Car Accident Benefits and Claims in Ontario

Ontario Car Accident Benefits & Injury Claims

When you have been in a car accident, there are a million things that are going through your mind. Not only about car accident benefit claims, but also you are worried about the state of your vehicle, you are worried about your own health, you worry how this is going to affect your family.

You may simply be stressed beyond what words can describe. While you may be injured and have gotten into a car accident that is changing your entire life, there are accident benefits that you may be eligible for.

Whether you were involved in a car accident to a distracted driver or weather issues, a car accident is a car accident, and it can cause serious health issues and problems for the future.

What Are Car Accident Benefits?

Car accident benefits are a part of the Statutory Accident Benefits Schedule (or SABS) that is the regulation of these benefits among insurance companies.

It should be noted that these benefits can be given to any person involved in a car accident, regardless of who was found to be at fault.

Therefore, these benefits are here for anyone who has been injured to the point that their overall lives are being affected.

What You Need to Know

When it comes to claiming these benefits during a car accident, there are several things that you need to know in order to make this process as easy as possible.

  1. You have to report your injuries to the insurance company as well as the damage to the car and the property damage that occurred during this accident.
  2. You need to report your injuries to the insurance company within 7 days after the accident happens.
  3. Your insurance company should send an Application for Benefits Form known as an OCF-1 Form that you have 30 days to complete once you receive this.

Remember, claiming this benefit is not like you are trying to get restitution for the accident and treating this as a personal injury. These are benefits that are available to everyone and anyone who has been involved in an accident.

Another important fact that you need to note is that you can be eligible for these benefits even if you were not the one that was injured in the car accident.

If you are the caregiver of someone who has been injured in a car accident, then you may be eligible for these benefits as well.

Are there Exclusions?

As with everything, there are some exclusions that a person needs to be aware of. Since these benefits are from your insurance agency, they are going to use a full investigation of the accident to ensure that they are giving their benefits to someone who truly needs them and did not in any way try to scam the system.

Some of the exclusions that can be used as a basis for dismissing your claim to benefits include:

  • Any person who knew they were driving the car without valid insurance
  • Any driver that did not have a valid driver’s license
  • Any driver who excluded from driving under an insurance policy
  • Any driver or passenger who know that the driver was driving this vehicle without the owner’s consent
  • Anyone who used a material that misrepresented the insurance company
  • Anyone who was engaged in a criminal act at the time of the accident for which they can be convicted of committing

There are other instances in which these benefits can be denied. However, the above reasons are often the most common that are given to those who try to get these benefits.

Types of Car Accident Benefits in Ontario

There are several different types of accident benefits that you can be eligible for. However, not all of these are going to apply to your individual situation. Here are examples of what can be earned:

  • Income Replacement Benefits: This is meant to compensate you for the loss of your income when you cannot work due to the injuries that you received from the car accident.
  • Non-Earner Benefit: This is for those who may not work but are unable to carry on with their regular tasks. This benefit is meant to compensate you for 26 weeks after the accident.
  • Caregiver Benefit: This benefit is for those who cannot carry on as the main caregiver for a member of the household who is under the age of 16 or who is over the age of 16 and has a disability. This is a weekly payment that is given while you are recovering from the accident.
  • Medical and Rehabilitation Benefit: This benefit is given to those who need medical or rehabilitation care that is not covered by the government health plan or supplementary health plan that you have.
  • Attendant Care Benefits: If you require a caregiver or nurse attendant after the car accident, this benefit is meant to cover this expense.
  • Other Expenses Benefit: This benefit is meant to pay for other expenses that you may have due to the car accident. For example, educational expenses, cost of housekeeping, home maintenance or repair. It can even be used for replacing lost or damages that occurred due to the car accident.
  • Death and Final Payments Benefit: This is given to the survivors of a person who was killed in a car accident and is meant to help pay for the funeral expenses.

You can qualify for more than one of these benefits, and this is something that you will have to consider when filing a claim.

Making a Claim

Once you have been in a car accident and have contacted your insurance company, the OCF-1 Form will be sent to your home.

You will need to complete the required information. This is pretty straightforward and usually does not cause issues for those who are applying for these benefits.

Remember to read the questions thoroughly and answer honestly, as the medical evidence they collect will tell if you are not being completely honest on this application.

Next, you will want to complete the Disability Certificate that must be completed by a healthcare professional.

This is why it is imperative that you keep going to the doctor after the car accident so that he or she can confidently document all your injuries and the results of these injuries to your life.

The medical professional will go through a series of tests to ensure that you do meet the criteria for getting these benefits for the medical issues caused by the car accident.

It could take several weeks to hear back about your claim, as some people have waited over a month to get an answer. What happens if your claim is denied? They will often give you a reason as to why this happened.

For many people, it may be nothing more than a clerical error on their part. For others, it could be a reason that makes no sense.

That is when the person may want to consider legal help.

Here at Conte Jaswal, we want each person to get what they deserve when they have been in a car accident. We are a personal injury law firm that puts your best interests at heart.

Contact us today if you are struggling after being involved in a car accident.
Contact us today for a FREE Consultation.

Learn more about Conte Lawyers

View More Articles