Never Abandon The Treatment Team When Settling Accident Benefit Claims

Author(s): Darcy R. Merkur

August 22, 2020

Too often Trauma Lawyers settle accident benefit claims and wrongly leave rehabilitation providers scrambling to deal with loose ends and to get paid for their hard work.

Rehabilitation providers work tirelessly to help accident victims recover from life changing injuries. They are commonly underpaid because of time consuming insurance red tape and insurance hourly rate restrictions.

Trauma Lawyers rely heavily on the incredible and valuable services provided by rehabilitation professionals to their clients. A good rehabilitation team is often the key to a client’s successful recovery with the Trauma Lawyer helping to ensure that the rehabilitation team gets all of the financial support they need to implement their recommendations.

Using the Trauma Resource Directory

Typically, an experienced Trauma Lawyer assisting a seriously injured claimant will handpick rehabilitation providers that are well-equipped to assist the accident victim based on the provider’s experience, geography, language issues and/or other relevant issues (like cultural dynamics, gender, age, etc., where appropriate).

Trauma Lawyers regularly find suitable providers by using the free online Trauma Resource Directory (known as the “TRD”) to evaluate experience, credentials, location and language abilities when assembling a rehabilitation team. Thousands of exceptional Ontario rehabilitation providers have uploaded their credentials to the TRD so that they can be considered for the available role.

In most serious accident benefit claims there comes a point where a settlement of that accident benefit claim becomes a possibility.

Settling Catastrophic Impairment Claims

In catastrophic impairment claims, both parties (the insurance company and the claimant) often prefer a resolution because of the “lifetime” obligation associated with the “catastrophic impairment” designation.

Claimants typically prefer an accident benefit settlement so that can access funds as they wish without having to go through the bureaucratic accident benefit process and without having to face the possibility of partial approvals, denials, and regular insurer’s examinations. The cumbersome and contentious accident benefit process only serves to increase anxiety, delay treatment and add an element of uncertainty associated with accessing ongoing services.

A settlement of an accident benefit claim often occurs suddenly and is commonly temporally associated with a resolution of the related lawsuit (tort claim).

When a Trauma Lawyer resolves an accident benefit claim it is imperative that, wherever possible, they ensure and insist that the accident benefit insurer remain responsible for approved services, not only up until the date of settlement, but to a fixed date sometime thereafter. It is unfair to announce a settlement that will result in the short-notice cancellation of various approved treatment appointments.

The best practice for a Trauma Lawyer is to always negotiate that, as part of any settlement, the accident benefit insurer continue to pay for all approved services, not only before the date of settlement, but to a date ideally at least two weeks later.

Importantly, it is vital that the accident benefit insurer expressly remain responsible for all approved services to the agreed date because, notoriously, there are providers who have not been paid for services provided months before, either because of oversight on their part in terms of rendering bills and following up or oversight on the part of the insurer who was waiting for things like clarity over contributions from group health insurers before paying the outstanding account.

Trauma Lawyers must do a better job appreciating the rehabilitation professionals that assist them by ensuring that they are always paid for the valuable help they provide.

Darcy Merkur is a highly regarded Ontario trauma lawyer helping accident victims such as pedestrians, cyclists and motorists, who have sustained catastrophic injuries. 

Darcy is one of just four plaintiff’s personal injury lawyers in Ontario recognized as a Certified Specialist in Civil Litigation by the Law Society of Ontario, listed in peer-reviewed publications – Lexpert®, The Best Lawyers™ in Canada, AV pre-eminent Martindale-Hubbell ® and the first lawyer in Canada to be qualified as a Certified Brain Injury Specialist by the Brain Injury Association of America. He is also a partner at Thomson Rogers, one of Canada’s Top 10 Personal Injury Law Firms as selected by Canadian Lawyer Magazine. 

Darcy can be reached at 416-868-3176 or by EMAIL.

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