Injury Law Group Blog

Hard times for family caregiver

Insurance Disputes

The Ontario Government has recently made a change to the Ontario Statutory Accident Benefit Schedule (SABS) which would basically eliminate friends and family members of injured loved ones from being paid for their attendant care services after a motor vehicle accident.  As of September 1, 2010, the definition of “incurred” in subsection 3(7)(e) of the SABS was changed to stop friends and family members from requesting payment for services provided to their loved ones after an accident, unless they proved they suffered an “economic loss” from providing these services.  After this change, many insurers argued that the person providing the service should only qualify to be paid up to the amount of their economic loss, regardless of the extent of the services they provide.

This change, effective as of February 1, was made without consultation with accident victims and their advocates. This amendment will change the way that plaintiff’s personal injury lawyers operate, since previously, these lawyers have encouraged friends and family to provide care to their loved ones  for many good reasons (i.e. the care provider’s interest in doing so, the injured person’s personal preference, limited money available to outsource these services, the quality service that would be provided, and the positive impact a loved one’s care would have on the injured person’s rehabilitation).

Now, loved ones have little hope of being reimbursed by the accident benefit insurer for their services. As a result, plaintiff’s personal injury lawyers will most likely have to recommend outsourcing attendant care services and hiring professionals to work within the low hourly rates restricted in the SABS. This result will be unfavourable to the plaintiff’s recovery and will also result in the family being required to pay the extra costs for paid care provided, causing even more stress.   Even when significant economic loss can be clearly proven by the care provider, the accident benefit insurer will likely demand monthly updates by the care provider to document every dollar of missed income, which will lead to a frustrating and painful investigation on the economic loss.  This legislative change is only related to attendant care benefits – not other benefits such as house-keeping and home maintenance.

To learn more about this, click the link below and go to pages 11 and 13.

click here