The short answer is yes. You may be eligible to receive general benefits in accordance with Ontario’s Minor Injury Guideline (MIG). The MIG provides a framework for the treatment of insured individuals who sustain minor injuries in a car accident. Below, we discuss this guideline in greater detail.
Our legal team at Greg Monforton & Partners has been helping Ontario residents fight for just and fair compensation for four decades. Our firm has successfully $300 million on behalf of our clients, including car accident victims. The initial consultation comes at no cost or obligation to you.
Objectives of the Minor Injury Guideline
The MIG is a part of the Statutory Accident Benefits Schedule or SABS. Under the SABS, there are different levels of benefits car accident victims may be able to receive based on the severity of their impairments. These levels include minor impairments, non-catastrophic impairments and catastrophic impairments.
For minor injuries or impairments, the MIG provides rules for the goods and services that will be paid for by the insurer to an insured individual.
The overall objectives of the guideline is to:
- Speed up treatment – Quicker access to rehabilitation services and treatment for car accident victims who sustain minor injuries without needing prior approval from the insurer
- Improve resource utilization – The intent is to enhance the operation of health care resources
- Provide cost certainty – Insurers and health care providers now have more certainty around costs and payment for injured victims, allowing for better planning and cost reduction
Minor Injuries That Qualify for Accident Benefits
Accident benefits are only provided to insured individuals whose minor injury qualifies under the guideline. The MIG defines a minor injury as one or more of the following:
- Sprain
- Strain
- Whiplash-associated disorder
- Contusion
- Abrasion
- Laceration or subluxation (partial dislocation of a joint)
- Any clinically associated sequelae (condition resulting from a disease or injury)
For instance, you may qualify for benefits if you suffered a sprain or strain in an accident that caused a partial, but not a complete tear to one or more muscles, tendons or ligaments.
The MIG also has a structured 12-week treatment course consisting of three phases that health care providers can use to help victims reduce or manage their pain and injury-related symptoms.
The Importance of Identifying an Injury Accurately
Although treatment of minor injuries from an accident does not require the insurer’s approval, the MIG does limit the benefit amount victims have access to.
An insured individual with minor injuries only has access to a maximum of $3,500 for medical and rehabilitation benefits. In some cases, this amount may be sufficient to cover costs, but for most injured victims, this amount is not nearly enough to pay for the treatment required to make a recovery.
This is why it is important that you seek medical care as soon as possible after an accident, even if your injuries seem minor. You do not want any injuries you suffer to be misclassified or discredited by an insurer. They work tirelessly to devalue and deny claims in an attempt to save themselves money.
An experienced lawyer can help you gather the proper evidence (i.e. reports and medical records) to accurately establish the extent of your injuries. Doing so could allow you access to additional benefits.
Schedule a Free Legal Consultation Today
A Windsor-based car accident lawyer from our firm is ready to communicate and negotiate with the insurer on your behalf to help recover the compensation you need. We have decades of experience handling car accident claims and are well-versed in different insurance policies.
Let us review your situation and any answer any questions you may have about the legal process in a risk-free consultation. There is no obligation after this initial meeting to have us represent you. However if you do decide to move forward, we charge no upfront fees to take or work on a case.
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If injured in an accident in Ontario, you may be eligible to claim accident benefits to help cover your medical bills and other related expenses. The amount of available accident benefits coverage to you will depend on the severity of your injuries. To help prove the extent of the injuries you sustained, an insurer may require that you attend an Independent Medical Examination (IME).
Greg Monforton & Partners is prepared to help you claim the accident benefits you need. There is no risk in calling us and no obligation to retain our services after completing an initial free consultation.
What is an Independent Medical Examination?
Ontario is a no-fault province when it comes to car accidents. This means that your insurer is expected to pay for certain accident benefits if injured in a crash. However, independent medical examinations are commonly requested by insurers after an injured victim has filed a claim for accident benefits.
An IME is a review of your medical status by an independent medical examiner. He or she will look over your medical history and current health related to your claim and offer a written opinion of your injuries and recovery. The medical examiner will not provide any treatment or medical advice directly to you.
The purpose of an IME is to provide insurers with a report from a doctor who is not treating you. They want an unbiased, neutral perspective on the injuries you suffered in order to pay out.
Other Reasons an Insurer May Require an IME
An IME is supposed to help an insurer determine whether or not an injured victim is eligible for compensation under Ontario’s Statutory Accident Benefits Schedule. Yet, some insurers may use an IME as a tactic to delay paying what is owed or attempt to deny paying altogether.
They may argue that your injuries are non-existent, pre-existing and unrelated to the recent accident or not as serious as you claim.
Working with an experienced lawyer can help ensure that you receive all of the accident benefits you may be qualified to receive without having your claim unjustly delayed or denied.
What to Expect at an IME
Insurers must issue injured victims advanced notice to attend an IME, which includes the date, time and location. The medical examiner will conduct an interview, asking you questions about the accident, your injuries and how they have progressed, the treatment you have incurred and how you are recovering.
The medical examiner will also likely review any other medical records and have you undergo a physical examination. This examination will vary based on your injuries. For instance, if you sustained a back injury in the accident, you be may asked to bend or move in different ways to determine your pain level.
It can take multiple hours to complete an IME, based on how extensive and severe your injuries are. Afterward, the medical examiner will send the report directly to your insurer who will then use it to assess your claim for accident benefits.
If you must attend an IME, it is important to remember that the independent medical examiner works for the insurer and is not your doctor. Be sure to not exaggerate or downplay your injuries. Be honest about any issues you are having since the accident, but do not volunteer information about your injury.
A Windsor-based personal injury lawyer from our firm is here to help prepare you for an IME, including providing guidance on what to expect and how to best conduct yourself.
What If I Refuse to Attend?
Refusing to attend an IME could harm your chances at obtaining accident benefits. The insurer may deem you non-compliant and deny your claim. Do not give an insurer any reason to try and limit the amount of money they may be required to pay you after being injured an accident.
Call Us for Help Claiming Accident Benefits
Greg Monforton & Partners has helped many injured victims file claims for accident benefits. An initial consultation is completely free and confidential. You are not obligated after meeting with us to hire our firm, but if you do, we charge no upfront fees. We only receive payment if you obtain compensation.
Give us a call at (866) 320-4770 to get started.