What Makes an Injury “Non-Catastrophic” or “Catastrophic”?
A couple of months ago, we wrote about what makes something a “minor injury” in terms of car accident benefits. Today we’re going to review the other two categories of injury: “non-catastrophic” and “catastrophic”.
Before we get into the details, it’s important to explain that “minor injury” and “catastrophic injury” are both categorizations made in the Statutory Accident Benefits Schedule (SABS) – which is the legislation that sets out the rights, responsibilities and rules for insurance companies and insured persons in dealing with auto insurance claims. You won’t find the term “non-catastrophic injury” in the SABS; it is simply any injury that doesn’t fit into the other two designations.
In Ontario we have mandatory no-fault insurance, which means that regardless of whose fault a collision was, both insured parties are entitled to obtain benefits.
As mentioned above, when you are injured in a car accident in Ontario, a non-catastrophic injury is one that is considered neither minor nor catastrophic. Despite the name, non-catastrophic injuries can still be life-altering.
Ontario’s criteria for catastrophic injuries are highly technical, but in general, the following injuries are classified as “catastrophic” – see section 3.1(1) of the SABS for a complete definition:
- paraplegia or tetraplegia
- amputation of arm or leg, or severe impairment of mobility or use of an arm or leg
- loss of vision in both eyes
- certain types of traumatic brain injury (there are different criteria based on whether the insured was over or under the age of 18 at the time of the accident)
- physical or mental/behavioural impairments that meet or exceed the 55% whole person impairment threshold (per the publications cited in the definition)
- certain impairments that preclude useful functioning due to mental or behavioural disorder (per the publication cited in the definition)
Catastrophically Injured – Now What?
If you are injured in a car accident, it’s vital that you contact a lawyer to ensure that you get the benefits you are entitled to.
But this is especially critical if you have suffered injuries that are or could be determined to be catastrophic. It is the insurance company, and not your doctors, that makes the final decision on whether your injuries are catastrophic—and insurance companies generally try to classify injuries as low in severity as possible.
A catastrophic injury will change every single aspect of your life, and your family’s life. Getting the maximum benefits to ensure optimal recovery and coping with daily life are absolutely essential. The difference between available benefits for non-catastrophic vs catastrophic injuries is significant.
If you or a loved one has been seriously injured, or if your pursuit of “catastrophic” designation has been denied, our office is here to help. With more than 25 years of experience, Frank Van Dyke is committed to helping injured Ontarians get the compensation and benefits they need and deserve.