What is a catastrophic accident?
Some accidents, by their very nature are serious and result in injuries so bad, they are defined at law as "catastrophic".
Courts and the Insurance Companies do not focus much on how the accident happened, so long as it involved the use and operation of a motor vehicle.
Instead, Courts and Insurance Companies want to know what the end result injuries are and how bad, or not bad those injuries are. If the end result injury from the car accident is catastrophic in nature, then the injured party's accident benefits will increase dramatically.
Catastrophic injuries include traumatic brain injury, loss of limb, paraplegia, quadriplegia, spinal cord injury and other injuries which result in a 55% impairment pursuant to the AMA Guidelines. Qualifying for catastrophic impairment is very difficult. The vast majority of car accident cases in Ontario do NOT meet the definition of catastrophic. Insurance companies and accident victims can fight for years and years over whether or not the injuries meet the definition of catastrophic.
In order to qualify for catastrophic accident benefits, your injuries must meet one of the following criteria:
- paraplegia or quadriplegia;
- if the accident occurred on or after September 1, 2010, the amputation of an arm or leg or another impairment causing the total and permanent loss of use of an arm or a leg;
- if the accident occurred between October 1, 2003 and August 31, 2010, amputation or other impairment causing the total and permanent loss of use of both arms or both legs, or one or both arms and one or both legs;
- if the accident occurred between November 1, 1996 and September 30, 2003, amputation or other impairment causing the total and permanent loss of use of both arms or both an arm and a leg;
- the total loss of vision in both eyes;
- brain impairment that, in respect of an accident, results in
- a score of 9 or less on the Glasgow Coma Scale according to a test administered within a reasonable period of time after the accident by a person trained for that purpose, or
- a score of 2 (vegetative) or 3 (severe disability) on the Glasgow Outcome Scale according to a test administered more than six months after the accident by a person trained for that purpose,
- an impairment or combination of impairments that, in accordance with the American Medical Association's Guides to the Evaluation of Permanent Impairment, 4th edition, 1993, results in 55 per cent or more impairment of the whole person; or
- an impairment that, in accordance with the American Medical Association's Guides to the Evaluation of Permanent Impairment, 4th edition, 1993, results in a class 4 impairment.
If your injuries are found to be catastrophic, your accident benefits will increase dramatically. You will also be entitled to a case manager to organize and arrange the services being provided to you. You will likely need the additional benefits for on-going care and treatment given the catastrophic nature of your injuries.