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
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.
Ottawa Injury Lawyers David Hollingsworth
We hate to be the bearer of bad news but we are today. The Ontario government has done it again. To further add to all the reductions in accident benefits that have been made over the last while, they announced even more changes last Thursday. These changes, in our opinion negatively impact Ontario drivers.
The changes are known as “The Fighting Fraud and Reducing Automobile Rates Act” and it was passed last week. What’s most disturbing in this Act is the removal of the right of motorists to sue an insurance company after they have been denied their claim. This new Act , in our opinion does not favour Ontario drivers and although it says it is designed to benefit drivers, removing the right to sue , will leave many Ontario claimants out of luck and in a potentially bad situation , where they are injured but the insurance company is not going to cover their injuries. It seems at every turn there are further and further reductions in Ontario Accident Benefits and now further rights are being removed.
Another change that Ontario drivers are facing is that the government has also reduced the interest rates that injured Ontario drivers and passengers get on their compensation from insurance companies which was reduced from 5% to 1.3% . This reduction in interest unfortunately can hurt Ontario drivers , as it gives less incentive for insurance companies to settle with claimants due to a lower interest rate.
Reducing Insurance Fraud. Really ?
The Ontario government would have us believe that their goal in this Act is to reduce insurance fraud and reduce insurance costs, but there is much more at play. So far the “promised 15 % reduction in insurance fees” has yet to be seen . The Toronto Sun reported that premiums have dropped by an average of only 6 %: a far cry from 15% !
The Importance of Accessing all Ontario Accident Benefits
We don’t disagree that automobile insurance is very expensive and lowering insurance premiums is important. What is even more important in our opinion is the ability to access ALL the accident benefits. We work each and every day with people who need these Accident Benefits not only for medical bills but also for expenses such as caregiver expenses, loss of income , etc.. Without access to these benefits, there are many people who will continue to suffer after an accident.
With further and further reductions in Accident Benefits what will be the end result? We don’t think it’s heading in a good direction at all. The Ontario Insurance Regime continues to change and Ontario drivers continue to have their rights and benefits reduced. This is frightening.
Our Ottawa Personal Injury Lawyers Are Here For You
If you have questions regarding Ontario insurance or making an accident claim, our lawyers and accident benefit specialists are here to help. Contact us for a free consultation or visit our website for more information.
Ontario Accident Benefits …Liberal Interpretation of “Accident” under SABS
By: Brent Meadows
Accidents in Ontario
In Ontario, if you are injured in a motor vehicle accident, you may apply for benefits under the Statutory Accident Benefits Schedule (SABS) regardless of fault. You may also seek compensation in tort by commencing a lawsuit against any person(s) at fault.
What is an accident ?
The Financial Services Commission of Ontario has recently dissected the term ‘accident’ in relation to the SABS. If an injured party can establish that they were injured as a result of an ‘accident’, they may apply for SABS benefits.
What accidents will be covered under accident benefits?
In Kasman and Security National, (FSCO A12-007175, October 2, 2014), Mr. Kasman, the applicant, alleged that he was injured in a motor vehicle accident and was therefore entitled to certain statutory accident benefits. He applied for benefits but was refused by Security National on the basis that he was not injured in an ‘accident’ as defined in section 2(1) of the Schedule.
By way of background, Mr. Kasman was struck on the head by the arm/gate that regulates entry into an underground parking garage. He walked and followed a car that triggered the arm to lift. The arm then lowered on his head as the car that Mr. Kasman was following continued into the garage triggering the sensor that causes the arm to lower.
Arbitrator Rogers had to decide whether or not Mr. Kasman’s injury was directly caused by the use or operation of an automobile. Security National relied on cases where individuals were not entitled to accident benefits and where their injuries were caused by an assault that occurred in or around a vehicle. In the ‘assault’ type of cases, Swaby v. Allstate Insurance for example, it was decided that the injuries did not arise out of the use of an automobile.
Arbitrator Rogers further differentiated the case at hand from Mahadan and Co-operators General Insurance Co (FSCO A00-000489, March 15, 2001) where an individual was injured after he placed groceries in the trunk of his car and soon after tripped on a pothole. The pothole broke the chain of causation and the claimant was not entitled to the accident benefits.
However in Kasman, the injury was directly caused by the car as it triggered the arm/gate to go up and down. Specifically, arbitrator Rogers noted that “Had the car hit the arm, which in turn hit Mr. Kasman causing injury, there would be no doubt regarding causation. I see no qualitative difference because the arm is remotely triggered.”
Arbitrator Rogers ultimately held that Mr. Kasman was injured as a result of an “accident” as defined in section 2(1) of the Schedule as the incident arose out of the use or operation of an automobile, and the use or operation of the automobile directly caused the impairment.
If you have been injured and aren’t sure of your rights, contact an experienced Ottawa personal injury lawyer. Most lawyers offer a free consultation and can walk you through your options and help you determine what’s best for you and your family moving forward. For more information, visit www.ottawainjury.ca/insurance-claims
Ottawa Personal Injury Lawyers and the Ontario Court of Appeal – Farmers insuring ATVs
By: Brent Meadows
The Ontario Court of Appeal had to decide whether an unmodified all-terrain vehicle (ATV) owned and used by a farmer for day-to-day farming operations was a “self-propelled implement of husbandry” (ie. vehicle for farming). If an ATV is considered as such, then it would not be subject to Ontario’s mandatory vehicle insurance regime. In other words, it wouldn’t necessarily have to be insured under said regime.
Mr. Matheson, the plaintiff, owns approximately 900 acres of farm land that abuts onto a highway. On the day of the accident he used his ATV to get from one part of his land to the other using the highway. He only intended to drive his uninsured ATV on the highway for a short period of time. Sadly, while driving on the highway he was struck by Mr. Lewis and suffered catastrophic injuries.
The plaintiffs brought, inter alia, a Rule 21 motion (ie. determination of an issue before trial) to determine whether their claim was statute barred by operation of s.267.6(1) of the Insurance Act which provides that a person is not entitled to damages for injuries that occur while operating an uninsured vehicle.
The motion judge held that the ATV was excluded from Ontario’s mandatory insurance regime as it was a self-propelled implement of husbandry. The ONCA however reversed this decision and held that the ATV was NOT a self-propelled implement of husbandry.
The court arrived at this decision by reviewing Ontario insurance regime and its intended purpose. The court then referred to R v. Van Berlo where it was held that a vehicle must be ‘manufactured’ or ‘designed’ for a specific use in farming in order to be considered a self-propelled implement of husbandry. While the plaintiff exclusively used the ATV for farming, it could not be said that the ATV was ‘manufactured’ or ‘designed’ for a specific use in farming.
Most importantly, with respect to Ontario’s automobile insurance regime, the ONCA held that an ATV cannot be both an off-road vehicle requiring insurance and a self-propelled implement of husbandry excluded from the insurance regime. Moreover, reg. 893 explicitly provides that an ATV is an off-road vehicle and not a self-propelled implement of husbandry.
The Court of Appeal ultimately decided that the plaintiff’s claim was statute-barred by s.267.6(1) of the Insurance Act as he was uninsured, and his claim for statutory accident benefits was barred by s.30(1)(a) of the SABS.
ATV accidents and insurance
This is undoubtedly an important decision for insurers in Ontario. Now more than ever it would be prudent for farmers to obtain insurance for their ATVs. One question comes to mind: If Honda were to manufacture and design an ATV for a specific use in farming, could it be exempt from the Ontario’s mandatory vehicle insurance regime?
If your child has been injured in an accident in Ontario, it’s important that you consult with an experienced personal injury lawyer before you meet or speak with your insurance company. The rules surrounding a child personal injury lawsuit and settlement are different from in a settlement case involving an adult.
When a parent commences a personal injury lawsuit on behalf of a child, they need to understand that their child will not receive the settlement monies until they reach the age of 18 years old. We often have clients who are unsure what to do with the compensation they receive for their child. Depending on the circumstances, we recommend several different options. A structured settlement is often the best solution for a child’s settlement. A structured settlement is when a registered insurance company will take over the settlement monies and pay out a set amount each year over the course of the child’s life. In most cases this pay out amount is also a tax-free set amount. Depending on the age of the child at the time of the accident, this usually makes the most sense. If the injured child is close to reaching 18 years of age, it may not be the most cost-effective plan, as the fees associated with a structured settlement might outweight the payout if the investment period is not very long .
Depending on the nature of the injuries, parents can also opt to have a trustee appointed and the trustee then holds the money. This is often the case when a child is disabled and may not be able to decide how best to manage their money.
It is tough to know what is best to do and what’s best for your child. We are able to help give you advice on this and help you come to the right decision, based on what’s best for your child and your family. One of the most important details every parent needs to know is that a settlement for a child in a personal injury case must be court approved. This is done to protect you and make sure that your child is being treated fairly . The Court will review the legal fees being charged by your personal injury lawyer, as well as the settlement amount being offered by the insurance company. In both cases, the amount must be fair and comparable to other similar personal injury cases.
Although, our Ottawa personal injury lawyers do not recommend it, you may decide to work directly with the insurance company and negotiate your own settlement amount. At the very least, we urge you to consult with an experience personal injury lawyer and have them review what is being offered to you . An experienced child personal injury lawyer can give you comparison settlement amounts on the spot and help you decide whether or not to accept the settlement offer. These consultations are free with most personal injury lawyers, so you have nothing to lose. In most cases, our Ottawa injury lawyers, not only offer excellent advice, they are able to point out many other accident benefits available to children that most people are unaware of.
Regardless of what stage you may be at in your personal injury lawsuit, you need to be informed and know your rights. You are not only caring for an injured child, you will need to make incredible important decisions for their future. We highly recommend you consult with an experienced child injury lawyer and take the time to decide what’s best for your child and your family. Our Ottawa injury lawyers can help you with this. We understand, we care and we’re here to help.
What are income replacement benefits?
If you have been in an accident in Ontario and have suffered personal injury, you are most likely eligible for Ontario accident benefits. Ontario accident benefits , can partially compensate you for any losses of income if you are unable to work because of your personal injuries. You are only eligible for income replacement benefits if you were employed at the time of the accident or, subject to certain conditions, during the year prior to the accident.
You may be eligible to receive income replacement benefits every two weeks to partially replace lost income due to your motor vehicle accident. This includes motorcycle accidents, boating accidents ATV accidents etc… If you are unable to perform your job, you may receive income replacement benefits for up to 104 weeks following the onset of your disability. You may qualify for income replacement benefits:
• Did I suffer physical or psychological impairments as a result of a motor vehicle collision and, as a result, am I unable to work?
• Do any of the following statements apply to you?
Were you employed or self-employed at the time of the motor vehicle accident ?
Have you worked for at least 26 of the 52 weeks prior to your accident?
Were you receiving Employment Insurance (EI) benefits at the time of your accident?
Were you unemployed but was at least 16 years of age or excused from attending school at the time of your accident?
If you answered “yes” to the above questions and qualify for income replacement benefits, you may also be eligible and elected to
receive a non-earner benefit or caregiver benefit instead. In this case, you will be disqualified from receiving income replacement benefits. If you are unsure of which benefits to elect, contact a Ottawa personal injury lawyer so they can best advise you as to which accident benefits will be best for you.
How much do you receive for income replacement benefits?
If you are eligible to receive income replacement benefits, you will receive a payment at least once every second week of 70% of your gross income salary minus any income replacement assistance paid by other sources, such as your employer, to a maximum of $400 per week. If you continue to qualify for income replacement benefits after 104 weeks, your minimum weekly benefit will be $185. The first week of your disability is not covered.
When you purchased your car insurance, you may have opted to purchase additional income replacement benefits from your insurance company which may pay up to $600, $800 or $1,000 per week depending on
how much additional insurance coverage you purchased. If you are unsure whether or not you are entitled to additional income replacement benefits, contact your Ottawa personal injury lawyer. They can help answer that question once they have reviewed your insurance policy.
Your gross income is your income before any deductions and taxes. The gross income amount you receive will be calculated on the information you put down on your application form. In general, income replacement benefits are calculated
• If you are employed at the time of the accident, income replacement benefits are based on your gross income either:
in the 52 weeks before your accident or in the 4 weeks before your accident multiplied by 13.
• If you were self-employed at the time of your accident, income replacement benefits are based on actual income earned
in the last 52 weeks or in the last fiscal year completed before the accident.
• If you were not working at the time of your accident but you were receiving EI benefits, or had worked at least 26 weeks of the 52 weeks before your accident, the income replacement benefits will be based on income earned
in the 52 weeks before your accident including your EI benefits.
• If you are over the age of 65, income replacement benefits are payable for up to 208 weeks and are gradually reduced.
• If you are 65 years old and are receiving income replacement benefits, your income replacement benefits are converted to a lifetime pension at a reduced rate.
Ottawa Injury Lawyers David Hollingsworth We work day in , day out with Ontario insurance claims and know how to ensure that our clients are receiving all the Ontario accident benefits they are entitled to. Do yourself a favour and take the free consultation from a personal injury lawyer.
What are Ontario income replacement benefits ?
If you have been in an accident in Ontario, one of the first calls you may make after you have taken care of yourself is likely to your insurance company. You will need to make this call within 7 days if possible. This early reporting will help significantly when it comes time to settling your claim. If you are unable to work because of your accident, you will likely be eligible for basic weekly income replacement benefits.
How much can you receive for income replacement benefits?
These benefits will add up to 70% of your gross income , to a limit of $400 per week. There are options to top up your insurance by purchasing additional insurance coverage. Optional income replacement benefits can increase the maximum weekly pay out on income replacement benefits to $600, $800 or $1,000, depending on how much optional accident benefits coverage you purchase. I know that paying additional premiums on top of already high insurance rates seems ridiculous; however, if you ever need to access these benefits ,you really need them and would never regret your purchase. Depending on your income level, topping up your Ontario accident income replacement benefits makes a lot of sense.
If you are unsure of whether or not you are accessing all of your Ontario accident benefits and needs some advice, please contact our lawyers and we would be happy to answer any questions you may have. Besides income replacement benefits, there are many other benefits that you are most likely entitled to but not accessing through your insurance company. A free consultation with a personal injury lawyer can be very beneficial. In your meeting you will learn of all the Ontario accident benefits available and which are available to you and which are available to your family members as well. Your accident impacts you but it also has a direct impact on your family members and this can be compensated. We highly suggest you get informed.
Ottawa Personal Injury Lawyer David Hollingsworth and Associates: lawyers for Ontario accident victims.
Compensation for Pain and Suffering in Ontario
Ontario Insurance. There are two types of damage compensation in Ontario: pecuniary damages and non-pecuniary. Pecuniary damages can be calculated and non-pecuniary damages cannot be calculated.
Damages for Pain and Suffering in Ontario (Non-Pecuniary Damages)
Most serious accidents in Ontario result in personal injury and pain. There is the obvious pain suffered immediately following the accident, the pain following the treatment of the injury (ie surgery, physio etc..) and then there is the ongoing pain that can last for weeks, months, years or throughout one’s life following an accident. In many cases, a serious injury may never fully heal, leaving accident victims with a life long pain problem. Thankfully the Ontario insurance regime compensates accident victims for pain and suffering.
In Ontario, the amount awarded for pain and suffering varies depending on the situation. Some factors that help determine the maximum amount of compensation for pain and suffering are:
- the severity of the injury
- the length of time it should take the injury to fully heal
- treatment required to treat the personal injury (ie surgery required?)
- hospitalization? rehabilitation? how long?
- the physical and emotional damage that the injury has caused now and moving forward
- pre-existing injuries
I will be honest, it is difficult to sue for pain and suffering after a car accident claim in Ontario. We have however had great success in helping our accident victims get the maximum amount of compensation for pain and suffering.
Nowadays, in order to sue for pain and suffering, your injuries need to meet a legal threshold . The legal threshold must show a serious and permanent impairment of an important bodily function. This impairment can be viewed in many ways . To keep things simple, it basically means that you cannot work, be a caregiver, or participate in normal activities of daily living as a result of your pain and suffering.
Also, to receive compensation for pain and suffering , your injuries must be permanent. What makes this particularly difficult is the fact that it is sometimes tricky to show that an injury is permanent without waiting for at least a year after the accident . Accident victims are struggling throughout this year and it is difficult to try to rebuild a new life without knowing what lies ahead.
In order to claim compensation for pain and suffering in Ontario, the personal injuries suffered in or after the accident must be proven to the courts,should the insurance company try to deny compensation. Unfortunately, in most cases, that’s exactly what they will try to do. As an Ottawa personal injury lawyer, I find this to be so disturbing as often times people with “invisible” injuries are the people who need the compensation the most .That is why I take all pain and suffering claims in Ontario very seriously. I see how much pain people are in and how they have lost their everyday life to an accident. I do everything I can to really help these accident victims.
Ontario Insurance: Pain and Suffering Claims Deductible
Not only to pain and suffering claims need to be a specific threshold in Ontario, the Ontario government has also legislated that they surpass a $30,000 deductible for pain and suffering claims. Sadly,what this translates to for accident victims is that they do not receive the first $30,000 in compensation; however, this deductible does not apply to injury claims where the pain and suffering damages exceed $100,000. As an experienced Ottawa personal injury lawyer, this is where I can truly help. The system is not fair and that is why experienced personal injury lawyers can make all the difference.
If you have suffered and are continuing to suffer from an accident, we can help you. You are not alone. Our dedicated team of Ottawa personal injury lawyers can help you get through these difficult times. We know you need financial compensation,as well as emotional. We have all the resources you need are we are here to help. For more information ,visit us at www.ottawainjury.ca
Snowmobile Accidents and Accident Benefits Insurance Claims
There are far too many snowmobile accidents each year. A tragic snowmobile accident took another life: the life of a 24 year old man in Val des Monts yesterday. My thoughts go out to his family and friends and I am truly sorry for their loss. I have many clients who have injured themselves in a snowmobile accident . A snowmobile is considered a motor vehicle and yes, Ontario accident benefits apply to snowmobile accidents. So the good news is there is support and compensation for people who suffer injuries in snowmobile accidents. The bad news is, there seem to be a lot of snowmobile accidents in our region and some of them are sadly, fatal. Please ride safely…
Transport Canada has prepared an amazing site full of interesting information that relates to road and snowmobile safety. For example, did you know that there are over 700,000 registered snowmobiles and more than 161,000 km of snowmobile trails in Canada? Snowmobiling can be safe and enjoyable. As long as drivers are cautious and follow safety rules, there is no reason not to get out and enjoy a fantastic sport.
The Canadian Council of Snowmobile Organizations or CCSO highlighted that between the years of 1994 and 1999, when promoting safety and snowmobiling became a focus, snowmobile accident fatalities dropped by 2% – from 96 to 94 deaths;however the number of snowmobile drivers increased by 40%. This goes to show that more and more people can ride safely ,when safety is a focus.
Avoiding Snowmobile accidents safety tips:
- Tell someone where you plan to go and when you plan to get there.
- Ensure that your snowmobile is tuned up.
- Dress properly to protect yourself and avoid hypothermia, especially in children.
- Always have a first aid and survival kit available.
- Ride at your own speed.
- Try to use snowmobile trails whenever possible.
- Remain on the right side of all roads, paths and trails.
- If you don’t know the area, slow down and drive cautiously.
- Be careful crossing roads and train tracks.
- At night, drive with headlights and slow down.
- Know the ice conditions and if you are unsure, do not cross.
- Always wear flotation-type clothing.
- Always be on the look out for wildlife.
It’s impossible to completely avoid all accidents but please, let’s try. Snowmobiling does not need to be a dangerous sport. Be safe and ride as safely as possible. Enjoy !