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Minor Injury Guideline > Accident Benefit Changes in Ontario – Part 5

A significant change in September, 2010 was to introduce a new concept, the “Minor Injury Guideline”, into the lexicon of car accident claims in Ontario.

The actual Minor Injury Guideline is found on the FSCO (Financial Services Commission of Ontario) website here.

The Minor Injury Guideline imposes a $3,500 hard cap on the Accident Benefits insurer’s obligation to fund all treatment and assessments for those injuries that fall within.

Simply put, if you have an injury that falls inside the Minor Injury Guideline, you will then only receive up to $3,500 in treatment in Accident Benefits.

The intention and expectation of the Minor Injury Guideline is that most claims will fall within. Whether it’s internal industry estimates of 65% of claims or practitioners who think that even more claims will fall within, this legislation is expected to have “bite” and is going to change the industry.

What falls within and is considered a Minor Injury? It’s a wide range, which includes:

· sprain, strain, whiplash associated disorder, contusion, abrasion, laceration or subluxation and any clinically associated sequelae;

· partial tears of tendons and ligaments;

· partial dislocation of a joint; and

· arguably, injury to the spine which is not a fracture or dislocation.

The Minor Injury Guideline sets out the treatment parameters and tightly mandates what primary medical practitioners (usually chiropractors, physiotherapists, etc) can provide by way of treatment.

It is important to note that this Minor Injury Guideline does not affect tort claims in Ontario at this time. In this way, it differs from the Alberta experience (see our June 16, 2009 blog) and the Nova Scotia experience (see our January 29, 2010 blog).