With the introduction of the Alberta Minor Injury Regulation in 2004, the provincial government created a financial cap on the amount that can be recovered for certain injuries. These capped claims relate specifically to soft-tissue injuries sustained in motor vehicle accidents in Alberta. The province introduced the cap in an attempt to strike a balance between the rights of victims to be compensated for their injuries and the need to maintain affordable insurance premiums for Alberta drivers. Prior to the introduction of the cap, Alberta’s insurance industry had extensively lobbied the government for change, claiming that insurance providers were being bankrupted by settlements to injured parties. They claimed they had no choice but to keep raising premiums to make up for the losses caused by these claims. The government hoped that capping claims for minor injuries would allow sufficient recovery for the injured parties while keeping insurance affordable.
The initial amount of the cap in the first year it was implemented was $4,000.00. Since then, the amount has increased each year for inflation, and currently sits at $5,296.00 as of January 1, 2020. Notably, the cap applies specifically to the injuries itself and not to associated damages such as the loss of income, current or future medical expenses, loss of housekeeping capacity or cost of care.
Which Types of Injuries are Capped?
The injuries subject to the capped amount are classified in the Minor Injury Regulation as:
- WAD Injuries (whiplash associated disorder – for more information on whiplash associated disorders, please see our page dedicated to this topic)
The injury must occur as the result of a motor vehicle accident and, in order to be considered minor, it must not pose a risk for serious impairment.
Sprains vs. Strains
While many of us use the terms “sprain” and “strain” interchangeably to refer to minor pain in a limb or our back, they actually refer to different injuries.
A sprain is defined under the Minor Injury Regulation as an injury to a tendon, ligament or both. Tendons are bands of tissue that connect bones to each other at a joint, while ligaments are bands of tissue that connect muscle to bone. A sprain generally occurs suddenly as the result of trauma.
On the other hand, a strain results when we tear or stretch a muscle itself, rather than the connecting tissue. Strains can occur suddenly as the result of trauma, or they can develop over time.
Are All Sprains, Strains and WAD Injuries Capped?
The short answer is no. While the legislation purports to cap all injuries described above, in truth the law can be quite ambiguous and complex, particularly when factoring in common law interpretations of the legislation by various Alberta courts. For example, courts have held that an injury that would normally be classified as minor under the Regulation is no longer considered to be such if it continues for more than 10 or 12 months. At this point, the injury will be classified as chronic pain, since the issue has not resolved. In these cases, the victim would no longer be subject to the cap.
In addition, while a person may have a minor ankle sprain that would ordinarily be capped, if they also have a non-capped injury such as a concussion, they will be permitted to pursue a non-capped claim for damages.
What Should I Do If I’m Told My Injuries Are Capped?
Insurance companies are often quick to proclaim that an injury falls within the guidelines for a capped claim, however it is important to keep in mind that many injuries cannot be fully assessed until several months after an accident. While pain might resolve itself within a few months, it is also possible that injuries and the symptoms thereof can worsen over time. For this reason, we strongly recommend that clients avoid accepting an insurance company’s initial offer with respect to payment. These offers are generally provided soon after the accident before the extent of the injures can be fully assessed.
We generally recommend that the injured party avoid contact with the at-fault driver’s insurance provider while they are in the process of assessing their damages. While your own insurance provider owes you a duty to act in good faith with respect to your insurance coverage and claims, the at-fault driver’s insurance company is not subject to the same obligation. They may even attempt to convince you that your injuries are capped when, in fact, they are not.
It is important to keep in mind that you have 2 years from the date of the injury to settle the claim or file a lawsuit. This limitation period provides time to fully determine the extent of your injuries and whether they will resolve. If injuries last more than 5-6 months after the accident, this may indicate that they are more extensive or severe than originally thought.
At Cuming & Gillespie Lawyers, we are committed to helping you and your loved ones. If you or a loved one have been injured in a motor vehicle accident, you may be entitled to compensation for damages. Please contact the award winning lawyers at Cuming & Gillespie Lawyers either online or by calling 403-571-0555. We can get started with a free case evaluation and are dedicated to providing you with the legal help that you deserve.