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(The Insurance Bureau of Canada of Canada says that those in N.L. are entitled up to $25,000 for medical rehab following a motor vehicle accident, but since no two accidents are alike, not everyone is entitled to the same compensation…)

ST. JOHN'S, N.L. — When Teena Smith-Spurrell and her two daughters were in a motor vehicle accident involving a transport truck in July 2023, she suffered from headaches and stiffness.

She considers her injuries minor compared to her daughter's.

“My oldest was in the back seat. When she saw the transport truck, she tried to hop over to the other seat and when she did, it hit,” said Smith-Spurell.

“Because she was moving, she has a lot of shoulder and neck pain.”

Dr. Cam Simone is the clinical director of On-Site Medical, a virtual clinic that offers injury assessments and rehabilitation for auto-related accidents. He said there are more benefits people can access after a motor vehicle accident, including medical devices, caregivers, or house modifications.

Cap on her insurance

She was told by the insurance company to go see a chiropractor right away.

“With the insurance, eventually, we might get some massage or chiropractor coverage, but they want us to use our insurance first, and there is a cap on that,” said Smith-Spurell.

“So for example, from this accident, we use up our insurance. And then two years down the road, something else happens. Then our insurance is all used up.”

Smith-Spurrell found this frustrating because the accident wasn’t her fault. At the same time, she knew she had to do something because her daughters were in pain.

This is when a friend suggested using On-Site Medical for additional support.

On-Site Medical

Clinical director Dr. Cam Simone offers injury assessments and rehabilitation for auto-related accidents through On-Site Medical, which operates throughout N.L. with satellite clinics.

He's specialized in motor vehicle accidents for 23 years, but his current focus is on ensuring people are obtaining full medical benefits from auto insurance carriers.

When he came to the province two years ago, he noticed a lack of awareness among people about their entitlements.

“There are so many services and entitlements that people are unaware of here,” said Simone

“And the auto insurance companies aren't going to turn around and go you're entitled to this because they want to keep it basic and close the file.”

All citizens in N.L. are entitled to $25,000 of medical rehabilitation benefits, he said.

“A lot of people that I've interacted with think that they're only entitled to active therapy with a physiotherapist or chiropractor and some pain medication,” said Simone. “But it's far more than that.”

Accessing benefits

Some people, he said, are eligible for medical devices, caregivers, or house modifications.

Insurance companies have their own doctors who do the same assessments he does, but Simone considers their assessments biased and favour the insurance company.

“I don't appreciate insurance company's business practices and what they do to individuals,” said Simone.

“Their job is to assist with people, and unfortunately, their business practices aren't doing that.”

Simone said all the services he provides are covered by auto insurance, with no out-of-pocket expenses for patients. He also works with family doctors to ensure comprehensive care.

'Whatever we need'

Smith-Spurell turned to Simone for help after her accident.

“Dr. Cam told us that anything from the accident that's an injury will be covered,” said Smith-Spurell.

“He said that either they'll set up appointments or we'll do the appointments and get reimbursed for it.”

On-Site Medical set them up for various treatments, including chiropractic care, kinesiology, massage therapy, and knee braces for her daughters.

"Dr. Cam always encouraged us to get whatever we needed," said Smith-Spurell.

Both Smith-Spurrell and her daughters are still availing of treatment with no out-of-pocket cost.

No two accidents alike: Insurance Bureau of Canada

Smith-Spurrell said that her insurance company wasn't able to tell her how much she was entitled to – something Simone said is common.

However, the Insurance Bureau of Canada (IBC) said it's not that insurance companies aren't telling people, it's that no two accidents are alike and not everyone is entitled to the same compensation.

"Insurers work with health-care providers to make sure that the right treatment for the injury sustained is received by those injured victims," said Amanda Dean, vice-president of Ontario and Atlantic for IBC.

Dean did confirm that in N.L. there is up to $25,000 in coverage for medical rehab.

“If you are injured, you would be entitled to the health care that's required to get you better, and get you back into the shape that you were in before the accident,” said Dean.

“That's one of the big principles of insurance, the concept of indemnification, which means putting you back to where you were before the loss. Not everyone is going to need the same amount of care to heal.”

When it comes to why there is a perception that insurance companies are keeping these benefits from people, she said she isn't sure because insurers put it in black and white for every customer.

“The numbers are laid out clearly by your insurer. They are publicly available and again, they are laid out in legislation and or regulation in the province of Newfoundland and Labrador,” said Dean.

Teena Smith-Spurell said after dealing with On-Site Medical following a car accident, she felt her medical needs were met. - Contributed

On-Site Medical's clinical director, Dr. Cam Simone

It also caused trauma for her oldest daughter, she said. Now when she sees a transport truck, she’ll pull onto the side of the road for it to pass.

Smith-Spurell's other daughter, who was driving, also suffered from knee, neck, and shoulder pain.

Calling her insurance company

The accident occurred in St. John’s when a transport truck driver misjudged its turn, said Smith-Spurell.

Their vehicle was stopped at an intersection when the driver tried to correct his turn, but once he started turning again, he crushed the back of their vehicle.

After the accident, due to the extent of their injuries, she called her insurance company, but she admits, she finds insurance companies to be "very daunting."

“I called the insurance, and they took the basic information and told us there would be some compensation,” said Smith-Spurell.

“But we had no idea how much or what is covered.”

Cameron Kilfoy | Posted: Sept. 13, 2024, 10:45 a.m. | Updated: Sept. 13, 2024, 2:04 p.m. | 6 Min Read