frequently asked questions
Motor Vehicle Accidents
If you are the passenger in a car, a pedestrian, a cyclist or the driver of a car that was not at-fault you also have the right to sue. You can also sue the at-fault driver for economic losses such as lost income incurred due to a vehicle collision.
Persons injured in car collisions are entitled to sue an at-fault driver for permanent and serious disfigurement or permanent serious impairment of an important physical, mental or psychological function, as well as any income losses. The amount you can recover is reduced by amounts received by way of accidents benefits. You can also recover legal costs incurred in pursuing your lawsuits.
Any law suits must be commenced no later than two years after the collision. As well, certain notices and documents must be prepared and sent to the at-fault driver within 120 days of the collision Failure to meet these deadlines can affect your recovery. Be sure to call a personal injury lawyer experienced in dealing with collisions.
If you are injured in a vehicle collision you must notify you own insurance company within 30 days of the date of the collision, otherwise the insurer can take longer to process the application. That might even affect how much you recover from the driver who is at fault.
Write down the name, address and phone number of anyone who witnessed the incident. Also, record all trips to health care providers such as the emergency department or your family doctor.
If you are hit by a drunk driver see a lawyer immediately. Sometimes you can sue a tavern and increase your recovery. If you think there was a roadway defect, you must give notice to the appropriate party within 7 days. In fact, if anything other than a car was involved in the crash you may be able to increase your recovery significantly. Delay in the investigation will complicate your case.
If you think there was a defect in the brakes of your car, your seatbelt, or anything else that contributed to the collision or your injuries, before getting it repaired, be sure to provide the insurer or insurers an adequate opportunity to inspect the alleged defect.
Although you have two years to sue, you must send out certain documents within 120 days of the collision. Missing the 120-day document deadline may affect what you are able to recover in a lawsuit. Missing the limitation of two (2) years to sue for your damages however will extinguish your right of recovery. There are discoverability exceptions in the law, but you will need to consult a personal injury lawyer to make that determination.Ensure you meet all of the necessary guidelines by calling a personal injury lawyer experienced in representing collision victims.
Insurance companies may tell you that you don't need a lawyer if you have been injured in a vehicle collision. Independent advice about whether you need a lawyer should be sought only from a lawyer and not from your insurer who may desire to minimize its obligation to you.
You have many rights and obligations under the current car insurance laws. Delay in pursuing compensation may negatively affect your recovery. Be wary of an insurance representative who says "we'll take care of everything" or "you don't need a lawyer" - it is in the insurance company's interest to pay out as little as possible to you.
Persons injured in vehicle collisions are entitled to recover accident benefits and sue an at-fault driver for permanent and serious disfigurement or permanent serious impairment of an important physical, mental or psychological function.
To successfully sue, a number of deadlines must be met starting within 120 days of the collision and a number of documents must be prepared. The current law governing car crashes is very complex. Interpreting that law and insuring all steps are taken to maximize recovery is time consuming, and requires the knowledge and experience of a professional. Only a lawyer acting in your best interest can properly prepare your case to ensure you maximize your recovery.
Get the facts and know your rights from a source you can trust - a lawyer acting on your behalf. Call Verbanac as soon as possible after the crash.
If you are injured in a vehicle collision, there are benefits available to you from your insurance company regardless of who is at fault. Notify your insurance company within 7 days of the crash and ask them to send you accident benefits application forms. The law requires you to apply for benefits within 30 days of the collision. Although late applications are usually accepted, failing to submit a timely application can result in processing delays so you should submit your application as soon as possible.
Completing the forms requires you to provide detailed information about yourself, including a medical form from your doctor and a statement from your employer. If you, or someone that you are dependent upon, owns or leases an automobile that is insured, you send your completed forms to your own insurance company. This automobile does not have to be involved in the crash in order for your insurer to handle the claim.
If you do not own or lease an automobile, but are listed as a driver on someone else's insurance policy, send you forms to the insurance company that issued the policy you are listed on.
If you, your spouse, or someone upon whom you are dependent do not own or lease an automobile, or you are not listed as a driver on a policy, other rules apply which can be complicated. For advice and recommendations concerning where to make applications for accident benefits, contact a personal injury lawyer.
If your accident benefits have been denied, or if accidents benefits you have been receiving are cut off for any reason, you may have been unjustly denied. You should contact an experienced personal injury lawyer who will be able to advise you as to whether you are entitled to the benefits which have not been provided.
If you plan to dispute a decision by an insurance company, you must do so within two years of the insurance company's refusal to pay benefits.
In some cases, where you have sustained a personal injury that is not resolved quickly, it is a good idea to seek legal advice early on to avoid problems later. An experienced personal injury lawyer can advise you as to whether you should mediate your claim and further advise, depending on the mediation, whether you should proceed by way of arbitration or court action.
To sue for these damages you must prove that your injury "meets the threshold": This means that in order to recover damages for pain and suffering you must have sustained as a result of the accident either a:
- permanent serious impairment of an important physical, mental or psychological function; or
- permanent serious disfigurement (i.e. scarring)
If your injury meets the threshold, you are entitled to an award of general damages subject to a $39,556.53 deductible. In cases where the general damages amount to $131,854.01 or more, there is no deductible.
No. The threshold only applies to the extent that your injuries were caused by the negligence of other drivers and/or owners of motor vehicles.
Yes. Family members may sue for loss of care, guidance and companionship, although such claims are subject to a $19,778.27 deductible.
No. They only apply when you are suing for non-pecuniary general damages.
You cannot receive any loss of income for the first 7 days after the collision.
Before trial, you are entitled to 80% of your net loss of income (less any accident benefits which are received). After trial, you can receive 100% of your gross loss of income, less any accident benefits or other collateral benefits paid by your own insurance company or disability insurance provider.
If you have sustained an injury that meets the threshold, you are able to claim the cost of all medical and rehabilitation expenses incurred as a result of your accident, in excess of amounts paid or available from your own insurer.
A common example of "other pecuniary losses" is the cost of hiring somebody to perform your daily activities (i.e., household chores) that you are no longer capable of doing because of your accident.
No Fault Legislation
No. Pedestrians and cyclists are also entitled to accident benefits so long as an automobile was also involved in the accident.
If your injury meets the threshold, you are entitled to an award of general damages subject to a $39,556.53 deductible. In cases where the general damages amount to $131,854.01 or more, there is no deductible.
Yes. Insurers must accept late applications if you have a reasonable explanation for the delay. However, if you do not have a reasonable explanation for the delay, the insurer is allowed to delay up to 45 days in processing your application. It is always best to meet the 30-day time limit. No benefit is payable until a complete application is sent and approved by the insurer.
No. Any member of your immediate family may also be entitled to benefits if he or she suffers psychological or mental injury as a result of your accident.
Accident benefits only pay for losses that are not covered by some other private policy or employment benefit plan. If these other benefit plans cover only part of the expenses, accident benefits may pay the balance.
The insurer may be required to pay all of the reasonable expenses incurred as a result of your accident, including:
- medical, hospital and nursing care,
- chiropractic, psychological and occupational therapy,
- medication, prescription eyewear, dental and medical aids,
- transportation to and from treatment sessions,
- social and vocational rehabilitation,
- home renovations and vehicle modifications.
You are entitled to receive up to $65,000 in (combined) medical, rehabilitation and attendant care benefits for expenses incurred up to 5 years after the accident.
If your injury is catastrophic, as defined by the legislation, you are entitled to receive up to $1,000,000 for (combined) medical, rehabilitation and attendant care expenses incurred over your lifetime. As well, anyone can purchase additional (optional) coverage for combined medical, rehabilitation and attendant care expenses, to provide a maximum of $130,000 in benefits for non-catastrophic injuries and/or $2 Million in the event of catastrophic injury.
No. You must notify your insurer within 7 days after the accident, or as soon as practical after the accident, that you wish to apply for accident benefits. Your insurer must then promptly give you application forms. To avoid delays in processing your application, you must file the completed application forms with your insurer within 30 days after receiving them from your insurer.
- physician,
- psychologist,
- physiotherapist,
- dentist,
- optometrist,
- chiropractor.
Insurers are entitled to refuse to pay for treatment unless a treatment plan is completed. Pre-Approved Framework Guidelines apply to certain soft tissue claims that provide a fixed package of benefits to people without going through the treatment plan process. The guidelines mandate the provision of treatment, and goods and services for certain types of injuries, without the injured party having to obtain insurance company approval. Currently, Guidelines have been introduced to deal with Whiplash Associated Disorders (WAD) Grade I or II, with or without back symptoms. Treatment for injuries falling outside of these categories must be pursued through the ordinary treatment plan procedure.
If you have been injured in an accident your insurer may be required to pay the cost of providing for an aide or attendant. These benefits include the services of one of your family members caring for you at home. The insurance regulations have special forms, which can be completed by an occupational therapist or physician for this benefit.
You can receive up to $3000 per month in attendant care for two years after the accident. If your injury is catastrophic, you can receive up to $6000 monthly to a maximum of $1,000,000 for (combined) attendant care, medical and rehabilitation expenses, and there is no time limit.
Yes. Your own treating health care specialists can perform an assessment under the regulation and in most cases the insurer is obligated to pay for the cost of that assessment.
When an insured person dies as a result of a motor vehicle accident, the insurer may be required to pay funeral expenses incurred to a maximum of $6,000.
If the deceased was married, a sum of $25,000 would be payable to his or her spouse. If the deceased was not married but was survived by a dependant(s), the $25,000 is divided equally among the dependants. If the deceased was a dependant at the time of the accident, $10,000 would be payable to the person upon whom the deceased was dependent.
In order to qualify for death benefits, the deceased must have died within 180 days from the accident, or, if the deceased was continuously disabled as a result of the accident, within 156 weeks of the day of the accident.
You are entitled to receive weekly income replacement benefits for up to the first 104 weeks (excluding the first week) after a collision in the following circumstances:
- you were employed on the date of the accident and thereafter suffered a substantial inability to perform the essential tasks of your employment;
- you were not employed at the time of the accident but worked at least 26 of the 52 weeks before the accident (or were receiving Employment Insurance benefits at the time of the accident) and thereafter suffered a substantial inability to perform the essential tasks of the employment in which you spent most of your time during the 52 weeks before the accident; or
- you were entitled to start work within one year under a legitimate written contract that was made before the accident and, as a result of the accident, you suffer a substantial inability to perform the essential tasks of that employment. Note that this latter scenario is only applicable with respect to accidents that occurred before April 15, 2004.
You will not receive income replacement benefits for the first 7 days after a collision. Then, as long as you qualify, you can receive 70% of your gross weekly income (less any benefits you may be entitled to from other insurance policies or employment plans).
You can receive a maximum of $400 per week. If optional coverage was purchased, you can receive a maximum of $1,000 per week. If you are entitled to group benefits or private benefits you may still be entitled to up to an additional $400.
Yes. Self-employed persons are entitled depending on their income and expense situation. Usually an accountant will be necessary to determine eligibility and quantum.
Income replacement benefits are payable for 2 years following the accident so long as you suffer a substantial inability to engage in the essential tasks of your pre-accident employment. To continue to receive benefits beyond the 2-year mark, you must be suffering from a complete inability to engage in any employment for which you are suited by education, training, and experience.
So long as you continue to satisfy the eligibility criteria, income replacement benefits are available to you up until age 65, at which point they are reduced on a gradual basis.
If, at the time of the accident, you were not working but were enrolled in school or had completed your education during the year prior to the accident and were not employed in a job that reflected your education, you may be entitled to a non-earner benefit. You are only entitled to this benefit if you suffer a complete inability to carry on a normal life and are over 16 years of age.
The amount of the non-earner benefit is $185.00 per week. However, nothing is payable for the first 26 weeks after the accident. If you were enrolled in school or had completed your education in the year prior to the accident, you are entitled to a non-earner benefit in the amount of $320 per week after the first 104-week period has expired.
You may be entitled to a caregiver benefit if you were living with and were primary caregiver for a person in need of care and were not being paid for these activities.
The maximum amount of the caregiver benefit is $250 per week for the first person in need of care plus $50 per week for each additional person.
No. Only one of the income replacement, non-earner and caregiver benefits is payable for any given period of time.
You must elect one or the other. Advice from a personal injury lawyer may be of assistance in making the decision that is best for you.
Your insurer may stop payment of weekly benefits in the following cases:
- If, despite your insurer's request, you fail to provide a certificate from a health practitioner stating that you continue to suffer from the disability, the insurer may stop payment of weekly benefits after 21 days of its request;
- If your insurer arranges an assessment by a health practitioner and it is determined that you are no longer disabled, your insurer may stop payment of the weekly benefits. However, you are entitled, within specified time frames, to have a health practitioner of your choice rebut the insurer's decision to stop payment of your disability benefits.
You may attempt to return to work at any time during the first 104 weeks of your disability without affecting your entitlement to receive income replacement benefits so long as you cannot continue with the employment because of the accident.
Your insurer is not obligated to pay income replacement benefits, non-earner benefits, lost education expenses, expenses of visitors or home maintenance expenses if you were the driver of an automobile at the time of the accident and you;
- knew or ought to have known that the automobile was not insured;
- were not licensed to drive;
- were an excluded driver under the contract of insurance for the vehicle which you were driving at the time of the accident;
- were driving a vehicle, or were an occupant of a vehicle, when you ought to have known that the vehicle was being driven without the owner's consent;
- were convicted of impaired driving;
- were convicted of driving with a blood alcohol level exceeding legal limits,
- were convicted of failing to provide a breath sample;
- were engaged in a criminal offence, or were an occupant of an automobile that was being used in connection with a criminal offence;
- misstated facts to the insurer in order to obtain motor vehicle insurance;
If your family members and other individuals who were living with you at the time of your accident visit you, they are entitled to payment of all reasonable and necessary expenses incurred as a result of the accident during your treatment or recovery. There is no payment after 104 weeks unless the injury is catastrophic.
If you are unable to continue in a program that you were enrolled in at the time of the accident, the insurer will pay for lost education expenses.
The maximum amount you can receive is $15,000. This amount is meant to compensate for expenses incurred before the accident, such as tuition, books, equipment, and room and board.
You can receive a maximum of $100 per week for all reasonable expenses for housekeeping and home maintenance, if you suffer substantial inability to perform these services and you performed these services before the accident.
Your housekeeping and home maintenance expenses are paid for 104 weeks unless the injury is catastrophic.
Your insurer may by be obligated to replace or repair clothing damaged in the accident, prescription eyewear, dentures, hearing aids, prostheses, and other medical or dental devices lost or damaged in the accident.
Some examples of catastrophic impairments are paraplegia or quadriplegia, permanent loss of use of both arms, loss of vision in both eyes, and severe brain injuries. In other cases, once your condition has stabilized or three years has elapsed since the accident, you may make an application to your insurer for a determination that the impairment is catastrophic.
If your injury is defined as a catastrophic impairment by the Insurance Act you are entitled to a much higher level of medical and rehabilitation benefits and attendant care benefits (a maximum of $1,000,000 for medical, rehabilitation and attendant care benefits combined). These benefits are payable over your entire lifetime.
An insurance company may not require an injured person to attend an insurance examination (IE) with respect to an application for a benefit that is provided under the pre-approved framework guidelines.
If you have purchased optional benefits from your insurance company, the amount of benefits available to you may be increased. For this reason you must always review your insurance policy and provide a copy to your lawyer to determine if these optional benefits have been purchased.
You must notify your insurer within 7 days from the date of the accident that you wish to apply for benefits and your insurer must then promptly give you application forms. To avoid delays in processing your application, you must file the completed application forms with your insurer within 30 days after receiving them from the insurer. If you cannot do so within 30 days because of the severity of your injuries, the application must be made as soon as reasonably possible.
If you are having difficulties recovering the benefits to which you are entitled you should consult with a lawyer. Any lawsuit or arbitration proceeding to enforce the payment of these benefits must be commenced within two years from the time the benefit was terminated or denied.
The system that has been established to govern accident benefits is technical and complex. It is advisable that you speak with a lawyer with experience in dealing with personal injury matters to assist you in navigating any issues that may arise.