Brain Injury Laws in Ontario: Who Pays Your Medical Bills After an Accident

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Brain Injury Laws in Ontario: Who Pays Your Medical Bills After an Accident
If you’ve sustained a head injury in an accident, it’s important to know about the brain injury laws in Ontario. You may be concerned about how you’ll cover costs while dealing with your recovery.

Who Pays Compensation?

If your brain injury is the result of an accident, the Law Society of Upper Canada lists a few places where you may be able to make a claim. The first, and most obvious, is against the at-fault person’s insurance company. The Financial Services Commission of Ontario also has a Motor Vehicle Accident Claims Fund that provides compensation if you’ve been injured in an accident and the at-fault person doesn’t have insurance. If you were injured at work, the Workplace Safety and Insurance Board has a compensation system for injured workers. Contact a lawyer as soon as possible after the accident so your lawyer can collect the details, talk to witnesses, and deal with insurance companies and adjusters on your behalf.

Who Pays for Health Care?

The Ontario Ministry of Health and Long-Term Care has a comprehensive list of who is responsible for costs after a motor vehicle accident. Ontario’s Statutory Accident Benefits Schedule requires that the insurance company pay for any required non-professional health care service, whether the services are provided at home or in a hospital, long-term care home, or other community setting. If treatment exceeds the benefit maximums, the Ministry of Health and Long-Term Care may fund some or all of the services required. Limits may vary depending on the insurance company. The limit may be a monthly or yearly cap on payments.
The insurance company is responsible for providing community support services like meals and transportation. This can also include support for family members helping you, home maintenance and repair, and access to social or recreational services. If you need help with personal care or housekeeping, the at-fault person’s insurance company is also responsible for providing assistance with your personal hygiene, laundry, and housekeeping.
The Ministry of Health and Long-Term Care pays for all physician services and hospital services. It also covers air ambulance service and use of mental health facilities. Some in-home health services are also covered, like nursing, occupational therapy, physiotherapy, speech-language pathology services, and nutritional counselling. These professional services can be provided in your home, at school, or in the community. If the Ministry of Health and Long-Term Care does pay for services like housekeeping or attendant care, the ministry will contact the insurer for reimbursement, not you.
Your lawyer will know which services should be paid for by the Ministry and which ones are the responsibility of the insurance company. By ensuring that the proper claim has been filed, your lawyer will take care of the details so you can focus on your recovery.
Since the brain is a complex organ, it takes a long time to heal. An experienced brain injury lawyer knows this and can help you determine the kind of support you’ll need so you can focus on rehabilitation. Knowing about brain injury laws in Ontario can help you ask the right questions when you’re looking for a lawyer.
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