Like the hum of a refrigerator, the warmth of a room on a winter day, or the colour of your front door, your health is so omnipresent that you usually don’t notice it—that is, until it changes. And when your health is in jeopardy, after a serious motor vehicle accident for instance, you’ll rue having taken your previous good health for granted. With car accident injuries come hospital treatment, outpatient care, prescriptions, and missed work, not to mention your own mental distress. The question is, what does your insurance recover for you in the event of a personal injury, and when should you think about consulting a good motor vehicle accident lawyer?
When Can I File a Suit?
Because of Ontario’s modified no-fault insurance system, the legal framework permitting injured parties to file lawsuits contains certain limiting restrictions. For example, you are not allowed to bring any action on account of pain and suffering (non-pecuniary losses, in the legal jargon) unless the injuries you’ve sustained meet the high threshold set out in Ontario’s Insurance Act. And while suing for economic losses (e.g. loss of income, loss of earning capacity) is not subject to any threshold, the maximum amount recoverable in a suit is 70 per cent of net income. Of course, if you’re barred from seeking the help of a good motor vehicle accident lawyer, your insurers won’t simply leave you to fend for yourself.
Accident Benefits
Regardless of the severity of your injuries after an automobile accident, your insurer will provide you with certain benefits. There are six accident benefits required by law in every insurance policy:
- Income replacement benefits;
- Non-earner benefits;
- Caregiver benefits;
- Medical, rehabilitative, and attendant care benefits;
- Payment of other expenses; and
- Death and funeral benefits.
As you likely surmised by the names above, not all of the benefits will be paid out to all motor vehicle injury victims. In fact, no injury would entitle the injured party to all of these benefits, since some are contradictory: income replacement recovers lost wages as a result of your injury, whereas non-earner benefits are designated specifically to those who do not qualify for income replacement. Perhaps the most commonly misunderstood benefit is the medical, rehabilitative, and attendant care benefit, since much of the medical expenses an injured person incurs would be covered by OHIP or a private insurance plan. As a good motor vehicle accident lawyer knows, the medical benefit covers reasonable and necessary services not typically under OHIP, such as:
- Dentistry, optometry, nursing, ambulances, and speech-language pathology services;
- Chiropractic, psychological, occupational therapy, and physical therapy services;
- Medication;
- Prescription eyewear;
- Wheelchairs and other mobility devices; or
- Transportation to and from treatment sessions.
Insurers, however, are not liable to cover more than the prices set out by the Financial Services Commission of Ontario in their Professional Services Guidelines.
If you find that your insurance benefits do not cover the services you need, a good motor vehicle accident lawyer can help you. Toronto personal injury lawyers are experts in securing you the compensation you need, so look for your free consultation as soon as possible!
Sources:
https://www.ontario.ca/laws/statute/90h08
https://www.ontario.ca/laws/statute/90i08#top