ACCIDENT BENEFITS. Benefits in the form of money or assistance provided to persons injured in a motor vehicle accident, regardless of who is at fault. Types of accident benefits including: non-earner, income replacement, attendant care, caregiver, medical, rehabilitation, funeral expenses, visitor expenses, housekeeping and home maintenance.
ADJUSTER. A person who investigates and/or adjudicates insurance claims on behalf of an insurance company.
AFFIDAVIT OF DOCUMENTS. A sworn document that sets out all documents that are now, or have been, in your possession or within your power or control and which are relevant to the issues in your lawsuit.
ATTENDANT CARE. A type of accident benefits an injured person receives to pay for assistance in his or her daily living. Assistance may take the form of cooking, cleaning, helping the injured person get dressed or supervising the injured person. In most instances, at least part of the costs for providing attendant care may be paid by the insurance company to the person providing the care, whether it be a health care professional or a family member.
CAREGIVER BENEFIT. A weekly benefit paid to an injured person who was the primary caregiver to a person in need of care before the accident. The caregiver benefit is designed to compensate the injured person for reasonable and necessary expenses incurred in caring for a person in need of care where the injured person is no longer able to perform his or her pre-accident caregiving duties.
CASE MANAGER. A rehabilitation professional who coordinates rehabilitation services following an injury.
CATASTROPHIC IMPAIRMENT. The most serious of personal injuries. Examples include injuries resulting in an impairment of 55% or more of the whole person, quadriplegia, paraplegia, amputation of both arms or limbs, loss of vision in both eyes, traumatic brain injury. A person having a catastrophic impairment becomes entitled to maximum of $1,000,000.00 for medical/ rehabilitation needs and attendant care plus housekeeping expenses, payable over the lifetime of the injured person.
DAMAGES. In a lawsuit, damages are the losses the plaintiff has suffered as a result of the defendant’s conduct. These losses can take many forms including compensation for pain and suffering, loss of income or ability to attend or complete schooling, physical, mental or psychological impairments, loss of social or familial relationships, etc. Damages are also what a plaintiff seeks to recover in a lawsuit usually in the form of money to compensate for the losses.
DEDUCTIBLE. In lawsuits arising from a motor vehicle accident, after an award for compensation for pain and suffering is established in court or during the settlement negotiations, the defendant has the right by law to deduct an amount from the award, reducing the total award to be paid for pain and suffering. This is referred to as “the deductible”.
DEFENDANT. In a lawsuit, a defendant is a person/persons and /or corporation that are being sued by a plaintiff. Examples of defendant corporations include an insurance company, a leasing company, a municipality, a tavern, a property owner, a hospital, etc. Most defendants in personal injury lawsuits are insured. A defendant’s insurer will usually appoint a lawyer to act on behalf of the defendant.
DSM GUIDE. The “Diagnostic and Statistical Manual of Mental Disorders” is the handbook most often used by psychiatrists and psychologists to diagnose mental illness and disorder.
EXAMINATION FOR DISCOVERY. Examination for discovery is a process in which the lawyers may examine the plaintiff or defendant under oath. The examinations take place in a business office of an official court reporter. This process allows the lawyers to understand the plaintiff and defendant’s answers and positions on the essential facts of the case.
GLASGOW OUTCOME SCALE EXTENDED. A medical test used to determine the existence and extent of brain impairment as a result of an accident. It measures the severity of brain injury based on a patient’s outcome several months after the accident using structured interviews and all available medical information relating to the injured person.
HEALTH CARE EXPENSES. A category of accident benefits and tort entitlement, which includes medical, dental, and nursing expenses, as well as medication costs, prescription eye wear and other goods and services of a medical, rehabilitation, attendant care or non-medical nature which an injured person requires.
HOUSEKEEPING AND HOME MAINTENANCE. An accident benefit of up to $100 per week that is paid to individuals who are no longer able to carry on their pre-accident housekeeping duties. The benefit is only payable to individuals who have suffered a catastrophic impairment.
INCOME REPLACEMENT BENEFIT. An accident benefit of up to $400 per week that is paid to individuals who are disabled from their pre-accident employment for up to two years. After two years, the individual may continue to receive income replacement benefits if they are completely disabled from any employment.
INSURER EXAMINATION CENTRE/SECTION 42 ASSESSMENT. The insurer may appoint health care professionals of their choosing, to perform assessments in order to determine whether to pay a benefit. Legal advice should be sought before you decide whether you should submit to such an assessment.
OCCUPATIONAL THERAPY (OT). Therapeutic use of self-care, work, and recreational activities to increase independent function, enhance development, and prevent disability; may include adaptation of tasks or environment to achieve maximum independence and optimum quality of life.
LIMITATION PERIOD. When a person suffers an injury, the law imposes a time limit in which to issue a Statement of Claim. If one fails to issue the Claim within the time period allotted, all rights to compensation are lost.
MEDIATION. An informal settlement conference involving the lawyers, their clients, and a neutral third party mediator. A settlement cannot be forced upon the parties at mediation and nothing said at the mediation can be used against either party at a later date.
LOSS OF CONSCIOUSNESS. The loss of ability to perceive and respond, ranging from an altered state of awareness to total unconsciousness (coma).
NON-EARNER BENEFIT. An accident benefit paid to individuals who are no longer able to carry on a normal life and who do not qualify for an income replacement benefit. An example of someone who may qualify for a nonearner benefit or caregiver benefit is a person who was not employed at the time of the accident and who had not worked at least 26 of the previous 52 weeks.
PARAPLEGIA. Total or partial paralysis of both lower extremities, generally from the waist down. Total and partial paraplegia are catastrophic impairments.
PERSONAL INJURY LAW. The area of law that concerns persons who have been injured as a result of being in an accident. Accidents include motor vehicle accidents, slip and fall, medical malpractice, boating accidents, pedestrian accidents, assault, ATV or motorcycle accidents, etc.
PRE-CLAIM EXAMINATION. The accident benefit insurer may request an assessment by health care professionals of its choosing, before you even apply for benefits. The injured person has the right to refuse this assessment and may do so without penalty.
PLAINTIFF. In a lawsuit the person or persons who have sued another person(s), corporation or insurer (the “defendant”).
PHYSICAL THERAPIST (PT). A health profession concerned with promotion of health, with prevention of physical disabilities, with evaluation and rehabilitation of persons disabled by pain, disease, or injury, and with treatment by physical therapeutic measures as opposed to medical, surgical, or radiologic measures.
PRE-TRIAL CONFERENCE. A meeting between the lawyers and a judge of the Superior Court of Justice to try and settle the case without a trial and to narrow the issues for trial.
QUADRIPLEGIA. Total or partial paralysis of all four limbs; generally from the chest down. Total and partial quadriplegia are catastrophic impairments.
RANCHOS LOS AMIGOS SCALE. An evaluation used to measure the severity of deficit in cognitive function following a brain injury. A person is categorized from level one (no response) to level eight (purposeful, appropriate).
STATEMENT OF CLAIM. A document that begins a lawsuit and claims “damages” from one or more defendants based on the defendant’s negligent acts or omissions causing loss, injury or harm to the plaintiff. A Statement of Claim is generally prepared by the plaintiff’s lawyer.
STATEMENT OF DEFENCE. A defendant’s response to the Statement of Claim. It is usually prepared by the Defendant’s lawyer. Often, it will deny the allegations made in the Statement of Claim.
THRESHOLD. To succeed in a motor vehicle personal injury lawsuit with a claim for pain, suffering and loss of enjoyment of life, an injured person must prove that their injury meets a threshold test. This means that the injury must be either a permanent, serious disfigurement (like a scar) or a permanent, serious impairment of an important physical, mental or psychological function. There are many court decisions which help a lawyer specializing in personal injury law to advise you about whether your injuries “meet the threshold”.