After more than 20 years of being law, Ontario’s no-fault insurance program still causes a lot of confusion. No-fault does not mean that no one is responsible in the event of an accident.
In a no-fault insurance system, the injured party must deal with their own insurance company regardless of who is at fault.
It also means that you are automatically eligible for no-fault benefits. Pedestrians and cyclists who are injured by a vehicle in a collision are also covered. Catherine Shearer, a personal injury lawyer at McKenzie Lake Lawyers in Guelph says, “If you’re in a collision, you should call a lawyer, even if it’s just to know what your rights are. It’s also important to get information surrounding limitations and what you might be entitled to.”
The benefits available might be different for each individual, depending on the severity of the injuries, if another party is at fault, and if they have access to benefits as an employee. Shearer adds, “The different benefits schemes interplay with each other, so it’s important to know from the beginning what you are entitled to and how you access it.”
What benefits are available?
No-fault insurance allows everyone to get basic benefits quickly in the event of an accident. The type of no-fault benefits you will be entitled to depend on many factors, including how your injuries affect your daily living.
Basic benefits include:
- Medical benefits such as physiotherapy, occupational therapy, and prescription medication.
- Rehabilitation benefits
- Income replacement benefits
- Death benefits and funeral expenses
- Attendant care expenses
- Housekeeping and home maintenance expenses
- Expenses related to the collision such as ambulance fees and damaged clothing
It’s important to contact a personal injury lawyer in addition to your insurance provider. Shearer says, “If you only contact your insurance company and submit the completed applications, you may not get the benefits that you need or are entitled to.”
If you need physiotherapy for example, not all treatment providers will provide treatment under the Statutory Accident Benefits provisions.
Submitting forms completed correctly from the start sets the stage for how to claim will be adjudicated. Shearer warns, “If there are some errors or omissions in the forms, that can be held against you. And while the insurance adjuster is supposed to be on your side from day one, they often do what is in the best interest of the insurer despite their duty to act in good faith.”
Limitations on no-fault benefits
You must notify your insurer of your intention to apply for no-fault benefits with 7 days of the accident.
The application forms must be filed within 30 days after you receive them. The paperwork can be overwhelming. That’s why it is important to contact a personal injury lawyer who can guide you through the process. A lawyer will ensure the paperwork is completed correctly and submitted on time.
Consult a personal injury lawyer
Shearer advises, “Whether your injuries are minor or more serious, there is always some benefit in contacting a personal injury lawyer to know where you stand.”
If you need rehabilitation, personal injury lawyers often have working relationships with local treatment providers who have extensive experience with accident benefits and will adjust their rates to ensure that you are receiving the care you need to make a speedy recovery. After the initial shock wears off, you may realize that some of the impairments you are suffering with may be more long term.
Catherine Shearer is an experienced personal injury lawyer who will ensure that you are applying for everything that are eligible to apply for. She will make sure that you are receiving the right treatment from the right providers who have experience with accident benefits.
Working with a local legal team is beneficial because you can have face-to-face contact with your lawyer who knows the treatment providers in your area.
Catherine Shearer would be happy to assist by providing a free, no obligation consultation. It doesn’t hurt to know what your rights are and it can set you up for success down the road.