As previously discussed, when catastrophic injuries are sustained through the fault of an under-insured motorist most British Columbians enjoy Underinsured Motorist Protection “UMP”.
Sections 148.1 – 148.4 of the Insurance (Vehicle) Regulation deal with UMP Claims. When disputes arise as to the availability or the amount of UMP coverage the matter needs to be resolved through private arbitration as opposed to a public lawsuit. The law requires all UMP decisions from 2007 onward to be published on ICBC’s website. These cases, unfortunately, are published in PDF Format and they are not search friendly. To remedy this I’ve decided to include UMP case summaries on this blog. With that in mind here is the first in a series of UMP cases summaries.
The first UMP judgement published was RAH v. ICBC. In RAH the Claimant was injured in a 2002 motor vehicle collision. Fault was admitted. It was agreed that the value of the claim would exceed the Defendant’s insurance limits and the parties agreed to have the value of the claim adjudicated by way of UMP Arbitration.
The Claimant suffered a comminuted fracture of the left medial and tibial plateaus. These required surgical correction. Unfortunately, even with surgical correction, the injury was so severe that the Claimant was left with “a marked disruption of the articular surface which accounted for on-going pain and inability to regain full movement of the left knee“. The prognosis was for gradual worsening with a likelihood of a total knee replacement. It was accepted that this injury would seriously impede the Claimant’s ability to earn a living and total damages of $681,000 were awarded. In assessing non-pecuniary damages (money for pain and suffering and loss of enjoyment of life) at $95,000 the arbitrator (Donald Yule) provided the following reasons:
The Claimant sustained severely comminuted medial and lateral tibial plateau fractures of the left knee. He has undergone two surgeries, one to reduce the fractures with two plates and 10 screws and a second procedure to remove the hardware. He faces the prospect of further surgery for a total knee joint replacement with a possible further revision 15 years later. He has permanent on-going pain which will inevitably worsen over time until the first knee joint replacement surgery is done. He has permanent loss of flexion of the left knee and knee joint replacement surgery will likely increase the loss of flexion. He cannot return to his former occupation as industrial nurse/medic. He cannot walk or sit for prolonged periods of time without causing an increase in left knee pain. He takes non-morphine analgesics on a daily basis and occasionally Percocet for break-through pain. He continues to use a cane. Prolonged standing, walking on uneven surfaces, and going up and down stairs all aggravate his symptoms and will hasten the time when knee joint replacement surgery is required. The claimant was physically active outdoors, apart from his work, before the Accident, both in the Scouting and Fourth Ranger groups and for recreational hiking, hunting, fishing and camping. These activities except in a most limited and superficial manner, are now foreclosed to him…
…I assess the non-pecuniary damages at $95,000.
I should point out that this case was decided in 2008 and adjusting for inflation the assessment would be approximately $100,000.