If you are injured in an accident involving a motor vehicle, you are entitled to apply for medical, economic, and other benefits. It does not matter who is at fault for the accident. If you are injured because of a car accident, you are entitled to apply, even if you do not have insurance.
The amount and type of benefits available depend on the type of injury. There are three main categories of injuries: minor injuries, catastrophic, and non-catastrophic.
A common dispute with the insurance company and the insurance adjuster is a difference of opinion with respect to the category of the injury.
Statutory accident benefits cover a wide range of damages, regardless of who caused the accident. SABS lists some of the available benefits:
Income replacement benefit – if you are unable to work because of your injuries, you can receive up to 70 percent of your gross weekly income (with a max figure of $400.00 per week and a max duration of 104 weeks). If you are unable to do any job that is reasonably suited for you can receive benefits past 104 weeks.
Non-earner benefit – if you don’t qualify for income replacement benefits but are at least 18 and “suffer a complete inability to carry on your normal life,” you can receive non-earner benefits, which entitle you to $185.00 per week for a period of 104 weeks.
Medical and rehabilitation benefits – Medical and rehabilitation benefits – covers medical and therapeutic expenses not covered under OHIP. Common items include physiotherapy, chiropractic, massage, acupuncture, medications, assistive devices, and home and vehicle modifications. There is a maximum amount available depending upon the severity of the injuries of $3500 for a Minor Injury, $65,000 for a non-catastrophic injury and $1,000,000 for a catastrophic injury unless you have optional benefits.
Attendant care benefits –if your injuries require you to hire an attendant to assist you with personal care activities, this benefit will provide you with up to $3,000 per month to help with the costs.
Expenses of immediate family members to the hospital.
Reimbursement for personal effects destroyed in an accident.
Funeral and Death Benefits
There are also other optional statutory accident benefits to which you may be entitled provided that you purchased these optional benefits. Common optional benefits are:
Housekeeping and Home Maintenance benefit – if applicable, you can receive up to $100 per week for this benefit.
Caregiver benefit – if you are a caregiver (which may include a parent) who no longer can perform your duties due to your injury, this benefit will provide you with $250 per week for the first person and $50 per week for each subsequent person. This benefit is only available if you have optional benefits or sustain a catastrophic impairment
If you have sustained a catastrophic injury, then there are enhanced accident benefits available to you. The following are the enhanced benefits available:
Medical and Rehabilitation Benefit -$1,000,000 payable over a lifetime
Housekeeping and Home Maintenance Benefit – $100/week for life
Services of a case manager
Expenses of visitors to the hospital
Lost education expenses
Reimbursement for personal effects destroyed in the accident
Caregiver benefit – $250/week for expenses incurred to continue to provide care, plus $50/week for each extra person
Steps to Take After a Car Accident Has Occurred:
1. Ensure that the police have been informed about the accident
2. Notify your employer or school
3. Notify the Accident Benefits insurance company within 7 days
4. Check for access to other insurance coverage
5. Keep receipts, dates, and records of all related expenses for both you and your family members (i.e. parking, hotel costs, days off work, time spent caring for the injured person, etc.)
6. Inform your family doctor of the accident and your injury
7. Record the names and addresses of the other motorists involved in the accident, along with the names and addresses of any witnesses
Call MK Legal Services to ensure your rights are protected.
Has your insurer denied your application for long-term disability benefits, even though you are up to date on your premiums and unable to work due to disability? There are options for legal recourse in the face of this unfair business tactic. Don’t give up and take the insurance company’s denial as the last word. You have the right to fight for your owed benefits.
Some of the commonly cited causes for denying long-term disability benefits include the insurance company’s claim that the insured:
didn’t meet the requirements for the definition of disability;
is no longer disabled as defined by the policy after two years;
gave false medical information on the initial long-term disability application or otherwise misrepresented his or her health;
doesn’t meet the qualifying time requirements for seeking benefits; and
failed to meet the terms of the contract (such as failing to pay premiums according to the schedule).
Mk legal services will hold disability insurance companies accountable when they deny legitimate claims or terminate benefits without valid justification. We force disability insurers to live up to their obligations and honour the terms of their policies.