Motor Vehicle Accident Claims - Important Questions and Answers:

Who can claim benefits and who can sue ?
In Ontario, every person, every driver, every passenger, every bicyclist and every pedestrian who has been injured by a motor vehicle has a right to claim accident benefits (regardless of who is at fault for the accident) and to advance a claim against an at fault driver. This includes people with their own insurance and those without their own insurance.

What if I don't have insurance ?
The insurer of the driver will extend coverage to you and respond to your claims. If they don't have insurance, the insurer of the other car will extend coverage to you. If they don't have insurance, the government has a fund, the Motor Vehicle Accident Claims Fund, that will extend coverage to you.

What claims do you have ?
You have two types of claims - the first is a claim for accident benefits (benefits to help you that having nothing to do with fault) and the second is a claim against the at fault driver.

What benefits can I claim for ?
Accident Benefits are provided by the insurer of the vehicle to any person injured in the accident. There are many benefits available to injured persons. You may qualify for regular benefits or catastrophic benefits depending on the severity of your injuries. Income Replacement Benefits to cover lost income. Housekeeping to pay for the costs of maintaining your home. These benefits are normally paid up to $100.00 per week for two years, or for catastrophic claims, for life. Attendant care to pay for the cost of caregivers for you while you are injured. These benefits are normally paid up to $3000 per month for two years, or for catastrophic claims, up to $6000.00 per month for life. Medical / Rehabilitation benefits up to $100,000.00 for ten years, or for catastrophic claims, up to $1,000,000.00 for life.

Catastrophic Impairment Ratings are complex and require the involvement of lawyers and experts who understand this system and are experienced in having injured persons assessed for these benefits. Case manager services are available to assist catastrophically injured persons deal with their recovery and in moving forward with their lives.

Catastrophic Impairment
It is essential to determine at the outset whether or not you meet the definition of catastrophic impairment. This designation will expand the scope and depth of benefits which you can access in your recovery

Who can sue ?
Any driver, passenger, pedestrian or cyclist injured in a car accident that was caused in part or entirely by another person. Even pedestrians who are struck by a car, who do not have their own insurance, can claim accident benefits from the insurance company of the driver who hit them and may sue the at fault driver.

What if I don't have any insurance, can I still claim benefits and sue ?
Yes. The law obliges the insurer of the person responsible for the accident to extend coverage to you. If that person doesn't have insurance, that the Motor Vehicle Accident Claims Fund will extend coverage to you. In all cases, there is help available.

What if the other person did not have insurance, can I still sue ?
Yes, you can sue them and you have coverage from your own insurer under the "uninsured" policy coverage for situations where the at fault driver did not have insurance. That means that you can sue the other driver and your own insurer will answer the claim.

What if the other person did not have adequate insurance, can I still sue ?
Yes, you can sue them and your own insurer will then respond to the shortfall under the "underinsured" policy coverage

What if the accident is my fault, can I still claim accident benefits ?
Yes. That is what no-fault insurance is all about. Even if the accident is your fault, your own insurer must still provide you with accident benefits regardless of fault.

How soon should I start?
Immediately. You can only claim pre-judgment interest on your damages from the date you give notice of your intention to sue. You can only claim attendant care from the date when you deliver a Form 1 assessment. Accordingly, time is of the essence.