Safety Tips and What To Do After A Car Accident In Ontario - Boland Romaine LLP

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Safety Tips and What To Do After A Car Accident In Ontario

By Michael Connolly

In an a blink of an eye your life could be changed forever. Car accidents often happen very fast and in that aftermath, your mind is racing as you try to process what just happened and what will happen next. 

If you are involved in a car accident, you are entitled to be paid for the costs of your treatment. You may also be entitled to payment for lost wages and assistance with your day-to-day needs. Ontario’s accident benefits system gives individuals financial relief and coverage for those sustaining injuries in motor vehicle accidents. 

What Are Accident Benefits?

Accident benefits may be claimed by every individual injured in an Ontario car accident from their own or a related auto insurance company, regardless of who is at fault for the collision. For this reason, accident benefits are sometimes referred to as “no-fault benefits.”

How Do I Claim Accident Benefits?

You should inform your auto insurance company about your car accident within seven days. After learning of your car accident, your auto insurance company will send you a benefits package with forms you need to submit. This package will include:

Application for Accident Benefits (OCF-1): The OCF-1 is your initial application for accident benefits. It will ask you to provide some essential information of your claim: your name, date of birth, date of the accident, employment, initial injuries, etc. You must complete and return your OCF-1 within thirty days of receiving the form. Your claim may be affected by any late submissions, which is why we encourage you to contact us soon after your motor vehicle accident.

Disability Certificate (OCF-3): the OCF-3 is a form to be completed by your family doctor or treating healthcare practitioner that addresses any disabilities or impairments following your car accident. It must be submitted in order to claim income replacement benefits, non-earner benefits, caregiver benefits, and/or housekeeping and home maintenance benefits. 

It is important that you provide an OCF-3 to your family doctor and all your treatment providers as early as possible. The OCF-3 is an essential element to claiming the disability benefits described above, and your auto insurance company is not obligated to pay any disability benefits until after it is submitted. A more detailed overview of the benefits you can claim on the OCF-3 is provided below.

What Accident Benefits Can I Claim?

Depending on your accident benefits coverage and the severity of your injuries, you may have access to funds for medical treatment, attendant care, income replacement benefits, non-earner benefits, caregiver benefits, and housekeeping and home maintenance benefits, among other benefits described below.

The amounts and types of benefits you may claim depends on the severity of your injuries. The accident benefit scheme organizes injuries into three broad categories:

Minor Injury 

Non-catastrophic injuries

Catastrophic impairments

The naming of each category is based on insurance industry convention. The amounts you can claim under each category of injury are set out in the Statutory Accident Benefits Schedule (“SABS”) and the terms of the standard Ontario automobile insurance policy, called the Ontario Automobile Policy – (OAP 1) Owner’s Policy. Those who purchase “optional benefits” may be entitled to claim additional benefits above the default accident benefits provided in the standard OAP 1.

Basic Accident Benefits Coverage

In Ontario, the standard accident benefits package provides a foundational level of support for individuals involved in accidents. This package encompasses a range of benefits such as coverage for medical bills, rehabilitation services, attendant care, income replacement, and other necessary expenses incurred as a result of the accident.

Minor Injury Coverage

The SABS defines a minor injury as “one or more of a sprain, strain, whiplash associated disorder, contusion, abrasion, laceration or subluxation” along with “any clinically associated sequealae to such injury.” Common examples are pain and strain or muscles. 

Injuries who have suffered “minor injuries” are automatically placed within the Minor Injury Guideline, which is a treatment protocol that obligates their auto insurance company to pay up to $3,500.00 for medical and rehabilitation benefits. 

However, not all those who suffer minor injuries will be limited by the Minor Injury Guideline: the SABS holds that the Minor Injury Guideline does not apply to those who suffer an impairment that is not a predominately a “minor injury”, or if the individual’s health practitioner determines and provides compelling medical evidence of a pre-existing medical condition that will prevent the individual from achieving maximum medical recovery if subject to the Minor Injury Guideline. 

Non-Catastrophic Injury Coverage

Individuals who have sustained injuries outside the Minor Injury Guideline or have injuries that are more serious than minor ones can access increased policy limits of $65,000.00 spread between medical and rehabilitation benefits and attendant care benefits. This higher level of coverage offers enhanced benefits such as extended rehabilitation, attendant care, and more comprehensive medical coverage. Benefits may be claimed for up to 260 weeks (approximately five years) after the date of your accident. 

Catastrophic Injury Coverage

At the highest level, there is Ontario’s accident benefits that will provide coverage for catastrophic injuries resulting from accidents. The definition of what is and what is not a “catastrophic impairment” is defined in the SABS, but generally includes severe brain injuries, spinal cord injuries, amputations, and other critical impairments. Those individuals found to have suffered “catastrophic impairments” receive a significant increase in policy limits: $1,000,000 spread across medical and rehabilitation benefits and attendant care benefits that may be access for the remainder of their lives. Those who have suffered catastrophic impairments also receive access to additional types of benefits, including case management workers and the housekeeping benefit. Overall, this level of coverage provides a more comprehensive support system to cater to the extensive requirements of individuals grappling with catastrophic injuries.

What Are Medical And Rehabilitation Benefits?

Medical and rehabilitation benefits generally refer to those forms of physical or psychological treatment you may claim from your auto insurance company. Common examples of treatment covered by accident benefits include chiropractic, physiotherapy, massage, psychological counseling, and medication costs. 

However, there are other types of rehabilitation benefits available to those seriously injured individuals, including life skills training, family counseling, social rehabilitation counseling, financial counseling, employment counseling, workplace modifications or devices, home modifications or devices, vehicle modifications or devices, transportation to treatment, as well as assistive devices to improve functionality.

Unless you have suffered a “catastrophic impairment” or purchased optional benefits, your auto insurance company will only pay for medical and rehabilitation benefits for up to 260 weeks (or approximately five years) after your motor vehicle accident.

How We Can Help Protect Your Rights After an Accident

We are personal injury lawyers with a trial record and a reputation for not backing down. We are proud to have successfully taken numerous cases to trial and in some changed the law to better protect and better compensate the public. Our personal injury lawyers have earned the respect of the insurance industry and settled numerous cases justly and fairly.

 

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