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Car Accidents in Ontario

Accident Benefits

Personal Injury

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WEEKLY BENEFITS

If you have been injured in a car accident and as a result you are not able to work or carry on your normal activities as before. There are important facts you need to know when applying for Weekly Benefits through your automobile insurance. This page will help explain the Ontario Laws concerning the payment of benefits to people injured in car  accidents. This includes:

  • people who have been employed
  • caregivers
  • those who have no income (non-earners)

IMPORTANT INFORMATION

DISABILITY CERTIFICATE REQUIREMENT

In order to receive income replacement, caregiver or non-earner benefits, your insurer will require a completed Disability Certificate (OCF-3) from a qualified medical person stating the cause and nature of your injuries with an estimate of how long your disability and treatment will last. Your insurer will pay for the cost of this certificate. Please note that if you fail to submit a completed Disability Certificate with your application for income replacement benefits, non-earner benefits, caregiver benefits or reimbursement of housekeeping or home maintenance services, no such benefit is payable until the day the insurer receives the completed Disability Certificate.

IF YOU REFUSE TREATMENT

Please note that your benefits can be suspended if you refuse to participate in rehabilitation or treatments that are reasonable or , in the case of the income replacement benefit, you are able and do not make a reasonable effort to return to work or to obtain other employment for which you are trained.

If after reading this you still have questions, please contact us by either filling out the contact form.

INCOME REPLACEMENT BENEFIT

The Income Replacement Benefit is for people who have been employed prior to their car accident. You may be eligible to get a payment every two weeks to partially replace the income you have lost, if within 2 years of an accident, you can no longer work at the same level or pace as before as a result of the car accident. You may qualify overall for income replacement benefit payments if you can answer ''Yes'' to the following questions:

  • Did I suffer physical or psychological injuries within 2 years of an accident involving a motor vehicle and as a result I am disabled from working?
  • As of the date of the accident, do any of 1he following situations apply to me?
  • Was I employed or self-employed?
  • Did I work for at least 26 weeks in the past 52 weeks before the accident?
  • Was I receiving Employment Insurance Benefits?

How Much Do I Get?

If eligible, you will receive a payment every two weeks of 80% of your net (take home) pay based on your income history before the accident, minus net income benefits payable from other sources such as your employer. The first seven days of your disability is not covered.

Your net (take home) pay is the total of your annual income minus Employment Insurance premiums, Canada Pension Plan payments and the income tax you would normally have deducted from your pay.

The amount you will receive will be calculated on the information you included on your application form. In general, benefits are calculated as follows:

  • for persons employed at the time of the accident, the income replacement is based on income earned in the 4 or 52 weeks before the accident;
  • self-employed people have their income replacement benefit based on income earned in the last 52 weeks, or their last fiscal year completed before the accident;
  • for persons unemployed at the time of the accident, but receiving Employment Insurance benefits or those who had worked at least 26 weeks in the 52 weeks before the accident, the Income Replacement benefit is based on the income earned in the 52 weeks before the accident including Employment Insurance benefits;
  • if you become disabled after age 65, benefits are payable for up to four years on a declining basis. If you are receiving benefits and reach age 65, your benefit will be converted to a lifetime pension at a reduced rate.

The maximum payment is $400 per week, unless you have purchased higher benefits.

The payments will begin within 10 Business days after your completed application and disability certificate are received by your insurance company. If your disability continues, a payment will follow at least every two weeks. If your application is questioned or refused, you will be give a written explanation immediately.

NON-EARNER BENEFIT

You may qualify for non-earner benefits if you do not qualify for Income Replacement Benefits, you no longer qualify for Caregiver Benefits, you were a full-time student, or you have completed your education in the past year but haven't yet secured employment related to your education. To qualify for this benefit, you must suffer a complete inability to carry on your normal activities.

How Much Do I Get?

You may be eligible to receive a Weekly payment of $185 every two weeks. The first 26 weeks of your disability are not covered. If you were a student at the time of the accident, and had been:

  • enrolled on a full-time basis in elementary, secondary or pot-secondary education at the time of the accident, or
  • had completed your education less than one year before the accident and were not employed in a job that reflected your education and training,

your benefits will increase to $320 per week after 104 weeks of disability.

CAREGIVER BENEFIT

A caregiver is someone who is responsible for looking after others. You may qualify for caregiver benefits under Ontario's automobile insurance legislation, if you are an insured person who, as a result of the car accident, is substantially unable to engage in the caregiving activities previously engaged in. The Law also says that you must:

  • be living with a person in need of your care, and
  • be the primary or main caregiver and, at the same time, not be receiving any income for your caregiving activities.

How Much Do I Get?

The caregiver benefit reimburses you for expenses paid out as a result of the accident in caring for your dependants. If eligible, you will receive $250 per week for the first person, and $50 per week for each additional person in your household for whom you were the main caregiver at the time you were injured.

As a caregiver , you may receive benefits for up to 104 weeks, during the period you are substantially unable to perform your caregiving activities. If you are completely unable to carry on normal activities, you may receive ' benefits after 104 weeks.

You may have purchased the optional caregiver and dependant care benefit from your insurance agent or broker at the time you bought your auto policy that pays a higher benefit of $325 per week for the first person and $75 per week for each additional person. Please check to see if you are covered for these increased benefits, which may increase your weekly payments.