The Insurance Claims Process

The Insurance Claims Process

The Insurance Claims Process


If you’ve been injured in a motor vehicle accident in Ontario, you will need to make an insurance claim. Generally, you will make a claim to your own insurance company. If you are uninsured, you can make a claim to the insurance company of the other driver involved, if there was one. If no driver is insured, you may still make a claim to the Motor Vehicle Accident Claims Fund. The best course of action, once your medical condition has been stabilized, is to engage a personal injury lawyer to help you with your claim.


Many people make the mistake of trying to manage their own personal injury insurance claims. They believe that since they’ve been paying the company regular premiums, the insurer is on their side. In fact, all insurance companies try to minimize the amount of money that they pay out in claims. This means that your insurance company will be looking for a way to pay out as little as possible, or to deny your claim entirely. A personal injury lawyer will know what your claim is worth, and will work on your behalf to ensure that you receive the amount of compensation that you deserve.


Sometimes people believe that working with a lawyer will be too costly. At a time when you are injured – and your income may be affected – money can be a real concern. However, personal injury law firms understand this. Instead of working by the hour, the vast majority of personal injury lawyers work on a contingency basis. This means that the lawyer will receive a percentage of any money you receive on the claim, but since claims negotiated by lawyers are substantially higher than those received by victims without legal representation, the smart move is to work with a knowledgeable personal injury lawyer.


What to Do


The accident should be reported to your insurance company within seven days. The insurance company will ask for the following information:

  • The name of the registered owner’s insurance company and their auto insurance policy number 
  • The make, model, year, registration and licence plate number of the vehicle
  • Details regarding the accident, including: 
    • The driver's name and driver's licence number
    • The date, time, and location of the accident 
    • The extent of any injuries 
    • The number of passengers involved
    • Any damage to the vehicle 
    • The names and driver's licence numbers of the other drivers, the names of their insurance companies and their auto insurance policy numbers
    • The licence plate and vehicle identification numbers of the other vehicles 
    • The name and badge number of the investigating police officer, if the accident was reported to the police
    • Your description of the accident

Your personal injury lawyer will be able to help you gather the documentation necessary to complete your injury claim. He or she may also do some investigative work to find out more details about the accident. Some personal injury lawyers are even knowledgeable about good resources for treatment and can help you with recovery. During a time when you may be in pain and facing an uncertain future, your personal injury lawyer can provide invaluable support. 


Types of Benefits


Depending on your injury and the circumstances surrounding it, you may be eligible for various types of benefits. These might include income replacement, which compensates you for lost income if you are unable to work temporarily due to your injuries, or if you are unable to return to your job even after treatment. A caregiver benefit provides compensation for expenses incurred when you cannot provide care for a family member due to your injuries. Medical and rehabilitation benefits pay for expenses occurred for medical reasons and for expenses associated with rehabilitation. If you need an aide or an attendant to assist you with daily tasks, you may be eligible for an attendant care benefit. You may also receive compensation for other expenses, such as costs for housekeeping or home maintenance that you are unable to do, lost education, or the cost of family travelling to visit you during treatment. You may also be eligible for compensation for pain and suffering and loss of companionship, if the seriousness of your injuries warrant this.


Note that if you are found to be driving impaired at the time of the accident, were driving without a valid driver’s license, did not have permission to drive the vehicle, or were in the process of committing a crime, some or all benefits may be denied.


Be sure to discuss your case with an experienced lawyer before submitting your claim. There are excellent boutique law firms in Toronto that focus on personal injury law, and that provide clients with personalized, committed service. Look for one that meets your needs. Knowing that a knowledgeable personal injury lawyer is on your side can make all the difference!