Personal Injury F.A.Q.’s

  1. I have been involved in a motor vehicle accident, what should I do?
  2. What is a claim for Accident Benefits?
  3. Can I make a claim for Accident Benefits, even though I do not have an automobile insurance policy?
  4. My insurance company has denied my benefits in my Accident Benefits claim, what do I do?
  5. What do I do if I have been offered a Full and Final settlement from my insurer in my Accident Benefits claim?
  6. How much will my settlement be?
  7. What is a limitation period?
  8. How long does a typical personal injury case take?
  9. Do I have the right to sue the other party involved?
  10. What if I am at fault for my accident or injury?

 

Personal Injury F.A.Q.’s

1. I have been involved in a motor vehicle accident, what should I do?

    • Seek medical assistance immediately
    • Try to collect the personal information of the parties involved. This should include name, address, vehicle information, phone number and insurance policy. If any a witness or witnesses are/were present gather their information as well.
    • File a Motor Vehicle Collision report with the police within 24 hours of the collision if the police do not attend the scene and prepare an accident report.
    • Report the physical property damage and any injuries to your Insurance Company within 7 days of the accident

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2. What is a claim for Accident Benefits?

An Accident Benefits claim is a claim that you would make to your own automobile insurance company for benefits that you may be entitled to under the terms of your automobile insurance policy, if you are involved in a car accident. Depending on what benefits you have purchased, these benefits may include:

    • Income Replacement Benefits (IRB): You may be entitled to claim this benefit to replace your loss of income for up to 70% of your gross weekly income prior to the accident, to a maximum of $400.00 per week. This amount can be higher if you purchased optional benefits.
    • Non-Earner Benefit: You may be entitled to a maximum of $185.00 per week if you are not employed, or a full-time student, at the time of the accident. Your entitlement to this benefit is addressed 6 months after your claim has commenced.
    • Caregiver Benefits: You may be entitled to this benefit to a maximum of $250.00 per week, if you are the primary caregiver for a person in need of care, plus $50.00 per week for each additional person requiring care. The entitlement to this benefit is optional and must be purchased under your policy. Furthermore, this benefit is only payable if the cost for replacing a caregiver is incurred as an expense to you.
    • Housekeeping Assistance: You may be entitled to claim housekeeping assistance for a maximum of $100.00 per week, should you require assistance with housekeeping or home maintenance activities you normally did prior to the accident. Again, the entitlement to this benefit is optional and must be purchased under your policy. Furthermore, this benefit is only payable if the cost for using a housekeeper is incurred as an expense to you.
    • Attendant Care Benefit: You may be entitled to compensation to hire help from another person who can care for your personal needs. This includes taking care of your personal hygiene, dressing and feeding.
    • Medical and Rehabilitation Benefits: You may be entitled to various forms of treatment to aid in your physical and mental recovery following a motor vehicle accident. This may include physiotherapy, chiropractic treatment, massage therapy, acupuncture and other modalities, as well as psychological treatment, driver’s rehabilitation etc.

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3. Can I make a claim for Accident Benefits, even though I do not have an automobile insurance policy?

If you do not have an auto insurance policy, there are certain provisions which may still allow you to claim for accident benefits under another valid policy of insurance. Your claim may be handled by the Insurance Company of a spouse, employer, the driver of the vehicle in which you were a passenger, or even the third party driver in certain cases.
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4. My insurance company has denied my benefits in my Accident Benefits claim, what do I do?

If your benefits have been denied, you are entitled to apply for Mediation with the Financial Services Commission of Ontario (FSCO), at no charge to you. Mediation is a form of alternative dispute resolution, which allows for an open discussion of matters in dispute between yourself, your lawyer, and your insurer. The Mediation is usually done by way of a telephone conference with an appointed FSCO mediator, who is assigned to your matter, to aid in a discussion for resolution of your claim on a partial or full and final basis.
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5. What do I do if I have been offered a Full and Final settlement from my insurer in my Accident Benefits claim?

The full and final settlement of your claim is a binding contract in which your insurer offers you monetary compensation to resolve your matter. Once signed, you will not be able to seek payment for any benefits owing to you, or that may arise in the future as a result of your automobile accident, so you must be sure that you are getting a fair settlement.
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6. How much will my settlement be?

Every case is unique and is based on a different set of facts. Your case will need to be assessed to determine the potential value and exposure, to determine a reasonable settlement.
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7. What is a limitation period?

In order for you to commence a claim against another party, you must abide by certain legal time frames. Failure to do so may prevent you from being able to sue or recover compensation. As a general rule you have 2 years from the date of your accident, or date from which time you discovered you are injured, in which to sue. It is best to obtain legal advice as soon as possible to determine your limitation period.
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8. How long does a typical personal injury case take?

Personal injury claims can take anywhere from several months to several years to resolve. We need to look at several factors in considering the length of time it takes to resolve. Some factors include:

    • The cause of the injury
    • The nature and extent of your injury
    • Whether you have an income loss, and inability or restriction to return to work
    • How long will it take for you to reach maximum medical recovery
    • How many parties are involved
    • How long you take to seek legal advice or legal representation
    • The legal time limitations
    • The type of judicial system under which your claim will proceed, (Small Claims Court, Superior Court of Justice , or the Financial Commission of Ontario)

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9. Do I have the right to sue the other party involved?

Yes, in some cases you can issue a claim against an at-fault party that was involved in your personal injury. Depending on the circumstances of your case, you may be entitled to sue for your pain and suffering, loss of income, out of pocket expenses, medical expenses etc. that arose as a result of the incident.
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10. What if I am at fault for my accident or injury?

If you are clearly at fault in a auto accident or other type of personal injury, you may not be able to sue. For injuries resulting from a motor vehicle accident, even in cases where you are not at fault, you must fall within certain exceptions of the law to be able to sue an at-fault driver, for example:

  • You must be suffering from a permanent serious disfigurement, or a permanent serious impairment of an important physical, mental or psychological function; and
  • Your injuries must be valued as significant enough to surpass the statutory deductible of $30,000;

If you believe that another party is at least partly responsible for your injuries in any type of personal injury, you are most likely still able to sue them. It is best to seek legal advice from our office to discuss your situation.
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