What benefits and rights do I have when injured in an auto accident?
There are generally two major auto insurance compensation claims that may be available to each victim, and possibly to the victim's family members in cases of serious injuries.
First is statutory auto accident benefits, or "no-fault benefits", or "A.B." (accident benefits) or "SABS" (Statutory Accident Benefits Schedule) benefits. All these terms are interchangeable for injury lawyers. "No-fault" is to indicate that regardless of how the accident occurred and regardless of whether or not you caused the accident and your injuries, the no-fault benefits are still available to you in 99% of the cases. The other 1% of the cases is where exclusions may apply. Some exclusions may apply where you were driving without insurance or were committing certain offences such as drinking and driving, or insurance fraud.
No-fault benefits in "catastrophic" cases can be more than 2.5 million dollars per victim. Old laws cover old accidents. For new accidents since September 1, 2010, (as further amended and reduced to about 1.5 million since June 1, 2016; but this reduction has subsequently been largely removed, and old levels restored), there are various levels of benefits. For minor cases there may be a few thousand dollars of coverage for treatment. Moderate cases there may be a few hundred thousand dollars of coverage. Benefits include an income loss for certain employed persons and rehabilitation benefits. For catastrophic cases, there can be 24 hours a day supervisory care for up to about $6,000 per month in attendant care benefits and $100 a week for housekeeping benefits. There are various other benefits in catastrophic cases including building of a new wheelchair accessible home etc... The right to claim may be there, but payment is made only if the insurer agrees that an expense is reasonably necessary. This is where disputes can arise and you will need legal representation because virtually all insurers are supported by experienced legal departments and lawyers who are very experienced in this field.
Second is the right to sue in court for your "tort damages". "Tort" is a French word, meaning "wrong" in English. So, you can sue whoever was wrong in causing or contributing to the accident. The compensation you receive under this second right is called "damages", to distinguish from no-fault accident "benefits", even though they are both dollars and nickels. A tort claim is a claim under this second right. Importantly you will note that this second right is only available if you can show that someone else was responsible in whole or in part for the accident or for your injuries. Finding out who is responsible for you may not be obvious in all cases. In a single car accident in Ontario winter might be the failure of the Ministry of Transportation to salt and sand the road. The accident might be as a result of a documented failure in the mechanics of the lone vehicle in the accident. The road design might be dangerous.
In a catastrophic case damages can be very high. But auto insurance that most people buy covers only about one million dollars for damages. Finding all the potential parties at fault in tough cases and finding all available insurance policies, and advocate for the highest level of care and damages are really what the most experienced injury lawyers are dedicated to do.
Auto injury law is quite complex and therefore mistakes by insurance companies, lawyers and licensed paralegals happen. The most important thing you can do is trying to find a specialist personal injury lawyer who is experienced to fight your case, and avoid preventable errors, but who is fair and clear in dealing with you including your fees. Remember that in Ontario (and probably everywhere in North America) the leading specialist lawyers cost you nothing upfront, and ultimately may cost you less than the average lawyers once you factored in the higher chance of their achieving better settlements or awards.
There are generally two major auto insurance compensation claims that may be available to each victim, and possibly to the victim's family members in cases of serious injuries.
First is statutory auto accident benefits, or "no-fault benefits", or "A.B." (accident benefits) or "SABS" (Statutory Accident Benefits Schedule) benefits. All these terms are interchangeable for injury lawyers. "No-fault" is to indicate that regardless of how the accident occurred and regardless of whether or not you caused the accident and your injuries, the no-fault benefits are still available to you in 99% of the cases. The other 1% of the cases is where exclusions may apply. Some exclusions may apply where you were driving without insurance or were committing certain offences such as drinking and driving, or insurance fraud.
No-fault benefits in "catastrophic" cases can be more than 2.5 million dollars per victim. Old laws cover old accidents. For new accidents since September 1, 2010, (as further amended and reduced to about 1.5 million since June 1, 2016; but this reduction has subsequently been largely removed, and old levels restored), there are various levels of benefits. For minor cases there may be a few thousand dollars of coverage for treatment. Moderate cases there may be a few hundred thousand dollars of coverage. Benefits include an income loss for certain employed persons and rehabilitation benefits. For catastrophic cases, there can be 24 hours a day supervisory care for up to about $6,000 per month in attendant care benefits and $100 a week for housekeeping benefits. There are various other benefits in catastrophic cases including building of a new wheelchair accessible home etc... The right to claim may be there, but payment is made only if the insurer agrees that an expense is reasonably necessary. This is where disputes can arise and you will need legal representation because virtually all insurers are supported by experienced legal departments and lawyers who are very experienced in this field.
Second is the right to sue in court for your "tort damages". "Tort" is a French word, meaning "wrong" in English. So, you can sue whoever was wrong in causing or contributing to the accident. The compensation you receive under this second right is called "damages", to distinguish from no-fault accident "benefits", even though they are both dollars and nickels. A tort claim is a claim under this second right. Importantly you will note that this second right is only available if you can show that someone else was responsible in whole or in part for the accident or for your injuries. Finding out who is responsible for you may not be obvious in all cases. In a single car accident in Ontario winter might be the failure of the Ministry of Transportation to salt and sand the road. The accident might be as a result of a documented failure in the mechanics of the lone vehicle in the accident. The road design might be dangerous.
In a catastrophic case damages can be very high. But auto insurance that most people buy covers only about one million dollars for damages. Finding all the potential parties at fault in tough cases and finding all available insurance policies, and advocate for the highest level of care and damages are really what the most experienced injury lawyers are dedicated to do.
Auto injury law is quite complex and therefore mistakes by insurance companies, lawyers and licensed paralegals happen. The most important thing you can do is trying to find a specialist personal injury lawyer who is experienced to fight your case, and avoid preventable errors, but who is fair and clear in dealing with you including your fees. Remember that in Ontario (and probably everywhere in North America) the leading specialist lawyers cost you nothing upfront, and ultimately may cost you less than the average lawyers once you factored in the higher chance of their achieving better settlements or awards.