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…I’ve been injured in a motor vehicle accident?
Seek appropriate medical treatment.
Promptly notify your own auto insurance company to apply for accident benefits. If you do not have insurance:
- you may be eligible on a policy held by someone on whom you are financially dependent;
- you may be eligible on the policy for the vehicle in which you were traveling during the accident:
- you may be eligible on the policy for the vehicle which struck you; or
- you may be eligible to claim through the Government of Ontario.
Promptly seek legal advice:
- before giving statements or consenting to insurer assessments in your home;
- to provide a notice letter against any at-fault party within 120 days of the accident;
- to protect any applicable limitation periods or notice periods;
- well before the two year limitation for claiming against an at-fault driver.
Request that Treatment Plans be completed by your treating therapists and submitted to your insurer before incurring the cost of any therapy.
Keep copies of all receipts and expenses incurred and submitted.
Ask your broker what optional (extra) benefits you had in place on your policy.
Request a copy of the Statutory Accident Benefit Schedule from your accident benefit insurer (pursuant to Section 67 of the Statutory Accident Benefit Schedule).
Request a copy of all documents contained in your accident benefit file.
Circumstances are unique in every case and we recommend that you seek legal advice to inquire about your particular situation. Our office is pleased to provide a free initial consultation to all accident victims.
What is the difference between a tort claim and an accident benefits claim?
When involved in a motor vehicle accident, there are two potential claims that can arise: a tort claim and an accident benefits claim.
For most accidents occurring after September 1, 2010
(Law suit against party who is at fault)
- Prove Negligence (fault).
- Give notice of claim 120 days after accident.
- Issue lawsuit within 2 years.
- No claims for health care (unless qualify for permanent & serious disfigurement impairment threshold).
- Can sue for proven pecuniary losses (out-of-pocket).
- Before trial, 80% of income loss less accident benefits usually = 0.
- Future Income Loss & Less of Competitive Advantage.
- Sue for pain and suffering less a $30,000 deductible (if under $100,000) if:
- (a) death; or
- (b) permanent serious disfigurement and/or permanent serious impairment of an important physical, mental or psychological function pursuant to the Statutory definition
- Family Law Act Claims
$15,000 deductible (if under $50,000)
(Application for benefits with your own insurer)
- Apply for benefits.
- Submit Treatment Plans and expenses to insurer in writing (even if they say not covered).
- Mediate and sue/arbitrate within 2 years of a refusal by insurer to pay any benefit.
- Medical and rehabilitation expenses covered up to 10 years, up to $50,000 (if reasonable/necessary). But insurers reduce limits to $3,500 if they classify you as a minor injury.
- 70% of gross income loss according to formula up to 2 years (then test changes).
- Other expenses – lost education expenses, damage to clothing, expenses of visitors to hospital, cost of assessments.
If your broker sold you optional extra coverage, you may have additional benefits, such as:
- attendant care
- caregiving benefits
- housekeeping benefits
- additional income benefits
*Settlement of accident benefits can prejudice the tort "At Fault" claims.