Trying to understand the legal process immediately after a car accident may be difficult.
In the unfortunate event in which you find yourself involved in an auto accident involving property damage or an injury, you will need to file a claim with your insurance company immediately.
In this blog post, we will be breaking down the entire Motor Vehicle Claims process in Ontario and lead you to the best possible outcome. If you are unsure where to begin your claim, or what the next steps in the claims process may be, this blog is for you. If you need more information on your particular situation, contact a personal injury lawyer today for additional assistance.
1. Review and Understand Your Policy
The first thing to do following a car accident is to review your insurance policy. It is important that you familiarize yourself with your insurance coverage, your rights as well as your responsibilities. You may also choose to read over the Ontario Automobile Policy (OAP 1), you can also ask your insurance broker, agent or claims adjuster for a copy.
2. Contact your Insurance Company and file your claim and accident report
Following an accident, you must file a report with your insurance provider within seven days (or as soon as possible). If you fail to file your claim within seven days, it may result in your claim not being honored.
Once your claim has been reported, you should expect to be contacted by a claims adjuster who will be assigned to your file. During this process, the adjuster will ask you questions about the accident as well as your injury. You will be required to give a detailed account of what happened and your injuries immediately after. To support your claim, you may also be required to complete a claim form, which is a sworn statement in support of your claim. During this call, your adjuster will determine the extent to which the claim is covered by your insurance policy.
When filing a claim you will need the following:
- Your policy number.
- Make, model, year, registration and license plate number of the vehicle.
- Accident details – driver’s name and license number (if the driver was not the registered owner)
- Date, time and location of the accident.
- Extent of any injuries. 6. Number of passengers involved.
3. The Insurance Company Accesses Fault
In each accident, there is always one party who is liable and at fault, whether partially or fully. The insurance company must determine the degree of fault to be assigned to each driver involved. This process is to determine which property damages apply to the accident and the driver who is at fault’s premium is adjusted accordingly.
There are a few rules your insurer will base their at fault decision off of (also known as the Fault Determination Rules). You can review the Fault Determination Rules here.
- Use diagrams to cover more than 40 accident situations that can be applied to almost every possible road collision scenario
- Are applied regardless of road or weather conditions, visibility, point of impact on the vehicles, or the actions of pedestrians
Using the rules mentioned above, fault is then allocated to each driver based on which accident scenario it most resembles.
How does being at fault affect you as a driver?
Assessed between zero percent and one hundred percent at fault, any driver who has more than a zero percent will have an at-fault accident on their insurance record. If you were found to be more than 25 percent at fault, your insurance premium will likely be affected. Follow up with your insurance broker to confirm how much your insurance premium will go up.
What if you do not agree with your insurance company’s assessment of fault?
If you disagree with your insurance company, and believe the decision they have concluded with does not accurately reflect the accident, ask your adjuster which Fault Determination Rules has been applied to your case. In this situation, you may bring any new and additional details to your insurance adjuster. However, your insurance company may refuse to revise its decision. In this case, if you still disagree, you may contact your insurance company’s complaint officer.
What to expect if your vehicle has been damaged?
Depending on your insurance coverage and who was found at fault, the amount you will receive for your damage claim will vary. Once again, it is important to check with your insurance adjuster and go over the coverages that are available to you and any deductibles that may apply.
Does your insurance company have to provide you with a rental vehicle?
If the other driver’s insurance company accepts complete fault for the accident, you will be entitled to a replacement vehicle, up to a limited time. However, if you are found to be partially or completely at fault for the accident and do not have Loss of Use Coverage, the rental vehicle cost may not be fully covered. It is always important to check your policy with your insurance company.
How does an insurance company decide whether to repair or write off your vehicle?
Your Insurance company will pay the lower of the 2 options:
- The cost to repair the loss or damage
- The “actual cash value” of your vehicle at the time of the accident
Your Insurance Company will not pay more to repair your vehicle if the damages cost more than its actual cash value.
What to expect if you have been injured?
Statutory Accident Benefits (SABS) Coverages are provided by law under every auto insurance policy in Ontario. Since SABS is mandated, the coverage provided is standardized across insurance companies.
Statutory Accident Benefits provide compensation, regardless of fault, to anyone who may suffer from an injury or death as a result of an auto accident. Below is what you may be entitled to if you have been injured in an car accident:
- Income Replacement
- Attendant Care
- Compensation for Other Expenses
To find out more information, a full description for the accident benefits is available to you in the Ontario Automobile Policy.
Applying for Accident Benefits
Your claims adjuster will provide you with an Accident Benefits Application Package when applying for accident benefits. The package includes five forms: