The $3,500 cap on minor injuries: A health care perspective

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The Coalition Representing Health Professionals in Automobile Insurance Reform is represented by a wide range of caregivers, including physiotherapists, chiropractors, occupational therapists, social workers and speech-language pathologists.

The Coalition’s co-chair, Dorianne Sauvé, says that a hard limit on minor injury benefits can lead to a “gray zone.”

Dorianne Sauvé: I think for the majority of people who would be considered [to have] a minor injury, that we perceive that the $3,500 would be sufficient. Where it becomes difficult is when you have a cap on anything like that … let’s say you purchased a policy for $50,000 and you have a cap within that $3,500. You don’t’ have access to the rest of that – at all – if you’re classified as a minor injury. And because all minor injuries would be under this, it doesn’t matter if you have one or two minor injuries or you have ten minor injuries. If you are someone who, for whatever reason, don’t follow the normal pattern for healing and don’t respond well to treatment and need to have additional services after you’ve reached the cap, you can’t access that if you’re a minor injury – despite having purchased a policy for $50,000.

So the questions is not whether or not $3,500 is enough; it’s whether or not there is a sufficient process in place to allow people who do not fit the norm to access care.

It’s for the people who are minor, or classified minor, but are on that borderline of serious. So whenever you put a cap on something, there’s always people who would need slightly more than that cap. So I think the concern is not… if you look at the majority of people who would be considered a minor injury, they should be fine within this. But for those who sit in that gray-zone where they might need a little more care, they won’t be able to access that.

Anytime you put a hard cap on something, there will always be people that are sitting at the line that won’t be able to access that care anymore.