Accident Benefits Lawyers in Ontario

Statutory Accident Benefits (also called “first party benefits”) provide benefits if you are injured in a car accident, regardless of who is responsible for the accident.

The types of benefits that can be provided include:

Income Replacement Benefit

If you qualify for this benefit, it compensates you for lost income to a maximum weekly amount. This is a tax-free income benefit.

Caregiver Benefit

If you qualify for this benefit, it compensates for some expenses incurred when you are unable to continue as the main caregiver for someone who lives in your house.

Non-Earner Benefit

This benefit provides compensation to those who do not qualify for the income replacement or caregiver benefit.

Attendant Care

This benefit provides compensation for the cost of having someone provide necessary care for you i.e. a personal support worker.

Medical

This can reimburse you for the cost of medical items not covered under any other medical plans, such as prescriptions that you require as a result of the accident.

Rehabilitation

This benefit covers the cost of treatment, such as physiotherapy, massage therapy and other rehabilitation treatments.

Other Expenses

You may be entitled to compensation for other expenses such as the cost of family visiting you during your recovery/treatment, housekeeping and home maintenance, to repair or replace items damaged or lost in the accident, and lost educational expenses.

Death Benefit

If you die as a result of the accident, your family may be entitled to compensation as well as payment for some funeral expenses.

It is important to note that depending on the level of severity of your injury, certain benefits may or may not be available to you. It is vital to speak with a lawyer so you can understand what benefits are available to you and so you understand what documents are needed for the insurance company to process your claim.

If you are hit by a car while riding your bike, you can apply for accident benefits under your own insurance policy, if you have one. If you do not have your own policy but are insured under the policy of a family member (in your household), you can apply for benefits under their policy.

If you have no insurance, you would make an application for benefits to the insurance company of the at-fault driver.

In some instances, when you have no insurance of your own/no policy you are covered under, you would have to make a claim through the Motor Vehicle Accident Claims Fund (MVAC).

For example:

• If you were the victim of a hit-and-run and you have no information about the driver
• If the vehicle was stolen and the driver not insured
• If the driver was uninsured with no access to insurance

A personal injury lawyer can help you to determine who the appropriate insurance company is to make your application to.

Under the Statutory Accident Benefits Schedule (SABS), your insurance company is entitled to request insurance examinations, whether it be a paper review or an in-person examination.

According to the SABS, you are expected to attend the in-person examination and submit to all reasonable testing requested by the assessor (physical, functional, mental, psychological).

The insurer is supposed to make reasonable efforts to schedule the examination for a date, time and location that is convenient for you. They may also provide transportation or reimburse travel expenses if applicable. 

Before you attend an examination, you should speak with your lawyer.

The insurance company is only allowed to arrange an insurer examination if they have a valid and reasonable medical or satisfactory reason to do so. It is important that you speak with your lawyer about any correspondence you receive from your insurer to make sure you understand what is required of you.

Yes. This is quite common.

A personal injury lawyer who practices this type of law would be able to help you with both your tort claim and your accident benefits claim.

Our lawyers have experience helping clients who have both accident benefits claims and tort claims simultaneously.

If a car strikes you as a pedestrian and you are injured, you would be able to apply for accident benefits through your own insurance policy, if you have one. If you do not have your own policy but are covered under a family member’s policy in the same household, you would apply to their insurance company for benefits.

In the event that you have no insurance coverage at all, you would look to the insurance company of the at-fault driver.

What happens if that driver didn’t have insurance or if the car was stolen?

Or if it was a hit and run? In these cases, and where you do not have any information about the other driver/their insurance company, you would have to apply for accident benefits through the Motor Vehicle Accident Claims Fund.

There are different “levels” of medical and rehabilitation benefits. The Minor Injury Guideline (MIG) is the lowest tier, where the maximum amount to be paid is $3,500 and you are expected to recover in 12 weeks.

It is a “guideline” for how much treatment you need and how long your recovery should take, based on your injuries. However, your injuries may be more severe than your insurance company realizes.

According to the Statutory Accident Benefits Schedule, a minor injury “means one or more of a sprain, strain, whiplash associated disorder, contusion, abrasion, laceration or subluxation and includes any clinically associated sequelae to such an injury”.

Your recovery may be taking longer than expected and your treatment providers may feel you need further treatment outside of the MIG.

It is possible to demonstrate to your insurer that your injuries fall outside of the MIG. For example, if you injured your knee and what was thought to be a sprain turned out to be a significant tear and surgery is required, you would require a longer recovery period. Your lawyer would help you by ordering your treating physician’s records and providing them to your insurer to demonstrate the evolution of your injuries.

When you are receiving income replacement benefits, your accident benefits insurer might, from time to time, assess your entitlement to benefits and require you to attend medical assessments. A functional capacity evaluation ("FCE") is a specialized assessment that measures your ability to perform a variety of functions and tasks. This includes tests to measure your physical abilities/endurance and range of motion, and tests that measure the consistency of your effort. An FCE is usually conducted over the course of a full day. If you attend an FCE, be sure to make a note of how you feel after the examination, especially if the testing has aggravated your pain levels, and report any symptom aggravation to your doctors/treatment providers.

If you are injured and unable to work, it can cause a huge financial strain and a lot of stress. There are a few options that can be looked into to cover lost wages including getting a loan from a reputable lender. At Aaron Waxman & Associates, can help you to get that loan to help you until your settlement goes through. Once that happens, part of your settlement funds will be used to pay back the loan.

When someone is involved in an accident there are two avenues that can be taken for compensation due to injuries; accident benefits (AB) and tort.

In Ontario, almost anyone that is involved in a motor vehicle accident with get accident benefits through your insurance company. AB covers things like medical bills, rehabilitation, attendant care and income replacement. 

A tort claim occurs when the victim’s injuries are 100% caused by another party. It’s brought against a third party (usually the driver if the other vehicle involved in the accident) rather than the insurance company, and covers things like pain and suffering, estimated future income lost and other expenses not covered by the insurance company.

Every personal injury case is different, therefore the amount you can get from you accident benefits will vary. Things that are considered before determining how much you can get include the severity of your injuries, how much it has impacted your everyday life and your level of responsibility in the accident.