Accident Benefits

What are the first steps I should take immediately after an accident?

  • Be sure that you or your passengers if any do not have any serious injuries and are able to move without any restrictions
  • If after the accident you are in a good shape, check the occupant(s) of the other vehicle to find out if anybody is in need of emergency services
  • If you have any suspicions that somebody is hurt or the other driver might be impaired call 911 immediately. Do not move anybody who is injured, you can aggravate their condition with this action.

What should I do next?

  • Collect all the information about the other driver involved in the accident: name and making of the automobile, name of insurance company including policy number and expire date, plate’s numbers and any other details you consider relevant information; if you have a camera handy takes as many pictures as you deem necessary, they will be very useful to back up any claims.
  • Contact your insurance company, report the accident facts and provide the information you gathered about the other driver.

The police came to the scene of the accident, what is the best way to approach them?

  • Be honest and just express the facts, do not give any personal opinion or blame your self or the other driver
  • It is very important if the Police ask you to fill an accident report to request a copy of it and be sure that all information related to the agent in charge of the incident is given to you, otherwise, in the future you will need to request that information to the Police Headquarters.

What could happen to me if I leave the scene of an accident?

You maybe prosecuted according to Section 252(1) of the Criminal Code and if found guilty, face the possibility of 5 years of imprisonment.

Should I visit my family doctor the day after the accident?

Lots of injuries are not felt or detected right away after an accident therefore is the vital importance that you visit your doctor in order to assess your state of health.

If I believe that I sustained middle or major injuries, when is the best time to contact a personal injury lawyer?

Do it as soon as possible in order to start your claim and apply for accident benefits.

How much should I pay to consult about my situation?

We do not charge for the first consultation, we carefully analyze your case and give you the options you have to succeed with your potential claim.

What are Statutory Accident Benefits?

If you are injured in a car accident you may be entitled to the following benefits:

  • Income replacement:

80% of net weekly earnings up to $400.00 dollars per week; for a maximum of 104 weeks

  • Non-earner:

$185.00 dollars per week for a maximum of 104 weeks, 6 month deductible applies

  • Medical & Rehabilitation:

No more than $100,000 Dollars for a period of 10 years

  • Caregiver:

$250.00 dollars per week for the first child, and $50.00 dollars for any successive children, for a maximum of 104 weeks. Only children under the age of 16 are entitled to this benefit.

  • Attendant care:

$3,000.00 per month for a maximum of 24 months, Monthly payments according to specific regulations

  • Other expenses:

Benefits pay for some expenses incurred such as: home maintenance, housekeeping, repair of replacement of items damaged or lost at the time of the accident and some educational expenses.

I have a very bad accident and major injuries; do I have the right to sue?

Yes, if the other driver was at fault, and you meet the requirements an award for damages will be given to you. You have the right to sue for pain and suffering but you must meet the threshold.

Can you describe the term “Meet the Threshold”

To meet the threshold, the test is often, whether or not the injured person sustained a “permanent, serious impairment of an important physical, mental or psychological function” or “a permanent serious disfigurement”.

How difficult is to get compensation?

The “no fault” System is very complicated, there are so many regulations and requisites that only an experienced lawyer can understand at full. Do not get confused about what you read or hear; large amounts are rarely awarded if the process is not handled properly and the information is not classified accordingly. We always make sure that every step is carefully examined and analyzed to the best for our client.

If I am compensated, there will be any deductions to the amount awarded?

One of the restrictions on an injured person’s right to sue is the deductible. Simple put, deductible is an amount of money that is subtracted from the amount awarded for pain and suffering. In Ontario the amount is $30,000.00. Is very important to emphasize that this deductible does not apply when the amount awarded is superior to $100,000.00

If I file a personal injury claim, will we settle out of court or go to trial?

Many injury cases can be settled out of court. A lot depends on what the insurance company offers as a settlement for your claim. As you representatives if we believe that the amount is fair to you, we will settle out of court. But if the offer is unacceptable, we may take the case to trial

What about my family?

Your family member also has a right to sue if one of the members dies or sustained serious injuries; the prime example is the bread winner not able to support the needs of children and wife. Damages may be awarded for lose of care, guidance and companionship.

What do I do with the legal documents which the Motor Vehicle Accident Claims Fund has forwarded to me and which appear to deal with a motor vehicle accident?

You must contact your lawyer or the solicitor for the plaintiff (the person making the claim against you).

What if I disagree with the claim being made against me as the uninsured motorist?

You must file a written dispute with the Fund or with the appropriate Court. You may also wish to consult your own lawyer.

My property (i.e. bicycle, wheelchair) was damaged by an uninsured driver. Can I make a claim with the Fund?

Yes, under certain circumstances. You should know, however, that the Fund requires specific information about the damage, its location and insurance details on your property before it can consider your claim.

Can I collect accident benefits from the Fund?

Only when no other source of automobile insurance recovery is available. If you have contravened the Compulsory Automobile Insurance Act then your benefits may be restricted.

How long does it take to get my first cheque?

If we have received all of the required information, you can expect to receive your first cheque within 14 days of processing your claim for accident benefits.

Why am I indebted to the Motor Vehicle Accident Claims Fund?

You were the owner and\or driver of an uninsured vehicle involved in an accident, in which someone was hurt, or property was damaged. Because you were uninsured, the party suffering the loss in the accident requested that the Fund pay for their damages on your behalf. You must now repay this amount to the Fund.

Why was my driver’s licence suspended?

The Fund paid for property damages or personal injuries caused by the uninsured vehicle of which you were either the owner or the driver. The Motor Vehicle Accident Claims Act requires that a suspension be recorded with the Ministry of Transportation against the owner and driver of the uninsured vehicle when a payment is made from the Fund on their behalf, until the amount is repaid in full or a satisfactory repayment schedule is established.

If I was not both the owner and driver of the vehicle, am I responsible for the entire debt?

Both the owner and driver are responsible for paying the full amount of the debt.

How do I get my driver’s licence reinstated?

Repay the full amount of your debt, or establish an acceptable repayment schedule by completing the Fund’s Repayment Application form and provide proof of your income and expenses. If you are the owner of a motor vehicle, you must have your insurance company forward an Ontario Certificate of Insurance to the Fund.

Why must I file an Ontario Certificate of Insurance with the Fund?

When a balance is owed, the Motor Vehicle Accident Claims Act requires that the Fund obtain the certificate of insurance before reinstating a suspended driver’s licence. This confirms that you are fully insured and protects the Fund from further liability should you become involved in another automobile accident.

What will my monthly repayment amount be?

Monthly repayments are established by law, and are to be at least 10% of your gross monthly income. A Collections Officer from the Fund will establish the exact amount in consultation with you.

After I have arranged to repay, when will my licence be reinstated?

The Ministry of Transportation will advise you of your reinstatement two to six weeks after they receive the Fund’s request for licence reinstatement.

Do I have to pay a fee to the Ministry of Transportation to have my licence reinstated?

Currently the Ministry of Transportation charges a fee of $150.00 for each reinstatement processed.

How will I know when my repayments are due and where I should mail them?

Your first repayment must be made to the Fund before your driver’s licence can be reinstated. A further repayment is due within one month. You will receive a statement and a return envelope fifteen days before each subsequent repayment is due, similar to credit card or utility bills.

Are there any other options available to me if I cannot repay the Fund?

In certain cases the Fund accepts settlements of less than the full amount owing if the debtor can show that paying the entire debt would cause undue hardship or if the settlement is otherwise satisfactory.

What if I refuse to pay?

The Fund will suspend your driver’s licence, and if it has paid a judgment on your behalf, a Writ of Seizure and Sale will be filed against you. If you are the owner of property, the Fund can seize and sell the property to pay off your debt. If you are employed, the Fund can garnishee your wages.

What happens if I declare bankruptcy?

The bankruptcy process renders any judgment null and void, limiting the Fund’s legal sanctions. However, the Fund’s authority to suspend your driver’s licence for non-payment is unaffected by the bankruptcy. The Fund can still maintain the suspension of your driver’s licence until you establish and adhere to an acceptable repayment schedule.

Does the Fund charge interest on outstanding debts?

Currently the Fund does not charge interest. However, in the future there may be interest or late payment charges, and a fee for returned cheques for “insufficient funds,” “stopped payments,” or “closed accounts.”

Insurance company has stopped paying accident benefits. What should I do?

If the insurance company refuses or stops paying benefits, they must give you written notice, including reasons for their decision. You can apply for mediation to specially designated branch of the Financial Services Commission of Ontario (FSCO) called Dispute Resolution Services (DRS). Mediation at FSCO is a mandatory first step in dispute resolution. An impartial FSCO mediator will help the involved parties reach a mutually agreeable resolution of their dispute.

What application forms I need to fill in to apply for mediation?

If you decide to apply for mediation, you must complete and send to the Dispute Resolution Services (DRS) of the Financial Services Commission of Ontario (FSCO) an Application for Mediation – Form A within TWO YEARS after you receive the insurer’s refusal.

What if the dispute is not resolved in mediation?

After the mediation, the mediator will send you a Report of Mediator listing the issues the parties agreed on and the issues that remain in dispute. If the dispute is not resolved in mediation, and you decide to apply for arbitration, you must complete and send us an Application for Arbitration – Form C within TWO YEARS after you receive the insurer’s refusal or within 90 days of the date of the Report of Mediator, whichever is later.

Can I apply for arbitration at once and skip mediation?

You cannot apply for arbitration unless you first complete mediation at FSCO and mediation fails.

What if I want to appeal the arbitrator’s order?

You may appeal the arbitrator’s order within 30 days on a question of law. If you decide to appeal, you must complete a Notice of Appeal – Form I and send it to FSCO and the other party. You may also wish to consider applying for neutral evaluation or variation/revocation.

Where can I get help?

Call us, email us or write to us! It’s the easiest way. However, if you decided to do it yourself then the Dispute Resolution Practice Code and Practice Notes describe the rules for participating in DRS proceedings. Guidelines for accident benefits and the claims process are given in the Superintendent’s Guidelines and can be found at: http://www.fsco.gov.on.ca/english/pubs/guidelines/Default.asp

Do I need a lawyer dispute resolution at FSCO?

You do not need a lawyer for dispute resolution at FSCO. You can choose to represent yourself. You are also entitled to have a friend or family member help you in an informal and unpaid manner, but only if the person receives no compensation directly or indirectly. However, disputes can become complicated and most insurance companies have lawyers representing them at arbitration and appeal, you should consider consulting one of our lawyers or licensed paralegals.

How much dispute resolution cost?

FSCO does not charge claimants for participating in mediation. If mediation does not resolve the dispute, a claimant must pay $100 to apply for arbitration, and $250 to start an appeal. There are different charges for insurers. At arbitration, most claimants and insurance companies will incur certain arbitration expenses, including legal fees, fees charged by doctors and other experts for preparing reports, witness, and other fees.