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What are Accident Benefits ? Have you been in accident? Are you wondering what your options are? In most cases if you reside in Ontario you may be entitled to Accident Benefits. The Statutory Accident Benefits Schedule, otherwise known as SABS is the provincial regulation of benefits. These are standardized benefits that all insurance companies in Ontario provide. The role of Accident Benefits is to provide insurance compensation, regardless of fault, if you, your passengers, or if you are a pedestrian and have suffered a serious injury in an accident. Depending on the nature of the accident and the extent of the injuries, certain relatives or dependents may also qualify, even if they were not directly involved in the accident. You may also qualify for accident benefits if you were not directly involved in an accident but are suffering from psychological and mental strains of injured relatives.
Not everyone is entitled to Ontario Accident Benefits. You may apply for Accident Benefits and your insurance company and may deny your coverage. You can appeal this decision and fight it. An experienced personal injury lawyer can assist with this type of appeal and will work towards getting you maximum compensation and the benefits you need.
Who is excluded from Ontario Accident Benefits?
An insurance company may deny Income Replacement Benefits, Non-earner Benefits and compensation for other expenses benefits to:
• a driver who was excluded from an insurance policy,
• a driver or passengers who were aware, or should have been aware that the vehicle was driven without the owner of the vehicle’s consent,
• anyone who made false misrepresentation to their insurance company , resulting in automobile insurance being provided, and
• anyone who at the time of the accident was involved in an act for which he or she is convicted of any criminal offence, regardless of whether or not the offence is related to the operation of a vehicle,
• a driver who knew, or out to have known, that they were driving without a valid insurance.
If you or a loved one has been injured in an accident, it’s important you get informed. Ontario Accident Benefits are your benefits and benefits you are most likely entitled to. If you are unsure of your rights or what benefits you are entitled to, contact our personal injury lawyers and we would be happy to provide you with what benefits you are entitled to and give you an idea of what type of compensation you can expect
Ottawa Injury Lawyers provide a brief summary of some of the most important upcoming changes to Ontario Accident Benefits and the License Appeals Tribunal (LAT).
Ontario drivers and residents will continue to see an erosion in insurance coverage and Accident Benefits. Here is what you need to know:
As of April 1, 2016, accident benefit arbitration applications are to be sent to the Licence Appeals Tribunal (“the LAT”) instead of the Financial Services Commission of Ontario (FSCO). Further changes were made in relation to Ontario’s Statutory Accident Benefits Schedule (SABS) for accidents that occur on or after June 1, 2016 which include the following:
· Catastrophic limits changed to $1 million combined for medical/rehabilitation and Attendant Care (reduced from $2 million to $1 million)
· Medical/rehabilitation and Attendant Care benefits for non-Catastrophic injuries are to be combined totaling $65,000 (reduced from $86,000 to $65,000)
· Medical/rehabilitation benefits for non-Catastrophic injuries limited to 5 years instead of 10 years
· The 6 month waiting period for non-earner benefits is eliminated, but the non-earner benefits will only be available for 2 years
· An update to the ‘catastrophic impairment’ definition consistent with more up-to-date medical information and knowledge to reflect modern medicine
LAT Dispute Resolution System
The Ontario Government maintains that the new LAT dispute resolution system is more streamlined than its predecessor. Additionally, FSCO mandatory mediations have been eliminated, and applicants are now expected to apply for arbitration as soon as a benefit is denied or terminated. The arbitration process will be as follows:
· Applicant will file Arbitration with LAT via a new form.
· The insurer will file a response and a case conference will be scheduled.
· Prior to the case conference each respective party will file a case conference brief/summary.
· A case conference will then take place. This will be similar to the FSCO pre-hearing.
· If the matter doesn’t settle, a hearing will occur by way of written, electronic, or in person hearings.
· Appeal – either party may request the Chair to reconsider the matter. Or, the matter can be appealed to the Divisional Court.
The transition to LAT from FSCO is not going to be easy. We are expecting backlogs. Moreover, the majority of FSCO mediators who developed an expertise in this very specific area of law did not transfer over to the LAT. In other words, knowledge and expertise will be lost in the transition. Further, appealing to the Divisional Court may be a difficult hurdle for applicants since courts are often hesitant to overturn arbitrators. With all that being said, it appears as though applicants suffering from catastrophic impairments will be impacted the most by this legislation.
If you have been injured in a accident , navigating the insurance process can be tricky. There are many variables that will help determine which insurance company you will be applying to for accident benefits. In Ontario, there are strict timelines for applying for Accident Benefits, and it is important that you report your accident in a timely manner. There are exceptions; however, if you don’t file an accident report within seven days of your accident, you can be denied accident benefits coverage. Once you have reported your accident and requested an accident benefits package, it is important that you take your time and properly fill out the included OCF forms and return the completed package with thirty days . Our Ottawa injury lawyers like to help our clients with this task. We want to ensure that no stone is unturned and that our clients do not put themselves at risk of possible being denied coverage because of a small mistake that was made on their OCF forms. We often will remove this stress from our clients and fill our the accident benefits package with them.
Sound simple enough ? Well, not quite. Determining which insurance company you should submit your application package to also needs to be determined. In most accidents, there are multiple insurance companies involved in an accident claim and it’s imperative the the accident benefits package is returned to the appropriate insurance company.
A few determining factors when applying for Accident Benefits:
Do you have your own insurance coverage ? If you do, then the package should be returned to your own insurance company.
Are covered by someone else’s insurance policy ? Are you covered under your parent’s insurance policy or maybe your wife’s ? The accident benefits package package needs to go to whomever’s insurance policy you are covered under.
Were you a passenger in a vehicle and don’t have insurance coverage? If this is the case, then the accident benefits package will be returned to the owner of the vehicle’s insurance company.
Were you a pedestrian and do not have insurance? Then the accident benefits package must be returned to the at-fault driver’s insurance company.
Were a passenger in the vehicle of an uninsured driver? Then you must make an application to the Motor Vehicle Insurance Claims Fund. This is a fund that is designed to help people who would otherwise not be covered under insurance. To learn more about this fund, click here.
Were you a pedestrian who was hit by an uninsured driver? Then you must make an application to the Motor Vehicle Insurance Claims Fund. This is a fund that is designed to help people who would otherwise not be covered under insurance.
Regardless of your situation, it is advisable that you contact an experienced personal injury lawyer who is familiar with personal injury law in Ontario to discuss your situation. Our Ottawa injury lawyers would be happy to help and we offer free consultations.
There are plenty of Ottawa personal injury lawyers out there and ottawa injury lawyer reviews but our team knows that we are different from the rest. In 2016, so far, we’ve been chosen as Top Injury Law Firs in Ottawa, Consumer Choice Award for Best Lawyer in Ottawa, Faces Award for Top Ottawa Lawyer, just to name a few…
Our Ottawa injury lawyers receive a lot of feedback from clients and we are happy to share this feedback with you in the hopes of you getting to our personal injury team a little better. Here are just some of the feedback we’ve received lately..
Personal Injury Lawyer Reviews
“The team is outstanding in this field. They truly understands the needs of those who have suffered a loss as a result of an accident and will do what is in their power to ensure that clients are receiving the maximum compensation that is available” D.P.
“Mr. Hollingsworth is a dedicated personal injury lawyer who works hard to ensure his clients and their families are well taken care of in their time of need. He is a compassionate and caring individual who demonstrates these qualities in everything he does. “ K.N.
“Because David Hollingsworth is a conscientious and dedicated injury lawyer and professional, he not only works hard at his law firm, but he also dedicates countless hours as a volunteer for his children’s sport teams. ” A.M.
“I feel they have personal attributes I would appreciate; approachable, courteous, direct, hardworking, focused. I believe they care about their clients and are fully prepared to represent them.” M.K.
“David Hollingsworth is intelligent, successful, capable, very hard working, caring, ethical- just to name a few of his attributes.” P.O.
” David and his team are dedicated to their clients . I have seen personally his hard work he does for his clients and how he has been able to help those in need after some terrible circumstances.” J.A
Our Ottawa injury team are proud of the work we do and the help we are able to get people. We appreciate all the kind words and feedback at the end of the day.