If you have been involved in a serious car accident resulting in injuries, you and your family may be entitled to compensation. In Ontario, every person injured in a motor vehicle accident may make a claim for accident benefits. Accident benefits are statutory benefits provided by your insurance company regardless of who is at fault in causing the accident. These benefits are to provide you with financial assistance for your injury-related expenses and losses, and include: medical and rehabilitation, attendant care, income replacement, caregiver, and housekeeping and home maintenance benefits.
There are three categories for injures based on severity of the injuries that are used to determine eligibility of benefits. Depending on the category of your injuries, you may be classified as having one of “minor injuries”, “non-catastrophic injuries” and “catastrophic injuries”. There are significant differences in the amount and type of benefits available to you depending upon your classification of injuries. The prescribed maximum for benefits increase significantly for “catastrophic injuries”. “Catastrophic injuries” are very serious injuries and there are strict guidelines that need to be met in order to qualify; and include brain injuries, paralysis of one or more limbs, or complete loss of vision.
If you believe that you are entitled to accident benefits, it is very important to act quickly after the accident. You are required to contact your insurance company within 7 days of the accident. Additionally, you are required to file an application for accident benefits within 30 days of obtaining the application. Failure to meet these timelines may affect your entitlements.
You may also bring a tort action against an at-fault driver to further recover for your losses. In such cases, you may be able to recover for pain and suffering and loss of enjoyment of life, loss of past and future income, medical and rehabilitation benefits, and loss of housekeeping and homemaking capacity. Your family may also be able to recover for their losses due to your injuries including for loss of care, companionship and guidance, and loss of income.
There are strict conditions that need to be met in order to be successful against an at-fault driver. In particular, your injuries must meet the “verbal threshold” which requires that you have sustained “a serious and permanent impairment of an important physical, mental or psychological function, or have sustained a serious and permanent disfigurement”. This threshold test can be met if you are unable to return to work, unable to be trained for new work, or unable to substantially perform your daily activities due to your injuries.
If you decide to bring a tort action, you have to notify the at-fault driver within 120 days of the incident of your intention, and must bring the action within 2 years of the incident. Failure to do so may completely prevent you from bringing the action.