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A Primer on the Minor Injury Guideline (MIG) and Catastrophic Impairment Designation in Accident Benefits
Daria Kagan
Personal Injury Lawyer in Toronto, Ontario
In 1990, the Ontario Motorist Protection Plan (Bill 68) created no -fault auto insurance in Ontario. With the passage of this law, car accident victims were no longer able to sue for minor injuries but would instead recover Accident Benefits(a.k.a. no-fault benefits) from their own auto insurers. Since then, through various legal developments, a framework was established to streamline howauto insurers process Accident Benefits claims. The most recent updates to this framework are the Minor Injury Guideline (MIG), released in 2010, followed by a revised MIG that took effect in November of 2011. The MIG created asimplified, cookiecutter system of classifying many kinds of injuries as minor injuries and it drastically reduced the Accident Benefits available to those people whose injuries fall within the MIGs broad definition of minor injury. What benefits are available from Accident Benefits? What Accident Benefits are available to you, and how much, depends on: whether your auto insurance policy is a standard policy or contains optional, additional coverage for extra Accident Benefits whether you meet the various tests for each type of benefit
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how severe your injuries are, specifically: whether your injuries are so severe that you to meet the test of Catastrophic Impairment, in which your access to benefits increases in amount and type of benefits available whether your injuries fall under the MIGs definition of
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person in need of a caregiver and $50/week for each additional person Housekeeping& Home Maintenance Benefits are not available unless you have optional coverage, in which case this is limited to $100/week
Minor Injury Guideline (MIG): If your injuries fall under the MIGs definition of minor injury, the Accident Benefits available to you (listed above under Non-Minor Injury) will be reduced as follows: Medical-Rehabilitation Benefits reduced to a limit of $3,500 No access to Attendant Care Benefits Catastrophic Impairment: If your injuries are severe enough to meet the test of Catastrophic Impairment, the Accident Benefits available to you will increase as follows: $1 million in Medical-Rehabilitation Benefits $1 million in Attendant Care Benefits Caregiving Benefits of $250 per week for the first person in need of a caregiver and $50 for each additional person Housekeeping Benefits of $100 per week
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What determines if I fall within the MIG and how can I get out of the MIG? A minor injury is defined by the MIG to include: strain or sprain of muscles, tendons, ligaments, including partial but not total tearing whiplash (except if this includes spinal dislocations or signs of nerve damage) cuts, bruises, lacerations partial but not total joint dislocation If your auto insurer decides that your injuries fall within the MIG, and you disagree, you need to:
Convincing your auto insurer that your injuries do not fall under MIG can be challenging if you dont have an experienced personal injury lawyer by your side.
1. provide your auto insurer with medical documents supporting that your injuries do not fall within the minor injury definition,
or
2. provide compelling evidence from a healthcare provider that you are excluded from the MIG because of a pre-existing injury or
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How is a Catastrophic Impairment determined? The definition of Catastrophic Impairment includes: amputation permanent loss of the use of a limb paraplegia quadriplegia blindness in both eyes certain types of brain impairment severe impairment due to mental or behavioral disorders a combination of impairments that result in at least 55 percent impairment of the whole person
What happens if the Accident Benefits insurance company refuses to pay my benefits? If youve been seriously injured in a car accident and your Accident Benefits insurer refuses to pay benefits to which you are entitled, you need an experienced personal injury lawyer on your side. One of our lawyers would be happy to speak with you, free of charge, to assess the benefits you may be entitled to.
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At Kagan Law Firm P.C., we have an Accident Benefits team dedicated to ensuring our clients take full advantage of the benefits available to them. When an Accident Benefits insurer cuts-off or denies benefits, we fight to enforce our clients rights and make the insurer pay. The different types of Accident Benefits are described below:
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