EXPERT ADVICE introduced, there have been many other changes to Ontario’s car insur-ance regime. Most of these have re-stricted the injured party’s entitlement to compensation. For example, an ac-cident victim is only entitled to claim for a portion of their actual loss of in-come. In addition, their claim for pain and suffering is reduced by a “deduct-ible” which is currently about $37,000. The no-fault accident benefits to which an accident victim is entitled have also been restricted. Entitlement to no-fault benefits involved various tests, such as “substantial inability to perform the essential tasks of [their] employment” and “complete inability to carry on a normal life.” These tests are as baffling to most health-care providers as they are to accident victims. Accident victims are now presented with a complex array of rules and reg-ulations governing their claims arising from car accidents. It is difficult for an injured patient to know what compen-sation they might be entitled to from the at-fault driver or what no-fault accident benefits they might be eligible for from their own insurer. Similarly, many doctors and other health-care providers are uncertain as to the tests for entitlement to compen-sation that might apply to their patients who have been injured in a car accident. It has become increasingly essential for accident victims to get legal advice from a lawyer who is knowledgeable and experienced in personal injury claims. In any case where injuries have been caused by the accident, the acci-dent victim should find out at an early stage what benefits and compensation they may be entitled to. A lawyer can help the accident victim understand the applicable tests that must be met. The lawyer can then work with the client’s health-care providers to ensure that the client’s injuries are properly documented, and that the client’s med-ical documentation addresses the ap-plicable legal tests. Most lawyers will not charge an in-jured accident victim for an initial consultation. This gives the injured party an opportunity to determine whether they are likely to have compen-sable injuries as a result of an accident, and whether the compensation they are likely to receive justifies the time and www.canadianchiropractor.ca Crash course on claims REGULATION Personal injury 101 for health-care providers BY MARC SPIVAK T MARC SPIVAK is a lawyer with Devry Smith Frank LLP in Toronto. He has practiced personal injury law for over 25 years. Marc offers free initial consultation to any patients who have been injured in a car accident. He can be reached at [email protected] 26 Canadian Chiropractor May 2017 Photo: Shutterstock he car insurance regime in Ontario has undergone extensive and significant changes over the past several years. Prior to 1990, Ontario had a “pure tort” system. Under this system, an accident victim was entitled to make a claim for compensation for damages against the negligent driver who was at fault for the accident. Dam-ages included pain and suffering, loss of income, medical expenses and any other losses caused by the accident. Under this system, there were very modest no-fault “accident benefits” available from the injured party’s own insurer. Following 1990, Ontario introduced a “no-fault” system. Although the right to sue a negligent driver was retained in some circumstances, it was taken away for all “minor” inju-ries. For pain and suffering claims, no claim was available unless the acci-dent victim suffered “serious perma-nent impairment,” referred to as the “threshold.” To meet the threshold, the injuries suffered in the accident had to result in an impairment that was both serious and permanent. In order for an impairment to be seri-ous, it had to materially impact the accident victim’s work, social or rec-reational activities. The injured party could still claim for any loss of in-come, medical expenses and other economic loss caused by the accident, regardless of the severity of the inju-ries suffered in the accident. Since the no-fault system was
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