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What to Expect If You’ve Been Injured in a Car Accident

Statutory Accident Benefits Coverage is provided by law under every auto insurance policy in Ontario. Because the regulations are provincially mandated, the coverage provided is standard among insurance companies. Statutory Accident Benefits provide compensation, regardless of fault, if you, your passengers, or pedestrians suffer injury or death in an auto accident.

For example, if you are injured in an auto accident, you may be entitled to the following accident benefits:

  • Income Replacement: This benefit compensates you for lost income.
  • Non-earner: This benefit provides compensation if you are completely unable to carry on a normal life and do not qualify for an Income Replacement or Caregiver benefit.
  • Caregiver: If you qualify for this benefit, it provides compensation for some expenses incurred when you cannot continue as the main caregiver for a member of your home who is in need of care.
  • Medical: This benefit pays for medical expenses incurred when you are injured.
  • Rehabilitation: This benefit pays for rehabilitation expenses incurred when you are injured.
  • Attendant Care: This benefit compensates you for some of the expense of an aide or attendant.
  • Compensation for Other Expenses: These benefits pay for some other expenses such as the cost of family visiting you during treatment or recovery. It may also pay for some housekeeping and home maintenance, the repair or replacement of some items lost or damaged in the accident, and some lost educational expenses.

If you die as a result of the accident, members of your family may also be entitled to the following benefits:

  • Death: This benefit pays money to members of your family.
  • Funeral: This benefit pays for some funeral expenses.

Applying For Accident Benefits

When applying for accident benefits, ask your claims adjuster to outline the procedures you must follow. As a first step, he or she will provide you with an Accident Benefits Application Package. This package should include five forms:

FORM 1: Application for Accident Benefits (OCF-1)

FORM 2: Employer’s Confirmation of Income (OCF-2)

FORM 3: Disability Certificate (OCF-3)

FORM 4: Permission to Disclose Health Information (OCF-5)

FORM 5: Treatment Confirmation Form (OCF-23)

In order for your accident benefits claim to be processed, you will need to complete all those sections of each form that pertain to your situation.

Note: To ensure that your accident benefits claim is handled quickly, make sure you:

  • print clearly, using blue or black ink;
  • double-check that your forms are complete and that you have not missed any sections before submitting them;
  • sign and date the forms; and
  • ask your employer, health practitioner, or anyone else submitting information on your behalf to fill out their forms in full and return them as quickly as possible.

Contact your broker or claims representative if you have any questions or have difficulty filling out your Accident Benefits Application Package.

Once your insurance company has received and reviewed your Accident Benefits Application Package, it will inform you in writing of which accident benefits you can expect to receive and which portions of your claim, if any, the company is not prepared to pay for.

Source: Financial Services Commission of Ontario


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