In Ontario, every automobile insurance policy is required by law to provide accident benefits coverage, regardless of who is at fault, if you or your passengers are injured. You may be entitled to income replacement, caregiver income, home care providers and reimbursement for other expenses in addition to medical and rehabilitation coverage.
If you need to make an accident benefits claim because you have been injured in a motor vehicle accident, it is critical that you start the claims process within a specific timeframe, or you may risk losing benefits. The benefits claim application and what comes after can get complicated, and you may find it beneficial to consult with a lawyer to help maximize your compensation.
Notify Your Insurance Broker/Company
Within seven days, you must notify your broker/company that you intend to submit an accident benefits claim. To begin the process, they will ask you to provide all the relevant details about the accident. These include:
- Your insurance policy number
- Year, make, model of your vehicle
- License plate number
- Time, date and location of the accident
- A detailed description of what occurred
- Injuries sustained by you or your passengers
- Damage to your vehicle
- Number of passengers
- Be sure to include names, contact numbers and insurance information for all drivers involved
- The name and badge number of the investigating officer
Complete the Benefits Application Package
The benefits application consists of five different forms:
- Application for accident benefits
- Employer’s confirmation of income
- Disability certificate
- Treatment confirmation form
- Permission to disclose health information
Your insurance adjuster will lead you through the initial application process and may request additional information. When people do not have a lawyer, we find that adjusters often ask for more information than they are entitled too, in order to look for reasons to deny a claim. You should seek legal advice prior to further answering any questions that you may not need too.
You have 30 days to assemble the information and submit the completed accident benefits claim application package to your adjuster. After reviewing the application, your adjuster will determine which benefits you qualify for.
Determine Fault
The determination of fault is not applicable to an accident benefits claim. You are entitled to the same accident benefits whether you are 0% responsible for the accident or 100% responsible for the accident.
Determine Compensation
Once the insurance company completes their investigation, they will determine the amount of compensation you are entitled to. Before signing any insurance documents, you would be wise to consult a personal injury lawyer to ensure you are receiving a fair settlement.
Denied Claims
If insurance companies paid the maximum compensation on every claim, they would not be in business for long. Their goal is to minimize the payout on your claim, which means that they will be looking for reasons to deny your claim.
If your claim is denied, a lawyer who specializes in personal injury law can help you decide what your options are and the best course of action to take. The good news is that you have up to two years after the accident to challenge the claim or proceed to file a lawsuit.
Knowing Your Rights
If you are injured in an accident and the other driver is at fault because of recklessness or negligence, you may also be able to file a lawsuit against the insurance company. If you choose to file a tort claim against the other driver, which is a complicated legal process it would be best handled by lawyer who specializes in accident claims.
It is important to remember that even if you are at fault you are entitled to the same accident benefits from your insurance company. Using legal representation might be more crucial in this case to help ensure you recover the accident benefits you deserve, as you will not be able to file a lawsuit against the other driver to cover any additional damages.
As a pedestrian or cyclist who has been hurt in an accident and without insurance of your own, a lawyer should also be your first call. A personal injury lawyer can help you advance your claim against the insurance policies of other vehicles involved in the accident and ensure you receive the proper compensation.
Contact Trianta Law and let our lawyers help you get all the compensation you are entitled to.