Accident Care Benefits under the revised Statutory Accidents Benefits Schedule

Default photo used for Accident Care Benefits under the revised Statutory Accidents Benefits Schedule

When involved in an accident, the last thing on your mind should be the anxiety that comes along with the insurance and paperwork that follows. Legislation is put in place to govern and supposedly make the process smoother from the time of the incident to its resolution.

For many, this is not the case. The initial paperwork and request forms that must be filled out can be overwhelming and more often than not the claimant may need help through the process. It is a lengthy procedure, often made so by insurers and can take months or years for reimbursement after a client has had to pay with personal funds.

We at Gluckstein Lawyers can guide you through the correct channels and procedures to help get the issue solved in a timely manner. This is just part of the service we provide when representing you as a client.

With the recent changes in the Statutory Accidents Benefits Schedule it is in your best interest to be knowledgeable about what your entitlements are. Here we take a look at a specific benefit that can impact your rehabilitation and finances.

Attendant Care Benefits

If you are in a motor vehicular accident, under the implemented "no fault" regime, you can be entitled for benefits regardless of who caused the accident. Attendant Care Benefits cover part of the personal care needed after a serious injury. Here an attendant or aide is paid to care for you if you cannot perform everyday functions like dressing yourself or handling your personal hygiene.

If you plan on applying for benefits, it is in your best interest to inform the insurance company within seven days or less after the accident. All cases are different and you may have valid medical reasons for not being able to make contact like being unconscious or otherwise incapacitated.

As soon as you are able, you should hire a  personal injury lawyer to help you with the process. Usually the insurer should respond in a timely manner with your benefits application package. You should then complete and send back within a thirty day period, ensuring you understand what benefits you qualify for.

Individuals who have been injured and sustained minor injuries do not qualify for attendant care services. However, if you have non minor or catastrophic injuries, you can receive benefits according to the recently amended legislation as long as you were injured in an automobile collision.

A legally registered nurse or therapist has to assess your physical needs, and then complete a Form 1 (Assessment of Attendant Care Needs Form) to validate your claim for care. From this point, after the form is sent back to the insurer, they have ten business days to offer a response. If they have agreed to pay for the care that is necessary, there is a thirty day threshold to start payment for the incurring and recurring expenses.

Non minor injuries can carry up to three thousand dollars a month for attendant care with a total of thirty-six thousand yearly within a two year period after the vehicular accident. Before the amendment, the maximum amount was seventy-two thousand and the Form 1 could be completed by anyone. Catastrophic impairments have a ceiling benefit payment of six thousand per month with a total maximum of one million for your lifetime.

Again, your needs have to be verified by a nurse or therapist for the completion and acceptance by the insurance company whereas before there were no restrictions as to who could complete the Form 1. 

Many cases have been challenged and appealed through the courts as no one case is easily rectified. Insurers have their team working on their side to ensure that claims are not fraudulent and that like any other business they operate efficiently to make a profit so you should ensure that you have someone working for your best interest as well.


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