Accident Benefits Newsletter – Paediatric Brain Injury Victim Denied CAT Determination
Generally, the June 1, 2016 Amendments to the Statutory Accident Benefits Schedule have made it more challenging for car accident victims to qualify for a determination of catastrophic impairment (catastrophic). The declared legislative intention is that the amendments were introduced to promote clarity in the catastrophic criteria, with the ultimate goal of providing more efficient and cost-effective resolution of these claims. However, from the claimants’ perspective, these goals appear one-sided in favour of the insurance industry. With fewer claims leading to a catastrophic finding, insurer payouts are reduced. At the same time, the greater challenges to a successful catastrophic determination operate as a disincentive to claimants, their care providers and legal representatives.