Getting things done properly, and in a timely manner can be the difference between getting the benefits you are entitled to or being denied these benefits.
Call the police, GET hospital note!
Before you call me, you should always report the accident to the police so that you have a proof your accident occurred precisely how you describe it. If for any reason you have not done it, make sure you attend the closest Collision Reporting Centre and report your accident there!
Click Here to see the addresses of the Collision Reporting Centers.
The sooner you call the police and attend the Hospital the better for your health recovery and your injury claim.
Remember, the insurance company will draw a negative inference given that the injured Plaintiff failed to seek medical attention right away. They will think that if this person was so hurt in the subject car accident, then why didn’t they receive medical attention right away; or in a reasonable time frame? Attending a doctor will also help build a medical file so that your personal injury representative can establish that your injuries are severe and were directly related to the subject car accident.
Delay or late filing of your claim might negatively impact your case. Reporting the accident to the police and claiming your injuries from the beginning will help you with your recovery and will help us to get a better monetary compensation for you.
Get the Insurance information from the driver!
It does not matter if you were a driver, a passenger, a bicyclist or a pedestrian. Ontario has a No-Fault system. This means you can apply for Accident Benefits in case you were at fault or not. However, the insurance policy is something we need to stat your claim. The at-fault driver is obliged by law to give you his Car Insurance Policy and ID. Please make sure you take pictures of it with your phone!
Application for Accident Benefits ( OCF-1)
Once your report the car accident to you own insurance company, they should send you out an Accident Benefits Package, which will include the OCF-1 Application for Accident Benefits.
We strongly advise you not to fill this in yourself nor give it to the clinic for completion! Any mistakes or inconsistencies on this form can lead to further insurance questions or even benefit denials!
Let your legal representative complete it for you. This will help your case to look strong and consistent from the very start.
Treatment and it’s impact on your claim
Once you make a claim, the Insurance Company might try to send you to one of their clinics. We urge you to always remember that the purpose of the insurance company is not to really help you with your recovery. The purpose of the insurance company is not to give you the best monetary compensation at the end of the day. It is actually the opposite! The purpose of the insurance company is to minimize its costs on handing your claim! Every form you submit to the insurance, every medical note and every statement matters. It directly impacts your file and settlement amount the insurance pays.
You need a medical professional that not only has a FSCO license, but also has the right expertise and experience to handle your claim. We are working with medical professionals all over GTA area. In case you choose your own Medical Facility, we advise you to make sure it is not the insurance company’s facility.
What treatments am I covered for?
As a driver, passenger, pedestrian or a bicyclist involved in a car accident you have coverage for multiple treatments and benefits covered by your insurance company. Those benefits include:
- Treatments and Medical Rehabilitation
- Income Replacement Benefits
- Non-Earner Benefits
- Attendant Care Benefits
- Funeral expenses support if needed
- Housekeeping, Caregiver and other benefits (Under the Optional Coverage or Catastrophic Impairment only)
When applying for medical benefits you need to remember:
Regardless if you are at fault or not, you are covered for medical treatment.
You have 7 days to notify your insurance company of your injuries. In some instances, you have up to 30 days from the date of the accident to report your injuries.
What Treatments will I get at the Rehabilitation clinic?
The rehabilitation clinic will provide you with medical treatment depending on the injuries you sustained in the accident. There are 3 types of categories and they all have different monetary cap:
- MIG (minor injury guideline) $3,500.00
- Non MIG up to $ 65,000.00 (This includes Attendant Care Benefit)
- Catastrophic injuries up to $2,000,000.00 (This was changed several times lately. From $ 2,000,000.00 to $ 1,000,000.00 and back to $ 2,000,000.00 again). It also depends on if you have Optional Benefits on your Insurance Policy.
The treatment will include:
Soft tissue therapy
Will My Insurance Go Up if I make a claim?
This is the question people ask me all the time. Your insurance will not go up as a result of you making an injury claim. FSCO Regulates Insurance companies and makes sure your insurance will not go up because you need medical assistance as a result of your accident. However, this does not mean your rates will not go up if you were AT FAULT in the subject accident. If your fault in the car accident is over 25% your insurance company might increase your insurance rate on the renewal date. This only applies if you have no accident forgiveness on your policy.
I want to be 100% clear. If you are at fault in the accident the insurance company might increase your rate regardless the fact you claim your injuries or not. Your Accident Benefits claim does not impact your car insurance rate!
When will I receive money?
It takes at least one year from the date of the accident to settle your claim with the insurance company. Usually, after one year we have medical opinions on both sides, medical notes, prescriptions etc. This defines the final Settlement Amount. It is necessary to fully cooperate with your legal representative and doctors to maximize the amount you receive at the end of the process.
If you lose your income the insurance company must reimburse you with Income Replacement Benefit which becomes available to you 7 days after the accident.
You might be also eligible for a Non-Earner and Attendant Care Benefit which is payable to you several weeks after the accident and usually up to 2 years.
Once the insurance company is aware of your claim, they are going to ask many questions about you, your family, your job, your pre-accident health, your income, your injuries, your family, even the size of your house. You don’t have to answer any of these questions without a legal representative by your side. Some of these questions are relevant. But some of these questions aren’t relevant. Don’t let the insurance company take advantage of you, particularly when you’re at your most vulnerable following a serious car accident. This will likely be your first time dealing with an insurance company in this situation. We know exactly how to answer the questions that are appropriate and refuse to answer any question that is irrelevant to your claim. Call us for assistance!