Saturday, March 27, 2010

Look at your Auto Insurance Policy!

Result of a serious automobile accident.Image via Wikipedia
As of September 1, 2010, there will be some 
big changes 
to Auto Insurance 
in Ontario.
How will it affect you?

Let's consider that... imagine this scenario:

One day, you get in your car to drive to the mall.  It's a lovely sunny Saturday afternoon, you're happy it's the weekend and have started to let go of the stress of week. Even though you really love your 6-figure salary working on Bay St., you value the time to yourself.   Your teenaged son is at his friend's house so it's the perfect time to get a little shopping done.

There's hardly any traffic, making your drive so much easier than it would normally be during the week. As you drive you think about how well you've done raising your son on your own. You smile to think that he still hugs you and says "I love you mom".

Ahead of you, you see a car coming in the opposite direction. You are alerted because the car is suddenly in the middle of the road, and you instinctively begin to pull over. Seems you might have been over-reacting, though, because the car moves back into a lane and everything appears well and under control. To be safe, though, you decide to stay in the far lane.

Out of nowhere, you hear tires screeching fade into blackness.

When you wake up, 3 hours later, you feel like you are in a bubble with fog clouding your vision and thoughts. Both legs are in casts and there is a tube sticking out of your nose. Your whole body is in searing pain and your hand wanders to feel stitches on your forehead and cheeks. A stranger is standing beside you. She says she's your best friend. She explains that you are moving to a nursing home.

"John?... John?" you ask.

The stranger gives you a strange look.

"Honey, you and John are divorced. You got divorced 4 years ago".

"No, no, no, no. Ok. Wait. Um...." You can't figure out how to ask her.

"You've had a car accident. But you'll be ok. The doctors say you need a little physiotherapy and you'll be as good as new!"

"Well, uh, no. John. No. I...I...I...oh shit. WHERE IS TIM?" Whew. You're so worried about your son.

"Don't worry, Tim is staying with your sister-in-law. He'll be fine".

Moving to the nursing home is confusing. Yes, you are getting physiotherapy, but you are so confused. You can't remember anything they are telling you to do. You cry a lot. Your friends visit, and when they do, they ask you to stop calling them countless times a day. Tim looks like he's afraid of you when he visits. He says you look so different, that your clothes look funny.

The nursing home arranges for you to get a walker, cane and special shoes with orthotics. They prescribe pain medication, and then, 3 months after the accident, you are sent home to live with your son.

For a few months, a physiotherapist comes to your home twice a week. She is helpful, and orders an orthopedic bed and pillow to help you sleep. Still you rarely sleep through the night and are in constant pain. And then the crying. You can't control it, and it seems to come on when you are feeling confused, which is most of the time.

Because your pelvis was crushed and both legs were broken in the accident, you can't keep up with the housekeeping and maintenance of your 2 storey house. You are struggling with childcare, even though you get occasional help from family and friends. Remembering Tim's schedule is really tough and you aren't able to help him with his homework like you used to. Sometimes you forget about meals, and he reminds you when he says he's hungry.

The first time you make it up the stairs to your room since your casts have been removed, you peer in to Tim's room. You worry when you see dozens of empty beer and liquor bottles. You are disturbed to see the holes in the walls and wonder about the new stereo and flat screen TV.Did you buy them for him? You can't remember. Probably. How else would he have gotten such expensive things?

"I should ask him about all this", you think to yourself. As you walk away, you get distracted by the phone ringing, and completely forget about everything you just saw and your plan to get to the bottom of it.

You have no money coming in because of the 6 month waiting period on your disability insurance plan. Since you're having trouble explaining yourself, your best friend speaks to your lawyer to explain the situation to see if your auto insurance policy will cover some support.

"Did she buy optional coverage for caregiving, housekeeping or home maintenance costs?" is the first question my lawyer asks.

After countless phone messages for the insurance adjuster who has been assigned your file, you lawyer finally reaches the adjuster. It turns out you actually declined the optional coverage, so aren't eligible for support. "By the way", the adjuster says, "your client has used up all of the $50,000 she is entitled to for medical & rehabilitation benefits".

"How is that possible? She hasn't even had any help for her " your lawyer asks.

"She's had 5 months of bi-weekly in-home Physiotherapy. There's the cost of the walker, cane, bed, shoes, orthotics and meds. It adds up..."

So now what? Here you are, your life in shambles, and you're stuck. You have no money and no financial support. Your son is on a fast track to trouble, and there's nothing you can do.

Your only choice seems to be to go back to work. But your physiotherapist says you've had a brain injury and need some help with your communication, cognitive skills and ability to adapt to your home and situation. She said she would have referred you to a Speech-Language Pathologist, Occupational Therapist and Social Worker but now, because there is no money left, that's not possible.....

Pardon the expression, but now you're up shit's creek and there's no paddle in sight.

Here's a summary of the main changes

  • Medical & Rehabilitation Benefits will be reduced from $100,000 to $50,000.  Perhaps $50,000 seems like a lot of money to you. That's a pretty decent annual salary, right?  Consider the situation above. Many disabilities, including physical, cognitive, language, emotional, spiritual can result from motor vehicle accident. Bones heal, but when brains are damaged, the implications are enormous.  The brain is the most complex of all organs and the most vulnerable in a car accident.   Keep in mind that the cost for both assessment and treatment comes out of that $50,000. Even though each assessment {along with the report} will be capped at $2000 each, if there are multiple service providers involved, that money won't go very far at all.
  • Housekeeping benefits and caregiver benefits will be eliminated.  Previously, a maximum of $10,400 was available for housekeeping benefits and caregiver benefits were $250/week + $50 per dependent.
  • Reduction of Attendant Care benefits from $72,000 to $36,000. That is, if you are eligible for attendant care benefits....
  • No ability to apply for Catastrophic Impairment Designation (and more rehab money) until 2 years post accident. That means if your $50, 000 runs out in the first 6 months after your accident, you will have to wait 1.5 years to go through the LENGTHY process of being considered for more funding. 

What should I do now?

Call your insurance company! Make sure your policy includes standard the $100,000 Medical/Rehabilitation benefits and housekeeping/caregiver/home maintenance as well as attendant care benefits.  It's worth it to top up your policy to get what you might need (god forbid).  This is your life and well-being we're talking about here!

Also, don't forget to find ask how this change affects car rentals or
Zip Car memberships...

The new regulations apply to all accidents occurring after September 1, 2010 (so if the accident happened on or before August 31, 2010, the current $100K etc. will apply for the lifetime of your file).  
For accidents that occur after September 1, 2010: Unless you renew your policy and opt for the standard (lower) new coverage prior to the Sept 1 Effective Date, all benefits under their policy shall continue to be in effect as per the old regulation (i.e., $100,000 in non-cat rehab funding) until the earlier of renewal or cancelation of the policy.   
Prior to Sept 1 consumers will have the option to opt for the new standard coverage.  At first renewal after Sept 1, the starting point will be the new regulation with options to buy-up benefits.

If you're interested, read more about the change in legislation here

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