Lofranco Corriero: Affordable Legal Help You Can Count On

You have the legal right to have assessments done on your behalf without any cost to you. The insurance company may be obligated to pay for the costs of these assessments.

Your Medical Assessments

The purpose of your medical assessment is two-fold; (1) to provide a diagnosis (the nature and extent of your physical injuries) and (2) make recommendations for treatment and rehabilitation. Your rehabilitation facility will attend to your medical assessment and will complete and submit a Disability Certificate and Treatment Plan to your insurance company for their approval. The costs of the assessments and the expenses for treatment are covered by the $65,000 that is available for medical treatment, rehabilitation, and attendant care. In the event you sustained psychological or emotional injuries such as depression, or panic attacks while driving, a Psychological Assessment will be arranged and the attending psychologist will submit an application for approval of the assessment to your insurance company and upon approval.

You may have to attend for a Psychological Assessment. On completion, the psychologist will submit the assessment along with a Treatment Plan to your insurance for approval. Once approved, you must attend for treatment.

Insurance Company's Medical Assessments

As you have the legal right to medical and non-medical assessments, so does your insurance company. The insurance company must provide notice in writing and you are obligated by law to attend. Usually, an insurance medical assessment will result in your benefits being reduced or terminated. This does not mean you are not still suffering from the injuries sustained in the accident, but represents a difference in medical opinion. Your lawyer will commence legal proceedings by filling out an Appeal with the License and Appeals Tribunal to have your benefits restored or negotiate a final cash settlement.

The Importance of Attending for Your Medical Treatment

The bottom line, if you don't attend for approval Medical Treatments such as physiotherapy, chiropractic, psychological counselling, or an approved chronic pain program, it will be interpreted that you are no longer injured, and you can resume all your pre-accident lifestyle activities such as work, housekeeping, caregiving, family social and recreational activities. As a result, you have no chance of obtaining reasonable cash settlement.

There are several factors that are taken into account in determining how much you will receive for your pain and suffering and loss of enjoyment of life claim. Some important factors are:

(a) The nature and extent of your physical, psychological and mental injuries
(b) Whether surgical intervention was or will be required
(c) Whether there has been a substantial interference with respect to your pre-motor vehicle family, vocational, day-to-day, social and recreational activities

All claims for General Damages are subject to a Statutory deductible (which as of January 1, 2017 is approximately $39,000 and adjusted for inflation) unless your General Damages claim has been assessed at $124,616.21 (again, as at January 1, 2017, subject to inflation) or greater in which case there is no deductible.

It is important to know that Jury’s in Ontario are not told in the course of the trial of this threshold or deductible when deciding a personal injury case.

You have the option to purchase insurance to reduce the amount of the statutory deductible and this should be discussed with your insurance broker.

Accident Benefits are the legal ways you can claim compensation or money as a result of sustaining injuries in a motor vehicle accident regardless of who was at fault for the accident.