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Accident Benefit Lawyers

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Accident Benefit Lawyers

After a car accident, you may experience significant personal injuries and resulting monetary damages or expenses. You may be faced with the expenses associated with medical treatments, doctor’s visits, and even hospital stays. You may be unable to work, costing you wages or income.

Ontario’s no-fault system of car insurance allows you to recover accident benefits, but those benefits may not always be clear-cut. In fact, they may also be disputed by the insurance company. It’s important to understand the requirements involved, as well as consult an experienced personal injury lawyer who can help you navigate the accident benefits process.

What Are Accident Benefits, and How Do They Work?

Accident benefits are designed to compensate you for some of the damages you have suffered as a result of an accident, particularly the wages or income you have lost if you are unable to go to work. There are many types of accidents that can result in personal injuries, including car and truck accidents, sporting or recreational injuries, and accidents that take place on the property of another, just to name a few. Accident Benefits claims are tied to accidents involving automobiles, trucks and motorcycles.

After a car accident, your life may be greatly affected by your personal injuries.  You may be unable to engage in some of the same work and activities as before if you have suffered a life-altering, catastrophic injury, or because you are living with chronic pain and suffering. Ontario’s no-fault accident benefits system allows you to recover compensation for the expenses you have incurred in your car accident, regardless of who is responsible. In some cases, if you were not at fault for the accident, you may be entitled to statutory accident benefits and still be able to file a tort claim against the responsible party.

What if you have been injured in a motor vehicle accident but you don’t own a car insurance policy?  In this situation, if you have been injured but you don’t have your own insurance policy and you are not listed on someone else’s policy, you can still make a claim if you have been injured. For instance in a bicycle or pedestrian accident where you have been hit by a vehicle, then you would make a claim with the insurance company of the vehicle that hit you.  Or if you are the passenger in someone else’s vehicle when you are injured then you would make a claim with the insurance company that insures the vehicle.  We see this commonly with passengers riding with family, friends, cabs, Uber or other car hire services.

Ontario’s no-fault system of car insurance allows you to recover accident benefits, but those benefits may not always be clear-cut. In fact, they may also be disputed by the insurance company. It’s important to understand the requirements involved, as well as consult an experienced personal injury lawyer who can help you navigate the accident benefits process.

What Sorts of Benefits Might You Receive?

Generally, accident benefits are classified into one of three categories: minor injuries, non-catastrophic injuries, and catastrophic injuries.

Examples of minor injuries may include whiplash or other soft tissue injuries. Broken bones, significant muscle tears, and other impairments that affect your ability to function are examples of more serious, but non-catastrophic injuries.

A catastrophic injury is one that severely impacts your life, causing life-altering changes. Paraplegia or quadriplegia, severe brain impairment, or amputations, for example.

There are various types of benefits under Ontario’s accident benefits system:

  • Medical, rehabilitation, and attendant care benefits provide reimbursement for necessary medical treatments and rehabilitation costs that result from your accident, along with an attendant to care for you either at home or at a healthcare facility.
  • Housekeeping and home maintenance benefits, meanwhile, can provide reimbursement for someone else to carry out your household responsibilities. However, unless you have sustained a Catastrophic injury, as defined by the applicable legislation, you must purchase this coverage as an optional benefit prior to your accident.
  • Income Replacement, Non-Earner or Caregiver Benefits OCF-10,
    • Income replacement benefits of $400 weekly are available if you are substantially unable to perform the essential tasks of your employment after your accident. This benefit requires that you demonstrate being presently employed or self-employed or were so employed for at least 26 of the 52 weeks preceding the accident.
    • Non-Earner benefits provide compensation if you are completely unable to carry on a normal life, and do not qualify for an income replacement or caregiver benefit.
    • Caregiver Benefits provides compensation if you are required to leave work to care for an injured member of your household.
  • Death and funeral benefits are available to the spouse and dependents of a victim of an accident. They are typically paid out as a lump sum, offering $25,000 to a spouse, $10,000 to each dependent, and up to $6,000 towards funeral expenses.

What Documentation Will You Need to Complete?

Unfortunately, Accident Benefit claims require a substantial amount of paperwork and documentation.  The insurance company will generally provide you with these forms and you can also find them at the Financial Services Commission of Ontario – Auto Insurance Claim Forms (OCF Forms)

You will, of course, need to file an Application for Accident Benefits (OCF-1), along with a form that details your expense claims (OCF-6).

Additionally, your employer will likely need you to fill out a form to confirm your income; an Employer’s Confirmation Form (OCF-2), and your medical provider will need to complete a Disability Certificate (OCF-3) regarding their assessment and whether they feel you are unable to work and noting your limitations as a result of your injuries.

Treatment providers such as Physiotherapist, Massage Therapist or Psychologist for example will need to complete a Treatment and Assessment Plan (OCF-18) that outlines a specific treatment plan including a proposed budget that addresses your injuries and submit this to the insurance company for approval.  Under the Minor Injury Guidelines , Accident Benefit guidelines only provide initial treatment for medical and rehabilitation benefits up to $3,500, whereas non-MIG injuries can have access up to $65,000 in benefits.

If you choose to apply for several types of benefits — say, medical, income replacement, and attendant care — you will likely need to fill out various forms for each type of benefit sought. In some cases, you may also need to provide a sworn statement describing the circumstances of your car accident and the resulting personal injuries you have suffered.

Because the accident benefits system can be complex and difficult to navigate, the help of an experienced personal injury lawyer can be invaluable. They can help you accurately assess your damages, collect evidence to back up your claim, and draft and file the documentation you need to recover your benefits. They can provide legal advice and ensure your rights remain protected. If your case ends up going to mediation or arbitration, they can walk you through that process as well.

A knowledgeable personal injury lawyer will help through the process of negotiating with the insurance company, whose goal is to minimize payout as much as possible. In some cases, an insurer may take an unreasonable position, refusing to pay the accident benefits to which a victim is entitled.

Insurance companies often have significant resources on their side, and hiring a lawyer can help ensure that your interests are properly represented. This way, you can focus on your health and recovery, and on putting your life back together after your accident. First, you need to report the accident to your insurer as soon as possible, and your claim needs to be filed within a specific deadline. An experienced lawyer will help you with this process.

How Can Derek Wilson Personal Injury Law Help With Your Accident Benefits?

At Derek Wilson Personal Injury Law, we have decades of experience working on all types of personal injury claims, and we pride ourselves on doing our best for our clients. We work with our clients to ascertain and value the damages in each unique case.

We offer a free initial consultation, and no payments are required until I have successfully recovered money on your behalf. For a free consultation with Ontario motor vehicle accident lawyer Derek Wilson, call us at 855-769-0418 or fill out an online request form.

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