This page is about getting insurance benefits after a motor vehicle collision in Ontario. This process is different from province to province, from state to state and country to country. The information here outlines the major issues and processes involved and may not contain all of the details relevant in a particular case.
What are accident benefits?
Anyone who has been injured in a motor vehicle collision can claim for accident benefits. Pedestrians and bicyclists who have been in contact with a vehicle qualify for accident benefits. Accident benefits are available even if the accident is your fault. An accident benefits claim does not affect your insurance rates.
Accident benefits are in place to cover many costs that may come up as a result of the accident. Help may include some or all of the following:
- Medical and rehabilitation expenses such as equipment, treatment or therapy
- Attendant care, for example, the extra care given by you or others to care for your injured child
- Income replacement benefits or non-earner benefits for those not working
- Visitation expenses, such as parking, meals, taxis or ride share services, and a place to sleep
- Lost education expenses
- Housekeeping expenses
- Damage to clothing expenses
Keep all receipts related to treatment
Accident benefits may not be able to cover lost pay at work. Instead, accident benefits can help with other costs. Collect all receipts to help you keep track of these other costs. You can use the receipts to prove to the insurance company what accident-related expenses you have paid.
You will probably have a lot of questions. They can best be answered by talking to your insurance adjuster or a qualified lawyer.
Making an insurance claim
Within 7 days of the accident, you should call the vehicle insurer to tell them that you want to apply for accident benefits. The sooner you call, the better. Your child may need special services or equipment when they leave the hospital. If you call the insurer early, it will make the transition smoother.
If you do not call the insurer within 7 days, you may not get your benefits right away.
Getting help at the hospital
Most hospitals employ a social worker who is trained to help with insurance matters for patients injured in a motor vehicle collision. Ask your child’s health-care team who this person is. See about getting their help filling out the forms and certificates that you will need to make a claim.
Calling the insurers
Call the first insurer on the list below that applies to you:
- The insurer of the child's parent/guardian's vehicle
- The insurer of the vehicle in which the injured child was an occupant
- The insurer of the at-fault driver or owner
- The insurer of any other vehicle involved in the accident
- The Motor Vehicle Accident Claims Fund: in Canada, call 1-800-268-7188
When you call the insurer, tell them that you want to start an accident benefits claim on behalf of your child and/or any other injured person in your family.
The insurer will ask you for some basic information, including the following:
- Name and age of the injured child
- Injuries to your child
- Your insurance policy number and vehicle information
- Basic details about the accident
After you have spoken with the insurer
Once you have spoken with the insurer, they will send you an application for accident benefits. An adjuster will be assigned to your file. The adjuster will call you with a claim number and will be your main contact at the insurance company.
Within 30 days of getting an application for accident benefits, you should send the completed application to the accident benefit insurer. If the form is not filled out and sent in, you will not get any money nor be able to access any benefits.
The application for accident benefits will include a disability certificate. Wherever possible, a completed disability certificate should be given to the insurer right away.
Getting a lawyer
Because insurance can be hard to understand, some families may want to ask a lawyer to help them decide what to do. A lawyer who knows personal injury laws involving children is the best person to help you with your accident benefits claim. Most lawyers will talk with you, free of charge, the first time you call. Information about how to find a qualified lawyer is available at the Toronto Acquired Brain Injury Network (TABIN) website: https://abinetwork.ca/individuals-families/finding-a-qualified-trauma-lawyer/.
For your reference
Date of accident:
Insurance company name:
- Telephone number:
- Policy number:
Accident benefits adjuster name:
- Telephone number:
- Claim number:
Investigating police officer name:
- Badge number:
- Region/Division:
- Telephone number:
Lawyer name:
- Company:
- Telephone number:
Notes: