As we've discussed extensively on our website and here, and as you've likely seen in the news, the benefits you are entitled to if you are injured in a car accident were reduced significantly since August 2010. Here are some of the most common questions that I hear.
Does the injured person have to be in a car to be eligible for accident benefits
Pedestrians and cyclists may also be entitled to accident benefits. Accident benefits are available to everyone who is injured directly as a result of a car accident. Accident benefits are also available to the driver of the car, regardless of who is at fault for the car accident.
Are accident benefits paid automatically after the injured person has a car accident?
No. The injured person must notify their car insurer within 7 days or as soon after as is practicable of the accident that the injured person wishes to apply for accident benefits. The injured person’s car insurer must then promptly give the injured person application forms. If the injured person is a passenger in the car then they must notify their own car insurer even though their car was not involved in the car accident. The injured person must file the completed application forms with their accident benefit car insurer within 30 days after receiving them from the car insurer.
Can the injured person apply for accident benefits after the 30 day deadline?
Most car insurers will accept later applications if the injured person has a reasonable explanation for the delay (ie. in the hospital for an extended stay due to the injuries from the car accident). However it is always best to meet the 30 day time limit. No benefit is payable by the car insurer until a complete application is sent and approved by the car insurer.
What documents have to be submitted to the car insurer?
The injured person should notify their car insurer, or the insurer that is responsible for providing the injured person with accident benefits, and request an Application for Accident Benefits. There is a standard application package. The documents can also be obtained from the Financial Services Commission of Ontario website (www.fsco.ca). The documents are not difficult to complete. If the injured person is unsure about completing the documents then one of our personal injury lawyers or accident benefit specialists can be consulted to assist in completion of the documents.
If the injured person is unsure as to which car insurer to submit the documents to, they can send them to the car insurer they think is appropriate to start the accident benefit process and the car insurance company will sort out who the appropriate company is. The injured person’s access to medical and rehabilitation benefits will not be interrupted while the car insurers try to sort out which company is responsible.
The injured person must also consent to the disclosure of medical information and/or loss of income information to the car insurer. This may involve signing waivers to permit the car insurer to obtain this information directly from the injured person’s doctor and/or employer. It is important to cooperate with the insurance company that is providing the injured person with accident benefits. The accident benefit is entitled to full disclosure regarding the injured person’s medical information. The failure to provide medical information, or access to medical information in a timely manner could result in the termination or suspension of accident benefits.
Is the injured person the only person covered by Statutory Accident Benefits in a car accident?
No. Any member of the injured person’s immediate family may also be entitled to recover benefits if the family member suffers psychological or mental injury as a result of the injured person’s accident. For example, where a child is severely injured in a car accident the injured person’s parent may require counseling to assist in dealing with the emotional trauma connected with providing ongoing support to a severely injured child.
You can find the answers to many more common questions on my website, or you can give me a call anytime.