Ontario Auto Insurance Claims Accident Benefits

Accident victims finding it's a long road to justice

If justice delayed is justice denied, then Ontario car accident victims are certainly getting the short end of the stick.

Under Ontario's no-fault car insurance system, those injured in car accidents are entitled to certain statutory accident benefits for things like partial income replacement, attendant care and rehabilitation services.

The extent of the benefits is dependent on the extent of the injuries suffered, defined as minor, non-catastrophic and catastrophic. But being able to obtain accident benefits on a timely basis is no easy task.

If an insurer denies a request for accident benefits, or declines to approve a treatment plan, the injured person is forced to turn to the Financial Services Commission of Ontario (FSCO) for mediation.

The FSCO, which regulates insurance companies, is an agency of Ontario's ministry of finance.

Now, there's nothing wrong with mediation in principle.

But it's non-binding and, worse, the waiting list for a hearing is about one year.

According to FSCO statistics earlier this year, there were 23,336 open pending mediation files. From March 2010 to February 2011, FSCO received 28,043 applications for mediation and closed 18,515 files.

That means the backlog is growing and will continue to do so until either insurance companies and their adjusters change their policies on benefits denial, or FSCO, that is, the provincial government, hires more mediators.

According to an executive director with FSCO, there has been an "unprecedented increase in the number of mediation applications received.''

I'd suggest the chief reason for the growing backlog is the increasing practice of the insurance industry to refuse treatment plans and benefits.

According to Nick Gurevick's experience -- he's president of the Alliance of Community Medical & Rehabilitation Providers -- the decline rate for treatment plans has more than doubled to about 30% in the past year. If mediation fails -- and the failure rate is about 30% -- the injured person must file for arbitration and wait another year or so for a hearing.

Ontario Accident Benefits Insurance Claims, Lawyer David ...

When you or a loved one is involved in an Ontario accident, the first step toward making a claim is to contact your own insurance company. This is the case regardless of whether or not you are at fault, whether you are a pedestrian, or whether you were a passenger in a vehicle. Your own insurance company will be responsible for providing you with Ontario Accident Benefits. Ontario Accident Benefits are designed to provide you with all of the medical treatments that you need, medications, assistance with housekeeping and homemaking, attendant care (someone to help you with your own personal care), other family expenses, income replacement or caregiver or non-earner benefits, occupational therapy assistance, assistive devices, job re-training, as well as other benefits.

Filling out the insurance forms can be a time consuming, confusing and frustrating task. Don’t let this stop you from getting what you help you need and deserve. David and his team of personal injury professionals will help you complete these forms. If you plan to pursue the other driver for compensation for pain and suffering, loss of income or medical or other expenses, you must first apply to receive Ontario Accident Benefits.

Let David tell you more about the importance of making an Ontario Accident Benefits claim and maximizing these benefits.

Accident

Ontario

Insurance for Dummies

The new life insurance investment advisor

The Complete Book of Insurance, Understand the Coverage You Really Need