Accident Benefits Frequently Asked Questions

How and when should I talk to the insurance company?

When you are claiming accident benefits, you need to notify the accident benefits insurer and provide information in support of your claim. In most cases, your insurance company will send an insurance adjuster to meet with you and talk about the accident and your injuries. Here are some important points to remember:

  • Be aware that anything you say to the insurance adjuster will go into your file and can affect your future accident benefit and tort claims.
  • Only talk to the adjuster when you are medically able.
  • Get legal advice and know your rights before meeting with the adjuster. Why? Insurance companies deal with cases like yours all the time. This is likely your first time dealing with an adjuster. Keep the playing field level by knowing your rights.
  • You have no obligation to speak to an adjuster from the insurance company of the at-fault person. However if you choose to, we recommend that you speak to a lawyer first.

How do I complete all of the forms?

When you are claiming accident benefits there are several auto insurance forms that must be completed before any benefits are paid. A personal injury lawyer from Thomson Rogers can help you complete the forms during the initial meeting.

What if the injured person cannot make decisions due to incapacity?

If an injured person has a severe injury that prevents the person from making his or her own decisions, then the family is entitled to make decisions regarding treatment while the person is confined to the hospital. Thereafter, it is possible to appoint a person as a substitute decision-maker on behalf of the injured person.

What if I am at-fault for the car accident – do I still have a claim?

Yes, regardless of how the accident happened or who caused it, your entitlement to accident benefits may be substantial, depending on your injuries.

What should I do if I am hurt in a car accident and can’t work, go to school or take care of my children?

There are accident benefits available to replace lost income, and recover school expenses, and in certain circumstances, to pay child care providers.

What if I was driving my car without car insurance and was involved in an accident?

You cannot pursue a claim against any at-fault driver if you were knowingly driving your car without car insurance. However, you remain entitled to claim medical, rehabilitation, attendant care benefits.

How will the accident affect my insurance rates?

If the accident is your fault, your car insurance rates may increase. If the accident is not your fault, your car insurance rates should not increase – even if you make a claim for benefits.

What if the accident occurred while I was working?

We suggest you consult a personal injury lawyer to determine if the claim should be pursued through the insurance company or the Workplace Safety Insurance Board (WSIB).

Who chooses the case manager or treatment providers?

The injured person is entitled to select case managers and other treatment providers. We recommend that you interview qualified health care professionals before you make a choice. Lawyers, social workers and insurers can put you in touch with these professionals.