August 23, 2019
Are Accident Benefits Mandatory In Ontario?
No one expects to be involved in a car accident. You may be the driver, passenger, at-fault, or the victim; no one can predict when they’ll be in these circumstances. That’s why accident benefits are a mandatory component of auto insurance policies in Ontario. To legally drive a car, you must have auto insurance. When you buy a car insurance policy from any provider in Ontario, it will come with standard accident benefits. There are also optional benefits you can add to your plan.
Learn what accident benefits cover, why you need them, and how to settle an accident benefits claim.
What Are Accident Benefits?
When you pay for auto insurance, you receive coverage for certain accident-related consequences. They’re a form of compensation to you and anyone else in your car at the time of the accident. Regardless of if the fault is yours, you are entitled to these benefits because you have auto insurance. The standard accident benefits are the same across all Ontario insurance companies. Accident benefits coverage include: income replacement, non-earner, and caregiver; medical, rehabilitation, and attendant care; death and funeral; other expenses.
1. Income Replacement, Non-Earner, And Caregiver Benefits Depending on the severity of the accident, you could walk away with injuries that prevent you from working. If so, you may be entitled to a weekly accident benefits income replacement equal to 70 percent of your regular income. However, that amount is capped at $400. If you paid for optional benefits, that amount could be as high as $1000. If you are unemployed or are a student, you may not be eligible for income replacement. You may still qualify for the income replacement if you had been earning income in the 52 weeks prior to the accident. In cases where you do not qualify for the income replacement benefit, you may be eligible for a smaller living allowance of $185 per week called the non-earner benefit.
Lastly, if you’re responsible for the care of another person and cannot fulfill that duty because of the accident, you may be eligible for the caregiver benefit. This allows you to hire someone to perform your caregiver duties until you’re able to do them again. These benefits are only available in certain cases if the injuries are catastrophic, or if the additional benefit has been purchased.
2. Rehabilitation, Medical, and Attendant Benefits
Medical bills can add up when you need to see specialists for your injuries. Although our healthcare system covers the basics, it doesn’t cover many of the services required post-accident. However, through your auto insurance, your accident benefits make up for OHIP’s shortcomings. They include physiotherapy, chiropractic services, prescriptions, and counselling. If you need at-home care services because of your injuries, you may be eligible for the attendant benefit. In this case, you must hire a caregivier to provide care services until you’re well enough to take care of yourself again.
3. Death and Funeral Benefits
Should the unthinkable happen and you die from a car accident, your loved ones can receive additional assistance through death & funeral benefits.
Funeral and burial costs can be exorbitant and overwhelming for a grieving family. Luckily, these benefits give your loved ones a monetary amount for anything they may need. Your spouse can receive up to $25,000, and each of your dependents can receive up to $10,000 each. An additional amount up to $6,000 is also given to the family to help specifically with funeral costs.
No one wants to focus on the worst-case scenario. Accident benefits are there so you don’t have to.
4. Other Expenses
You’d be surprised by the amount of money lost during recovery from an accident. If the accident causes you to miss a semester of college, “other” benefits may cover your tuition, books, and educational expenses to a total amount of $15,000. This usually applies to those who are in the hospital or at home healing and unable to go to school.
In some cases, the cost of having family visit you during recovery can even be claimed for an accident benefit. If your home becomes disorganized and unhygienic because your injuries prevent you from cleaning, you may be eligible for a housekeeping benefit in certain situations. This covers a maximum of $100 per week for home maintenance and housekeeping services.
What about your clothes that got ripped during the accident? Or your glasses that got smashed? You can claim these expenses under the “other” benefits category. You may be able to receive full or partial coverage for these items.
What are Optional Accident Benefits?
If you wish to pay for additional accident benefits, you may. The cost varies by insurance provider and the type of benefit you’d like to add. One option is to add a weekly payout to your dependants. This applies to people who were employed at the time of the accident and who now must incur additional expenses to care for dependants due to their injuries. It covers up to $75 for the first child and up to $25 for subsequent dependants.
You can also pay for the optional benefit of indexing. This means that your coverage amounts increase with general inflation instead of staying fixed. Indexing works in your favour if the Consumer Price Index of Canada increases between the time you purchase your policy and the time of the accident.
How to Settle an Accident Benefits Claim
You must legally wait one year after the accident before starting the settlement process for your accident benefits. The insurance company may propose a total settlement amount that you can either accept or reject. This is a crucial decision because once you’ve received payment the amount cannot be changed. You also cannot ask for additional coverage once the initial claim has been submitted and settled. Since this process is so tedious and imperative to your finances, it’s best to have a lawyer provide you with an opinion on the amount before you accept it. The insurer could be leaving out compensation you’re eligible for or try to pay you less than you deserve. Always consult a lawyer before committing to a settlement.
What if you have a dispute with your insurance company over your accident benefits? With the guidance of your lawyer, the dispute will be brought to The Licence Appeal Tribunal. This is a legal process with procedures likely unfamiliar to those not in the legal field. Having a personal injury lawyer you can trust is imperative. They need to be experienced in accident benefit claims and have a strong knowledge of the Ontario legal system.
The team at Michelle Linka Lawyers has the experience and expertise to settle your accident benefits claim. Recovering from an accident is stressful enough, let alone dealing with litigation. Allow us to ensure you receive everything you deserve. Get in touch with us to inquire about our Accident Benefit Claim services in Richmond Hill, Whitby, and Peterborough. Call us today at (416) 477-7288.