Effects of Minor Injury Guidelines To Your Claim

As part of the auto insurance changes in 2010, the Ontario government created the “Minor Injury Guideline (“MIG”)” as a category of injury. The MIG limits the amount of money the insurer has to pay in treatment and medical expenses for accident victims with certain types of injuries.

What Is Considered A Minor Injury?

Injuries defined by MIG and considered predominantly “minor” in nature include: 

• Sprains and Strains (including partial tears of tendons, ligaments, and muscles)
• Subluxations
• Abrasions
• Contusions
• Whiplash

Monetary Cap And Goals Of The Minor Injury Guidelines (MIG)

Treatment funds for minor injuries are limited to $3,500. Most treatment under the MIG doesn’t require prior approval from the insurer, and the stated goals of the MIG (according to the Financial Services Commission of Ontario), are as follows:

a) Speed access to rehabilitation for persons who sustain minor injuries in auto accidents
b) Improve utilization of health care resources
c) Provide certainty around cost and payment for insurers and regulated healthcare professionals
d) Be more inclusive in providing immediate access to treatment without insurer approval for those persons with minor injuries

Purchasing Optional Benefits Won’t Help You Avoid The MIG

Even if you have purchased increased coverage for medical and rehabilitation benefits from your auto insurer, you will still be subjected to the $3,500 cap if your injuries fall within the MIG. For example, if you’ve paid additional premiums to increase your medical and rehabilitation coverage to $1,000,000, but your injuries from an accident are limited to whiplash and a strained knee, your auto insurer will not pay more than $3,500 for your treatment. This regulation essentially means that you can’t “buy” your way out of the MIG, and you have no options for avoiding this cap by purchasing additional coverage. Also, you must use any extended health benefits you have through another plan before billing your auto insurer.

Exceptions To The MIG

There are some exceptions to the MIG that will give you access to the next level of medical and rehabilitation benefits, which provides up to $65,000 in coverage. Even if your injuries classify as “minor,” the MIG may not apply if you have compelling and documented evidence of a pre-existing condition that would prevent you from achieving maximal recovery with the allotted $3,500. However, the existence of a pre-existing condition will not automatically exclude you from the MIG, and the guideline explicitly states that it is intended and expected that the vast majority of pre-existing conditions will not do so. Therefore, it is crucial that you seek medical care or treatment as soon as possible after an accident. In addition, you must make any doctor or treatment provider involved in your treatment fully aware of your medical history and any pre-existing conditions you may have.

Consequences Of The MIG

For some with MIG injuries, $3,500 in treatment is sufficient to allow them to recover and get back to their normal life. However, for many other accident victims with so-called “minor” injuries, $3,500 is not enough to heal and get back to their pre-accident level of function. As an accident victim, your injuries might be prematurely classified as minor by your healthcare or treatment provider or unfairly classified as minor by the insurer in an attempt to save money. For this reason, it is imperative to seek legal advice from a personal injury lawyer immediately following an accident. A lawyer can coordinate with your healthcare team, gather the medical documents and compelling evidence required to get you out of the MIG and advocate on your behalf for access to increased benefits.

Personal Injury Lawyers and MIG

If you are in need of minor injury avocation, call 905-522-9799 to arrange a free initial legal consultation with Findlay Personal Injury Lawyers. Our lawyers work to protect accident victims from prematurely or unjustly being labelled minor by insurance companies cutting corners. We serve Hamilton, Brantford, Burlington, St. Catharines, Niagara Falls, Welland.

Get the financial support you need for optimal recovery with Findlay Personal Lawyers.