What are accident benefits, or ‘no fault’, auto insurance claims?
Since 1990, everyone injured as a result of the ‘use or operation’ of a motor vehicle in Ontario, has had the right to claim for a variety of benefits, regardless of fault.
What types of benefits do these no-fault claims usually involve?
Payments for medical and rehab expenses not covered by OHIP or other insurance. Disability benefits if you cannot work. Funds to replace damaged clothing or glasses. Some transportation, drug, and prescription expenses. The expense of a nurse, occupational therapist, or personal support worker, if needed. This is a small portion of what an auto accident victim might be entitled to.
Do you have to be in a car, or in a car “crash” to qualify?
No! As long as it involves the “use or operation” of a vehicle, you should make a claim. You could fall getting in or out of your vehicle and may have coverage in some instances. You could be hurt while maintaining your vehicle. You could be struck by a vehicle as a pedestrian or cyclist. You could be on a snowmobile or ATV. You could be loading or unloading a car. It just needs to be an accident involving a motor vehicle. If in doubt, consult a qualified lawyer.
Do I need to own a car to qualify for this coverage?
No. Everyone is covered if they are in an accident involving a motor vehicle. If there is no auto insurance policy identified to claim against, the Ontario Government has a Claims Fund you can apply to.
What if I need help with housekeeping or caring for my children after an accident?
The Ontario government significantly reduced no-fault accident benefits in 2010 and did so again in June of 2016. (We have a very effective insurance industry lobby in Canada). Housekeeping, attendant care, and care giver benefits that were once standard, have now become optional benefits in most cases. You have to pay more for “optional” benefits that were once standard. Most car owners do not know that their benefits have changed, and very few have purchased optional benefits. In my practice of almost 25 years, I have rarely had clients with optional benefits, and can count all of them on two hands.
Also in 2016, the Ontario government also reduced catastrophic benefits – for those that are horrifically maimed and injured in auto accidents – by half. They also capped the time that all other victims must receive medical and rehab benefits by half (10 years to 5) and made it harder to qualify for them. These benefits are getting weaker, but they are still mandatory parts of your insurance policy.
Should I be concerned about how my mandatory accident benefits have weakened over time?
Yes. Everyone thinks that they will never be in a car accident. I end up meeting the people that thought that too, but it happened to them. They are always shocked when they hear about the benefits that were taken away from them in 2010 and 2016. They are always upset that they “paid the same for less protection”, and rarely remember their insurer telling them about optional benefits. If you would like to learn more, I urge you to contact your insurance broker, and ask your broker about optional accident benefits, underinsured / uninsured motorist protection, and how to best protect yourself and your family from the accident you think will never happen – just in case that it does.
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