brings you  health, happiness and prosperity. We also want to thank all of our readers for their excellent comments, likes and shares. 2015 was a banner year for Goldfinger Personal Injury Law and the Toronto Injury Lawyer Blog and we hope to build upon that success in 2016.

What’s new for 2016? Well, Ontario has a set of laws which have just kicked in pursuant to the aptly named “Making Ontario’s Roads Safer Act“. As an aside, Ontario along with other jurisdictions have a tendency of giving grandiose names to acts which make the public think that they are not only AMAZING, but also do what they say they do. The reality is that within these incredibly named acts, there are sometimes provisions which have little or nothing to do with the name of the Act as well. Sometimes, it’s a way for legislature to pass laws under the rug, without the public or media catching on. We often see this with car insurance and the Statutory Accident Benefits Schedule and the Insurance Act.

In any event, the Making Ontario’s Roads Safer Act is a fantastic name for a set of laws. Whether or not it will do what it purports to do is still up in the air.

Here’s what you need to know:

There are increased fines for violations at crosswalks, school crossings, and pedestrian crossings. Those fines are DOUBLED in Community Safety zones. Drivers will be fined $150-$500 along with 3 demerit points for such offences.

Staring January 1, 2016, drivers and CYCLISTS must STOP and yield the entire road to pedestrians at pedestrian crossovers, and at school crossings where  there is a crossing guard displaying a school crossing stop sign. These pedestrian crossovers are identified with specific signs, road markings and lights. The new rules do NOT apply to pedestrian crosswalks at intersections with stop signs or traffic signals, unless a school guard is present.

The Making Ontario’s Roads Safer Act also gives municipalities the power to install new types of pedestrian crossings on low speed, low volume roads in addition to existing crossovers (think more speed bump crossings in a sub-division).

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The most serious motor vehicle accidents in Ontario are classified as “Catastrophic” by our Ontario insurance law. The term “Catastrophic” is a term of art; meaning that it carries its own legal definition; separate and apart from the common definition you would find in an English dictionary.

Being designated “Catastrophic” or “CAT” as its known in the medico-legal community is significant, as it provides accident victims and their families to a wider array of accident benefits, over a longer period of time. The advantages are significant such that insurers will fight very hard to find serious injured accident victims as not meeting the catastrophic definition.

Just because you’ve been involved in a serious car accident doesn’t mean that you will automatically be found to be catastrophic. There are a number of medico-legal tests which need to be met. In addition, there is one VERY important form that needs to be completed. This form is called the OCF-19 Application for Determination of Catastrophic Impairment form.  You can find a link to the OCF-19 CAT form, along with other OCF claim forms on the Goldfinger Personal Injury Law website here.

The OCF-19 is only two pages in length. Which, by comparison to some other forms (like the OCF-1 or the OCF-3) makes it a short form. But just because the OCF-19 CAT Claim Form is short, by no means is it not important or can it be completed carelessly.

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Here’s a call NOBODY likes to get:

This is the Social Worker from your local hospital. Your spouse has been involved in a serious car accident. They’re here in the Critical Care Unit. Their condition is stable, but you should come to the hospital right away“.

Your heart will skip a beat or two; and rightfully so. This is something you would never expect or want to happen. Millions of questions, concerns and grim scenarios are likely rushing through you head.

This first thing to do of course is to get to the hospital to be next to your spouse/loved one. Soon after the situation will stabilize and the next steps are very important. Here are some of Goldfinger Personal Injury Law’s tips on what to do if your spouse or loved one is in the hospital with a serious injury.

1. You should know that if anyone contacts you from any insurance company, you are under no obligation to speak with them. Chances are that if an insurance company has heard about this accident, they will want to get some information right away. Naturally, people want to be helpful and share information with the insurer. But, often times, the information which you are providing to an insurer without the assistance of a lawyer can damage your case right from the get go. Insurers won’t stop calling. It’s their job. I’ve actually seen adjusters arrive at an injured party’s bedside while they are medicated in a hospital bed and get them to sign forms and take a statement from them. This is all done under the guise of “information gathering”, but the reality is that they are slowly building their case at limiting their potential exposure and liability. Don’t speak with an insurer without a lawyer. You don’t have to take their calls if you don’t want to. It’s that simple.

2. Co-operate with the police. The police, much like insurers have fact gathering missions. But unlike insurers, the fact gathering missions of the police serve a much different purpose. If you’re more comfortable dealing with the police with a lawyer; then by all means, seek one out. But if the accident wasn’t your fault, then you should have nothing to hide. The police will want to bust the wrong doer just as bad as you for their negligence or bad decisions. It’s beneficial to your case to co-operate with the police as best you can.

3. Follow your doctor’s recommendations: if the doctor recommends that you stay in hospital an extra day, or get discharged to a long term care facility; then do so. Even if all you want to do is go home; or you have no interest in going to a long term care facility; the doctor knows best. Follow their advice so you can get better. It’s never good for a case, or for your health for that matter if you fail to follow a doctor’s orders. Particularly after a bad car accident.

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Only 1% of car accident cases go to trial.

That means that 99% of car accident cases settle outside of the courtroom.

There are many advantages to settlement. Certainly of the settlement and the lack of appeal rights of the parties to the settlement come to mind. You control your own destiny in a settlement vs. the uncertainty of the trial process (and appeal process thereafter).

This is very important because if you win big at trial, there’s nothing stopping an insurance company from tying up the case for many more years through their appeal rights following a trial.

But I don’t want to focus on settlement in this edition of the Toronto Injury Lawyer Blog Post. What I would like to focus on is what happens when a case actually goes to trial, in front of a jury.

Jury trials need to be requested by one party or the other. They aren’t automatic. A party will file a Form 47A Jury Notice. Some cases (such as cases against a Municipality) forbid jury trials.
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Serious accidents are exactly that. They’re SERIOUS.

They require a skilled, experienced, knowledgable and understanding lawyer to handle your claim.

But it’s not just the legal ups and downs that your personal injury lawyer will handle. A good lawyer, and one who knows what they’re doing, will help you get the rehabiliation and a team of professionals in place so that your treatment never skips a beat once you’re discharged from hospital. There is nothing WORSE seeing than a catastrophically injured accident vicitm who is not getting the rehabiliation or treatment which they need to help them get better. That irritates all of the lawyer and staff at Goldfinger Personal Injury Law. Arghhhhh…..

After a serious accident, it’s likely that you will be kept over at a hospital or a long term care facilty for an extended period of time. Chances are you might be transfered from one bed to another, or from one facility to another.

How long you stay at the hospital or the long term care facility is anyone’s guess. Ultimately, it’s up to the doctor to determine when it’s best for you to be discharged.

It’s important for the injured party and their family to understand that it’s the hospital’s goal to get you out of there, as safely and as efficiently as possible, so that they can free up another bed for another person. Much like a carousel, hospitals and rehab facilities are in a constant state of turnover. Patients come, and patients go. The longer a patient has to stay at the hospital, the fewer people that hospital has the capacity to treat and take on. Ultimately, the hospital or rehab facility wants to get you out of there ONLY when it’s safe to do so. Sorry to burst your bubble that they wanted to keep you there forever…
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Catastrophic Injury claims, by their very nature, are the most serious car accident claims which a personal injury lawyer will face during their legal career.

The term “catastrophic” has a special meaning at law for car accident claims in Ontario. At law, we were refer to “castastrophic” as a term of art. This means that it has a special legal significance, and means something very specific which is defined in the Insurance Act.

If you meet the definition of “catastrophic“, you will be eligible for a greater amount of accident benefits. In particular,, you will be eligible for:

$1,000,000 in medical and rehabilitative benefits, instead of just $50,000 or $3,500 under the Minor Injury Guideline
Up to $1,000,000 in attendant care benefits, instead of just $36,000 for non-catastrophic car accidents
Up to $100/week in housekeeping and home maintenance, instead of ZERO for non-catastrophic claims
Up tp $250/week for a caregiver claim, plus $50 for each dependant, instead of ZERO for non-catastrophic injuries
These differences are signficant, and dramatically increase the amount of value to any car accident claim. But, how do one’s injuries meet the definition of “catastrophic” in the first place? Read on and I’ll fill you in.
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