Legal FAQs:

ACCIDENT BENEFITS

Who can claim accident benefits?

Every person injured in a motor vehicle accident in Ontario is entitled to claim accident benefits, or ‘no-fault’ benefits, from their insurance company. If a person is not insured, they are entitled to claim these benefits from the insurer of the other individual involved in the motor vehicle accident. If there is no available insurance, an injured person may make a claim for accident benefits to the government’s Motor Vehicle Accident Claims Fund.

What are accident benefits?

Accident benefits, or no fault-benefits, are statutory benefits provided to victims of motor vehicle accidents in Ontario. They are governed by the Statutory Accident Benefits Schedule, which is a regulation under the Insurance Act.

What types of accident benefits are available?

The types of available benefits are various and include income replacement benefits, non-earner benefits, caregiver benefits, housekeeping and home maintenance benefits, attendant care benefits and medical and rehabilitation benefits. Please note that this list is NOT exhaustive. Please contact us for more information.

How much money can I get?

Each benefit has a statutorily prescribed maximum as follows. Please note that in the cases of catastrophic injuries, and in cases where additional coverage is purchased, different maximums apply. Please contact us for more information.

• Income Replacement Benefit – 80% of net weekly income up to maximum of $400.00 per week to a maximum period of 104 weeks. 7 day deductible applies.
• Non-Earner Benefit - $185.00 per week to a maximum period of 104 weeks. 6 month deductible applies.
• Caregiver Benefit - $250.00 per week for 1st child and $50.00 per week for each subsequent child to a maximum period of 104 weeks. Only applies for children under the age of 16.
• Housekeeping and Home Maintenance Benefit - $100.00 per week to a maximum period of 104 weeks.
• Attendant Care Benefits - $3,000.00 per month maximum to a maximum period of 24 months. The monthly amount payable is determined in accordance with a Form 1.
• Medical and Rehabilitation Benefits - $100,000.00 maximum. 10 year maximum period.

Do I automatically qualify for accident benefits?

No. Each benefit has its own qualifying criteria as follows. Please note that the following criteria are not an exhaustive list. Please contact us for more information.

• Income Replacement Benefit – This benefit is for insured persons who were employed for at least 26 out of the last 52 weeks prior to the motor vehicle accident and who, as a result of the accident, suffer a substantial inability to perform the essential tasks of their employment.
• Non-Earner Benefit – This benefit is for insured persons who were not employed at the time of the motor vehicle accident and who suffer a complete inability to carry on a normal life as a result of the motor vehicle accident.
• Caregiver Benefit – This benefit is for insured persons who are the primary caregiver of a child or children under 16 years of age and who, as a result of the motor vehicle accident, suffer a substantial inability to engage in the caregiving activities in which they were engaged in at the time of the accident.
• Housekeeping and Home Maintenance Benefit – This benefit is for insured persons who incur expenses as a result of an accident for housekeeping and home maintenance services and are payable if the insured person suffers a substantial inability to perform the housekeeping and home maintenance services that they normally performed before the accident.
• Attendant Care Benefits – This benefit is for insured persons who incur expenses as a result of an accident for services provided by an aide or attendant.
• Medical and Rehabilitation Benefits – This benefit is for insured persons who require treatment as a result of a motor vehicle accident, for example, physiotherapy, chiropractic services, assistive devices, prescription medication etc.

TORT CLAIMS

What is a tort claim?

A tort claim is a lawsuit for damages against a party or parties who has committed a civil wrong or an act of negligence against another party or parties. The person suing is known as the plaintiff and the person who is being sued is known as the defendant.

Can I sue the driver who hit me in tort?

The short answer is: that depends. Due to the no-fault scheme in Ontario, in order to maintain a successful lawsuit against an at-fault third party, you must meet two criteria, known as the ‘verbal threshold’:

1. You must have sustained a serious and permanent impairment of an important physical, mental or psychological function or have sustained a serious and permanent disfigurement; and
2. Your injuries must exceed the statutorily prescribed deductible which is $30,000.00 as of October 1, 2003.
   Contact us for more information.

How long do I have to sue the driver who hit me?

You have two years from the date of your accident to sue the at-fault third party or parties.

What if I missed the two-year limitation period?

If you missed the two year limitation period, your claim will be statute barred and will not succeed. The only exception to this rule is a principle known as the discoverability principle which permits the two-year period to run from the date when you knew or ought to have known that your injuries met the verbal threshold.

What types of things can I claim?

Typical relief sought in motor vehicle accident tort claims are general damages, or damages for pain and suffering, loss of income, loss of economic opportunity and loss of housekeeping and homemaking capacity. Please note that this list is not exhaustive. Please contact us for more information.

How much money can I get?

The amount of money recoverable in a tort claim varies case by case and depends on the particular circumstances and injuries of the individual along with the law of Ontario. Please contact us for more information.

DISCLAIMER:

The information provided in this website is for informational purposes only and Srebrolow Lebowitz Spadafora, Professional Corporation, does not assume any legal liability or responsibility for the accuracy, completeness or usefulness or any information contained therein. Legal advice should always be obtained by a lawyer.