In a hospital room on the eighth floor of North York General Hospital, Bella De Bartolo is worried about her husband’s future after he suffered a traumatic brain injury from a flying tire.
De Bartolo is also concerned about whether or not the couple will be able to afford Ben Schenk’s rehabilitation once the 32-year-old is discharged from hospital, with Schenk too injured to work, and De Bartolo having to work less to support her husband.
At this point, the couple’s lawyer has told them their insurance company has yet to designate Schenk’s injuries “catastrophic.”
De Bartolo and Schenk were driving northbound on Highway 400 near Highway 48 on May 18 when a tire from a southbound SUV struck their car, smashing through the roof and windshield.
If Schenk is not designated “catastrophic,” which would cover him for up to $1 million in medical, rehabilitation and attendant care, Schenk will only qualify for $65,000 to cover what are considered non-catastrophic injuries.
De Bartolo can’t believe her husband has to wait to qualify.
“He’s going to have a multitude of problems that are caused because of this accident. He’s going to need ongoing help at home. He’s going to need special equipment. He’s going to need care for the rest of his life,” said De Bartolo.
Trauma lawyer Darcy Merkur, who does not represent Schenk and De Bartolo but who works in the same firm as the couple’s lawyer, says victims of serious motor vehicle collisions unfortunately have to wait sometimes for as long as 18 months after an accident before they find out if their injuries are designated catastrophic.
Merkur explains that the Ontario Liberal government made auto reforms in June 2016 lowering the coverage for catastrophic injuries and making it harder for those with brain injuries to qualify.
“The patient, the client, is in no man’s land until their injury manifests over a six-month period, if not a year, before we can give them any certainty of whether or not they can get the designation,” said Merkur.
“And then when our assessors conclude that they believe they meet the test, then the insurance company notoriously has their own assessors re-evaluate matters, which causes a further delay. It takes typically a year and a half before they get the designation where before June 1, 2016, it would take a matter of weeks.”
Merkur recommends every driver in Ontario gets optional benefits to add to their basic coverage.
“Serious accident victims have roughly one-third of the money available to them, compared to what they used to have in 1996. It’s delayed to access and then you have a third to what you need. Regular car insurance is not enough to cover your needs if you’re seriously injured. And it should be. It should be designed to provide the bare minimum of what you need. The erosion of benefits since 1996 has been so devastating.”
WATCH: Police respond to serious collision on Hwy. 400 south of Barrie (May 2019)
Rhona DesRoches of Fair Association of Victims for Accident Insurance Reform says she’s not surprised Schenk has to wait to be designated catastrophic despite his critical injuries.
“It’s just very, very sad,” she said. “It’s increasingly difficult to get the benefits you need for recovery.”
Desroches said the Ford government promised in April’s budget to restore accident insurance to the pre-2016 level of $2 million for catastrophically injured Ontarians.
WATCH: Hwy 400 shut down in both directions as woman airlifted to hospital after wheel smashes through windshield (Jun 2019)
She hopes the Conservatives will honour their promise. Desroches says it’s not fair that Schenk has to wait and make due with the $65,000 worth of coverage designated for those with non-catastrophic injuries.
De Bartolo has had to start a GoFundMe page to help cover the couple’s expenses.