Bill 36: PROPOSED Enhancements to

the MANITOBA PUBLIC INSURANCE CORPORATION Act

Government tabled a bill today proposing a catastrophic injury definition and enhanced benefits for the Personal Injury Protection Plan.

Catastrophic injury definition

  • Current: There are no special provisions for those who are catastrophically injured.
  • Proposal: The bill proposes a broad definition of catastrophic injury:

-quadriplegia or paraplegia (complete and incomplete American Spinal Injury Association [ASIA] grades A and B);

-amputation resulting in two or more amputations (shoulder/arm/pelvis/hip/thigh);

-loss of functional vision (impairment of 80 per cent or more);

-functional alteration of the brain (brain damage) resulting in a determined impairment of 50 per cent or more (communication disorders, alterations of consciousness and cognitive function);

-psychiatric injury with a determined impairment of 70 per cent or more;

-full thickness burns resulting in consequential impairments, excluding scarring or disfigurement to all surface areas of the body other than the face, that are determined to result in a degree of permanent impairment of 75 per cent or more

OR

-A combination any of the following injuries resulting in a whole body impairment of
80 per cent or more:

single amputation (shoulder, arm, elbow, forearm, wrist, pelvis, hip, thigh, knee, below knee);

quadriplegia or paraplegia (incomplete ASIA grade C and D);

loss of functional vision (impairment of 50 per cent or more but less than
80 per cent);

functional alteration of the brain resulting in a determined impairment of 30 per cent or more but less than 50 per cent (upper limb function, standing and walking, bladder function, kidney function, anorectal function, sexual dysfunction, communication disorders, alterations of consciousness and cognitive function);

brachial plexus injuries;

psychiatric injury with determined impairment of 35 per cent;

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full thickness burns resulting in consequential impairments, excluding scarring or disfigurement to all surface areas of the body other than the face, that are determined to result in a degree of permanent impairment of 40 per cent or more.

Enhanced coverage benefits

Income Replacement Indemnity (IRI) coverage – This payment would be for injured claimants who are unable to work as a result of a motor vehicle accident.

  • Current: Manitoba Public Insurance ensures the minimum amount payable is no less than the provincial minimum wage. The maximum gross yearly employment income is $76,000.
  • Proposal: Increase the minimum income replacement for catastrophically injured claimants who are not able to work from minimum wage to the industrial average wage, for an increase of up to $19,000 per year. The new minimum would become $37,000, from the current minimum of $18,000.

Permanent impairment benefit

This payment is intended as an acknowledgement there has been a permanent after-effect of the injury (not an actual expense).

  • Current: The current maximum permanent impairment benefit is $136,160.
  • Proposal: The enhancement proposes those who meet the definition of catastrophic injury would receive $215,000 (indexed annually).

Personal-care assistance

This benefit is for injured claimants who need assistance to meet their activities of daily living (such as eating, bathing, dressing, etc.).

  • Current: The current personal-care assistance maximum is $4,084 per month.
  • Proposal: The enhancement proposes an increase of $800,to $4,884 from $4,084 per month, for catastrophically injured claimants who are entitled to 100 per cent of the current monthly maximum. Not all catastrophically injured claimants require this level of assistance.

Death payments

This lump sum payment is for beneficiaries of victims who succumb to their injuries as a result of an accident.

  • Current: When a victim suffers an injury that provides a permanent impairment payment, that victim cannot receive both a permanent impairment payment and a death payment. Instead, the death payment is offset by the amount of permanent impairment benefit paid when this payment is already made prior to someone succumbing to their motor vehicle related injuries. Also, when a person succumbs to the injury after the date of accident, the funeral expense reimbursement amount will now clearly be based on the date of death.

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  • Proposal: This enhancement proposes that:

-where a death occurs more than 90 days after the accident, both permanent impairment and death payments would apply; and

-the funeral expense payment would be based on the coverage at the date of death.

Transitional expense provision

  • Current: The corporation does not currently have any authority to provide funding for expenses covered by the proposal.
  • Proposal: This enhancement proposes expense benefits to a lifetime limit of $1 million (indexed annually) for catastrophically injured clients with a legitimate need for reimbursement created by unusual circumstances.

-When the PIPP maximum coverage has been reached but:

while co-ordinating access to services with other providers, such as Manitoba Health Services, until such time as that access become available; and

when further payment will reduce the total of any amounts payable by an amount that is at least equal to the amount of the expense paid.

-If there is no other coverage provided by PIPP but the corporation is satisfied that payment will reduce the total of any amounts payable that is at least equal to the amount of the expense paid.

-Decisions made under this provision would be exclusive to Manitoba Public Insurance and not within the appeal jurisdiction of the Automobile Injury Compensation Appeal Commission.

Co-ordination provision

Injured clients need access to funding that is provided by other provincial programs, such as homecare or family support.

  • Current: Injured clients who need access to these services have to access and facilitate their services directly with other provincial agencies, separate from Manitoba Public Insurance as there is no authority for the corporation to assist by co-ordinating and facilitating these services for them.
  • Proposal: This proposal builds upon the corporation’s commitment to assist claimants in obtaining benefits, not only under PIPP but also under other provincial programs such as homecare. This legislation outlines authority for Manitoba Public Insurance to co-ordinate and facilitate access to entitlements for these claimants. This proposal will also help to streamline services for clients and achieve efficiencies through co-ordination.

Finance implications

The proposed changes would not result in any increase to rates.