It’s Raining Paperwork

Right after your car accident, an insurance company will send you a bunch of complicated forms to complete. When we say that the forms are complicated we mean it. The forms are so complicated, that they change once every 4 years because government debates on ways to simplify them ( although they never have!).

These forms together are called an Accident Benefit Package. The Accident Benefit Package must be completed and submitted to the car insurance company within 30 days from the date of the car accident. So don't sleep on getting these forms completed with the assistance of a personal injury lawyer, and then submitted to the insurance company.

Of note, not all the forms can be completed on your own. Some of the forms need to be completed by your treating doctor following the accident. Some of the forms need to be completed by an Occupational Therapist. Some of the forms need to be completed by your employer. Speak with your lawyer before completing the forms so you know what to do.

TIP: Do NOT complete the forms on your own. Get a personal injury lawyer to help you.

The Accident Benefits Package will include the following forms:

Copies of these forms have deliberately been omitted from the Goldfinger Guide for Car Accident Victims© because these forms are constantly changing. Submitting an out of date form may nullify your accident benefit claim and your entitlement to compensation, so make sure that you're completing the right forms. The best way of making sure you're completing the right forms is by visiting our website atwww.goldfingerlaw.com, or by visiting the Financial Services Commission or Ontario's website at www.fsco.gov.on.ca and by searching for "OCF FORMS".

What are Accident Benefits and Why do I Have to Fill Out All of These Silly Forms?

Ontario has a "no fault" system of auto insurance. Nobody other than a personal injury lawyer understands what this means, or how this works.

Here's an explanation of "no-fault" insurance in Ontario in a nutshell:

Regardless of whose fault the accident is, you're entitled to a variety of "accident benefits" arising from the car accident. These " accident benefits" will be paid for by your own insurance company, regardless of fault for the accident. These "accident benefits" are not damages for pain and suffering. They are completely different. More on damages for pain and suffering later in the Goldfinger Guide.

If you were hit while as a pedestrian or cyclist and there was no car insurance in the household, then the other driver's car insurance will be responsible to pay for these "accident benefits". If the other driver was driving illegally without car insurance while you did not have any car insurance either, then the "accident benefits" will be paid for by the Ontario government through the Motor Vehicle Accident Claims Fund.

There is a large complicated hierarchy on whose responsibility it is to pay for "accident benefits". This has been the subject of many disputes between insurers (not accident victims so you don't have to worry). In legal terms, these disputes are called "priority disputes" and they happen all the time because insurance companies would rather not pay out benefits if they don't have to.

So what will accident benefits get me?

Don't confuse accident benefits with an award for pain and suffering. Accident benefits and damages for pain and suffering are two completely different things.

Accident Benefits cover a limited amount of headings and a limited amount of money which is set out in the Statutory Accident Benefits Schedule (SABS). The amount of benefits and what they cover is constantly changing. If your car accident happened in 1995, then your accident benefits and the quantum of those benefits would be different that the benefits available in the present. The reason these accident benefits are constantly changing is because the government is looking for the perfect balance to meet the needs of insurers vs. the needs of accident victims. The government has yet to achieve that balance.

Today's accident benefits cover:

  • Up to $50,000 in medical/rehabilitative benefits for non-catastrophic cases (physiotherapy, massage, occupational therapy, chiropractic treatment and other services not covered by OHIP) for up to 10 years
  • Up to $400/week for income replacement benefits
  • Up to $1,500/month for attendant care benefits for non-catastrophic cases
  • Up to $100/week in housekeeping and home maintenance benefits
  • $250/week for non-earner benefits
  • Up to $50,000 for death benefits for the victim's spouse
  • Up to $8,000 for funeral benefits
  • Up to $3,500 in medical/rehabilitative benefits if the insurer deems your injuries to fall in to the Minor Injury Guidelines (MIG)

Next Page: What is a catastrophic accident? >>

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