Injured face battle for benefits?
London Free Press
Injured face battle for benefits
INSURANCE: Ontario trial lawyers say proposed changes to definition of 'catastrophic injury' would mean fewer victims will receive critical financial compensation
By NORMAN DE BONO, The London Free Press
Last Updated: July 5, 2012
Seriously injured five years ago when his truck flipped, former trucker Brad Phillips rebuilt his life with his insurance settlement. But Phillips, shown at his Lakeshore-area home near Windsor, typifies the kind of crash victim the Ontario Trial Lawyers Association argues would be given short shrift under proposed changes that would redefine catastrophic injury coverage. (MARC GIRARD, QMI Agency)
Suffering chronic pain, Brad Phillips knows what his life would be like if he didn't have money won from his insurance settlement.
“I would starve. I need it to live on,” the 57-year-old Lakeshore resident said bluntly. “It would be hell.”
The benefits helped him rebuild his life, pay for treatment and therapy, support his family and even remodel his home as he struggles to walk.
A group representing Ontario's trial lawyers fears fewer accident victims will receive such benefits in the future because a commission is recommending to the Ontario government that the definition of “catastrophic injury” be changed.
“I would have to sell my house. I would have no quality of life,” Phillips said of not having benefits won from the insurer by his London lawyer Andrew Murray, a partner at Lerners.
In July 2007, the truck driver was seriously injured in a crash in Windsor. Phillips suffered a broken neck and serious nerve damage that has impaired his ability to walk. He's still taking painkillers.
Phillips can't work and has to rest several times a day. In September, he will see a London pain specialist and that could lead to costly treatments and therapy to cope with his pain and injury.
“He's exactly the kind of guy who wouldn't qualify” under changes proposed by the Financial Services Commission of Ontario to the Ontario government, Murray said.
He's president of the Ontario Trial Lawyers Association, which is leading the fight against the recommendations.
For those suffering catastrophic injury, the cost of care may total $8,000 a month, said Mitch Brogan, 31, a Londoner rendered a quadriplegic in 2006 when he was hit by a vehicle while riding his bike.
“I'm very concerned about this. People in the future may not be able to get the same benefit. It helps with future costs.”
Those bills include personal support workers, living expenses, treatment and therapy and buying equipment for rehabilitation, he said.
Brogan, who lives in Byron, uses robotic legs that cost $150,000 and will have to be replaced every five years. It costs $1,600 every three months to send the legs to New Zealand for repair and maintenance.
Phillips has $650,000 from his settlement and with it he's supporting his two sons who live with him after his marriage ended following the crash.
“It took years fighting,” he said of the settlement he received in December 2011. “I can't walk (more than 50 feet) or do a lot of things for a long period of time. I have to lie down about three times a day just to relieve the pain.”
Phillips' insurer initially wanted him back to work, telling him his injury was not catastrophic. It was only after a legal battle that he won the classification.
“It allows him to live with dignity and independence,” Murray said.
The changes being considered by the provincial government would likely slash in half the number of injured people classified as catastrophic, greatly reducing possible benefits.
That would mean more than 300 injured people a year may end up on welfare and using OHIP, Murray said.
In Ontario, catastrophic injuries total about 1% of the 65,000 injuries a year sustained in vehicle crashes, about 650 people a year.
The Insurance Bureau of Canada supports the proposals, saying the means of assessing injury claims is dated, slow and needs to revamped.
The catastrophic definition needs to be altered because it leads to a lengthy legal interpretation, said Pete Karageorgos, manager of consumer and industry relations with the bureau.
The bureau also believes changing the definition is important to keeping insurance premiums low, he said.
Changes to the definition can happen at any time because it involves changing regulations and not legislation. All it requires is a vote by cabinet ministers.
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THE ISSUE
A committee of the Financial Services Commission of Ontario has proposed radical changes to how those who are seriously hurt, with catastrophic injuries, would get insurance benefits.
Lawyers fear the changes stem from lobbying by insurers wanting to cut payments and will slash in half the number of accident victims getting benefits for rehabilitation.
The Insurance Bureau of Canada, representing insurers, says the changes are needed to modernize and speed up a dated system. It also warns premiums may rise without the changes.
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