If you have been hurt in a car accident in Toronto, the GTA or southern Ontario you know that the consequences can be life-changing.
No Fault Insurance:
Ontario has a no-fault insurance system for automobile and motorcycle accidents. This benefit is available if you are injured in a car accident, truck accident, or motorcycle accident. It is available whether you are a driver or a passenger. The benefits are available even if you are at fault for the accident. In addition to the no-fault Ontario Statutory Accident Benefits, an injured person in Ontario can also obtain compensation from the at-fault driver’s insurance company if there injury meets a certain threshold.
If you are injured as a result of a car accident or motorcycle accident in Ontario, you may be entitled to compensation from two sources:
- Accident Benefits from your own automobile insurance policy or from the insurance for another vehicle involved in the accident
- Tort Claim against the at-fault driver for compensation, including damages that are not available through accident benefits, such as pain and suffering.
Accident Benefits can be very complicated. First, the right insurer must be chosen to be the carrier of your accident benefits claim. There are certain priorities of which insurance company should be applied to. Sometimes a priority dispute may occur after applying for accident benefits, wherein two or more insurance companies will dispute which company should take ownership of the claim.
With Accident Benefits claims, come onerous and copious amount of forms to complete on an ongoing basis, along with stringent deadlines that must be adhered to. This can be a massive source of stress for claimants. To further complicate matters, accident benefits are constantly changing under the STATUTORY ACCIDENT BENEFITS SCHEDULE, O. Reg. 34/10. At Pranzitelli Law Firm, we handle all of your Accident Benefits forms, as well, we take over all communication with the insurance company on your behalf. This way, you can focus on what matters, getting the proper treatment and taking the steps to recovery without distraction.
Am I entitled to Accident Benefits?
Accident benefits are available to anyone involved in an Ontario motor vehicle accident regardless of who is at fault. These benefits are available under the Ontario auto insurance policy. Accident benefits may pay for items such as:
- Income Replacement
- Medical and Rehabilitation
- Attendant Care
- Non-earner Benefit
- Death Benefits
Income Replacement Benefits:
The accident benefits insurer is required to pay income replacement benefits for the period in which you suffer a substantial inability to perform the essential tasks of your employment or self-employment. The insurer is not required to pay an income replacement benefit for the first week of the disability or after the first 104 weeks of disability, unless, as a result of the accident, you are suffering a complete inability to engage in any employment or self-employment for which you are reasonably suited by education, training or experience.
Amount of Income Replacement Benefit:
The weekly amount of an income replacement benefit is 70 per cent of the gross weekly income, up to a maximum of $400 per week, unless optional coverage was purchased by you, which could increase the amount of the income replacement benefit.
If you were not employed at the time of the accident, you may be entitled to a non-earner benefit of $185 per week. The waiting period for meeting eligibility for non-earner is now 4 weeks. This benefit is available for a maximum of two years.
The accident benefits insurer is required to pay a caregiver benefit if you were a primary caregiver for a person in need of care and did not receive any remuneration for engaging in caregiving activities. The caregiver benefit is $250 per week plus up to $50 for each additional person requiring care, provided you sustained a catastrophic impairment as a result of your accident.
Medical and Rehabilitation Benefits and Attendant Care:
The accident benefits insurer is required to pay for medical and rehabilitation expenses and attendant care. Insurance policies in Ontario now combine Medical Rehabilitation with Attendant Care coverages. The amounts available for Medical and Rehabilitation/Attendant Care benefits depend upon the coverage you purchased as well as the classification of your injury. The amounts of coverage are generally as follows:
- $3,500 if you suffer a Minor Injury
- $65,000 if you suffer a non-catastrophic injury. If you purchased optional coverage, the amount increases to $130,000, if you suffer a non-catastrophic injury.
- $1,000,000 if you suffer a catastrophic injury.
As provided above, there are significant differences in available coverage depending upon the classification of your injury. Also, benefits for non-catastrophic injuries are only available for a maximum of 5 years for adults.
Housekeeping and Home Maintenance:
The accident benefits insurer is required to pay up to $100 per week for housekeeping and home maintenance services if, as a result of the accident, only ifyou sustained a catastrophic impairment, or if you purchased optional coverage.
The accident benefits insurer is required to pay the following death benefits for fatal accidents:
- $25,000 – $50,000 to the victim’s spouse – depending on the coverage purchased.
- $10,000 – $20,000 to each former supported spouse – depending on the coverage purchased.
- $10,000 – $20,000 to each of the victim’s dependents. This may be more depending on coverage.
- $10,000 – $20,000 to the person on whom the victim was dependent.
- Up to $6,000 – $8,000 in funeral expenses – depending on coverage purchased.