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Coverages

hedo2002

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So as was stated in the other thread on 2017 renewals.

Make sure you CHECK your coverage!!!

The government has again had us bend over for the sake of the insurers. The following reductions take place if your policy renewed in late 2016 or of course 2017.

Comprehensive deductible: If you previously had $300 as your selected deductible this is NO longer an option you are automatically bumped to $500.

Tort Deductible: If you have to sue your insurer, (or the other party for injuries), your deductible is now $36,905.40. This means that if your award is $100,000 the INSURER gets to keep the first $36,905.40, then of course you have to pay your lawyer, (typically 35% so $35,000) leaving you with a whooping $28094.60!!!

Medical and Rehab for NON catastrophic injuries: USED to be $50,000
Attendant Care for NON catastrophic injuries: USED to be $36,000
They are NOW combined and capped at $65,000 TOTAL (doesn't give you break down of how much is for each benefit).

(These are injuries that are NOT ruled to be Minor, under the Minor Injury Guidelines, or MIG), those are still capped at $3,500. So if you suffer longer term injuries then YOU have to fight the insurer via mediation to get yourself removed from the MIG, otherwise you get $3,500 total treatment. Even if your "lucky" enough to get past the MIG, still expect to spend countless days and hours, going to "assessments" by their doctors, (so they can tell you despite what your doctors and therapists say, that your healed and your benefits are now denied)!!!!

Medical and Rehab for catastrophic injuries: USED to be $1,000,000
Attendant Care for catastrophic injuries: USED to be $1,000,000
They are NOW combined and capped at $1,000,000 TOTAL, (again doesn't give break down as to the limit for each benefit).

Now the "good news is you can buy "additional" coverage for the injury benefits which will get you BACK to the previous level. In my case that is an additional $44.00 per year, (which ironically is LESS than the tiny premium reduction they told me I got for this year)..lol

Now you may say, well $50,000 is plenty, but if you need ANY sort of long term care or alterations to your house etc, that $50,000 doesn't go far at all. With just a broken ankle and broken collar bone less than 9 months ago, I have already used up approx $29,000 with the surgeon saying I may need further surgery down the road! They have also said I could easily need physio and other treatments for another 24 months.

So before you leap for joy at the SMALL decrease in your premium check your coverage!!!

Trust me as someone, who has been dealing with two claims for upwards of two years now, You will NEED to fight EVERY step of the process, only to be constantly told that they, (who have never met or seen you), know better...lmao
 
So as was stated in the other thread on 2017 renewals.

Make sure you CHECK your coverage!!!

The government has again had us bend over for the sake of the insurers. The following reductions take place if your policy renewed in late 2016 or of course 2017.

Comprehensive deductible: If you previously had $300 as your selected deductible this is NO longer an option you are automatically bumped to $500.

Tort Deductible: If you have to sue your insurer, (or the other party for injuries), your deductible is now $36,905.40. This means that if your award is $100,000 the INSURER gets to keep the first $36,905.40, then of course you have to pay your lawyer, (typically 35% so $35,000) leaving you with a whooping $28094.60!!!

Medical and Rehab for NON catastrophic injuries: USED to be $50,000
Attendant Care for NON catastrophic injuries: USED to be $36,000
They are NOW combined and capped at $65,000 TOTAL (doesn't give you break down of how much is for each benefit).

(These are injuries that are NOT ruled to be Minor, under the Minor Injury Guidelines, or MIG), those are still capped at $3,500. So if you suffer longer term injuries then YOU have to fight the insurer via mediation to get yourself removed from the MIG, otherwise you get $3,500 total treatment. Even if your "lucky" enough to get past the MIG, still expect to spend countless days and hours, going to "assessments" by their doctors, (so they can tell you despite what your doctors and therapists say, that your healed and your benefits are now denied)!!!!

Medical and Rehab for catastrophic injuries: USED to be $1,000,000
Attendant Care for catastrophic injuries: USED to be $1,000,000
They are NOW combined and capped at $1,000,000 TOTAL, (again doesn't give break down as to the limit for each benefit).

Now the "good news is you can buy "additional" coverage for the injury benefits which will get you BACK to the previous level. In my case that is an additional $44.00 per year, (which ironically is LESS than the tiny premium reduction they told me I got for this year)..lol

Now you may say, well $50,000 is plenty, but if you need ANY sort of long term care or alterations to your house etc, that $50,000 doesn't go far at all. With just a broken ankle and broken collar bone less than 9 months ago, I have already used up approx $29,000 with the surgeon saying I may need further surgery down the road! They have also said I could easily need physio and other treatments for another 24 months.

So before you leap for joy at the SMALL decrease in your premium check your coverage!!!

Trust me as someone, who has been dealing with two claims for upwards of two years now, You will NEED to fight EVERY step of the process, only to be constantly told that they, (who have never met or seen you), know better...lmao

Yes, that is the truth ,, been there done that,, my injuries have dragged on since 1991 ...turned right from right hand side of right lane to find someone trying to pass between me and the concrete pole.. he chose to miss the pole.. I got a good payout on the bike!!


today I am down to $3500 yr and I have a benefit pkge that covers $1500 .. I was always diagnosed BETTER after 10 weeks ... then a few reoccurances.. I was better in 10 weeks again..... so I was getting good at predicting when "they" would cut me off as I was better again!!


My friend injured 2 fingers.. by the time they talked him into amputating.. he was up to about $100,000 costs, losses, etc... we had to get a second lawyer to sue the first one to get less than half that.... long process ,,, loooooooooooooooong looooong longg. sigh.
 
Good post. I called when my renewal came and bumped my coverage back up to what it was. Cost difference was $50 for the year.
 
So as was stated in the other thread on 2017 renewals.

Make sure you CHECK your coverage!!!

The government has again had us bend over for the sake of the insurers. The following reductions take place if your policy renewed in late 2016 or of course 2017.

Comprehensive deductible: If you previously had $300 as your selected deductible this is NO longer an option you are automatically bumped to $500.

Tort Deductible: If you have to sue your insurer, (or the other party for injuries), your deductible is now $36,905.40. This means that if your award is $100,000 the INSURER gets to keep the first $36,905.40, then of course you have to pay your lawyer, (typically 35% so $35,000) leaving you with a whooping $28094.60!!!

Medical and Rehab for NON catastrophic injuries: USED to be $50,000
Attendant Care for NON catastrophic injuries: USED to be $36,000
They are NOW combined and capped at $65,000 TOTAL (doesn't give you break down of how much is for each benefit).

(These are injuries that are NOT ruled to be Minor, under the Minor Injury Guidelines, or MIG), those are still capped at $3,500. So if you suffer longer term injuries then YOU have to fight the insurer via mediation to get yourself removed from the MIG, otherwise you get $3,500 total treatment. Even if your "lucky" enough to get past the MIG, still expect to spend countless days and hours, going to "assessments" by their doctors, (so they can tell you despite what your doctors and therapists say, that your healed and your benefits are now denied)!!!!

Medical and Rehab for catastrophic injuries: USED to be $1,000,000
Attendant Care for catastrophic injuries: USED to be $1,000,000
They are NOW combined and capped at $1,000,000 TOTAL, (again doesn't give break down as to the limit for each benefit).

Now the "good news is you can buy "additional" coverage for the injury benefits which will get you BACK to the previous level. In my case that is an additional $44.00 per year, (which ironically is LESS than the tiny premium reduction they told me I got for this year)..lol

Now you may say, well $50,000 is plenty, but if you need ANY sort of long term care or alterations to your house etc, that $50,000 doesn't go far at all. With just a broken ankle and broken collar bone less than 9 months ago, I have already used up approx $29,000 with the surgeon saying I may need further surgery down the road! They have also said I could easily need physio and other treatments for another 24 months.

So before you leap for joy at the SMALL decrease in your premium check your coverage!!!

Trust me as someone, who has been dealing with two claims for upwards of two years now, You will NEED to fight EVERY step of the process, only to be constantly told that they, (who have never met or seen you), know better...lmao
Good info.
I have seen doctors reports that came in ranging from 1-10 grand depending on the type of report and assessment, that really eats into your accident benefits. I do not write policies without AB buy ups on them, the cost is soo little in the grand scheme of things.
 
Good info.
I have seen doctors reports that came in ranging from 1-10 grand depending on the type of report and assessment, that really eats into your accident benefits. I do not write policies without AB buy ups on them, the cost is soo little in the grand scheme of things.
Just a clarification, I had to have my lawyer confirm, as the insurer was being "very vague" in their response. If the insurer orders and assessment and a subsequent report, the cost of those assessments and the doctor's reports can NOT be deducted from the claimant's accident benefits. As a claimant, you ARE required by the Insurance Act to attend, if you fail to attend, (and of course co-operate), the insurer will immediately cut all benefits as per the Insurance Act. As it was explained to me, because the insurer is ordering the assessment and subsequent reports with a "threat" under the Insurance Act, then they are required to pay all expenses. Otherwise, the claimant would be justified in refusing to participate, in order to preserve their accident benefits for treatments.

I also find it ironic, as my renewal is set for 31 Jan, meaning under the Insurance Act, the insurer is REQUIRED to provide me with the renewal docs a MINIMUM of 30 days in advance for review and acceptance or to permit me to shop around. The paperwork didn't arrive, I called, Well after the 30 day period had lapsed), and was advised my renewal was "on suspend". When I asked what that meant, I was advised that before I could be "approved" for a renewal someone at head office had to review my claim!!! So the insurer gets to violate the Insurance Act, (by not getting the renewal to me, on time, as required), but I MUST adhere to the strict letter of the Insurance Act and attend their assessments, or they cut ALL benefits)...lol

They also get to deny all treatment requests submitted by my treatment providers until they get the assessment reports, (even though this means I now go without the required treatments, despite them having 7 months to schedule said assessments). Once they have the assessment reports then the treatment providers have to again submit their treatment plans, (they get paid out of my accident benefits to write and submit each treatment plan).

Best thing is to hope you NEVER have to submit a claim!
 
Just a clarification, I had to have my lawyer confirm, as the insurer was being "very vague" in their response. If the insurer orders and assessment and a subsequent report, the cost of those assessments and the doctor's reports can NOT be deducted from the claimant's accident benefits. As a claimant, you ARE required by the Insurance Act to attend, if you fail to attend, (and of course co-operate), the insurer will immediately cut all benefits as per the Insurance Act. As it was explained to me, because the insurer is ordering the assessment and subsequent reports with a "threat" under the Insurance Act, then they are required to pay all expenses. Otherwise, the claimant would be justified in refusing to participate, in order to preserve their accident benefits for treatments.
in order to qualify for accident benefits, for sake of argument lets say physio, the physiotherapist needs to complete an assessment and treatment plan. there is a cost to this assessment and it comes off your amount payable towards the AB claim.

i also believe that physiotherapists are required to do a reassessment every 90 days regardless of if there is a insurance claim.
 
Correct if YOU are applying for benefits, then the provider completes an assessment and files an OCF-18, they get compensated by the insurer out of your Accident Benefits.

I was merely pointing out that if the INSURER sends you for an assessment, be it with a doctor, physio, chiropractor etc, (of the insurers choosing), to determine if continuing treatment is required the cost of those assessments can NOT be deducted from the claimant's Accident Benefits, but rather must be paid directly by the insurer.

in order to qualify for accident benefits, for sake of argument lets say physio, the physiotherapist needs to complete an assessment and treatment plan. there is a cost to this assessment and it comes off your amount payable towards the AB claim.

i also believe that physiotherapists are required to do a reassessment every 90 days regardless of if there is a insurance claim.
 
Thanks for this. Just uped my coverage, 83 extra for the year to have million across the board for non cat, cat, and attendant. Also added accident forgiveness and colision with 500 deductables for 47 bucks, Brampton, 27, male, yzfr3, just under 950 bucks for the year.
 

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