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The Way it Works – Understanding Your ClaimPut simply, with most car accidents which are not your fault there are two sources of compensations wallets: (1) the at-fault driver and (2) accident benefits.
The Insurer of the At-Fault Driver
Whether you are not to blame for the accident, we will start a lawsuit against the driver who is responsible. His or her insurance company will then appoint a lawyer to defend its interests or may attempt to settle the matter just between our firm and their insurance adjuster.
You can sue the other driver for the following types of compensation:
1. pain and suffering; and
2. past and future loss of income or economic losses generally
3. future loss of housekeeping abilities
There are limits, however. These limits were put in place in order to discourage minor claims from reaching the courts.
First, you can only sue for pain and suffering if you have suffered either a permanent and serious impairment or a permanent and serious scarring or disfigurement. Often we won't know whether we meet this test until some time after the accident.
Second, unless we can prove that your pain and suffering damages are worth $100,000.00 or higher, any award of compensation for pain and suffering must be reduced by a deductible of $30,000.00.
Third, as far as your economic losses are concerned, you may only sue for 80% of your net wages up to trial (and for 100% following trial). This is meant to encourage early settlements. However, if you have received any weekly accident benefits from your insurance company (see below), these must be deducted. In other words, you cannot collect twice for the same loss.
Accident Benefits
Your own insurance company (or, if you don’t have insurance, the insurer of your spouse, or of a parent on whom you were dependent or of the driver of a car involved in the accident) is required to pay certain benefits to you as long as your injuries call for them. These include:
1. All reasonably necessary medical and rehabilitation expenses (such as your chiropractor, physiotherapist, etc.)
2. Weekly loss of income benefits if you were working at the time of the accident, equal to 80 % of your net income to a maximum of $400.00, so long as you cannot for reasons of health return to work
3. Housekeeping benefits to a maximum of $100.00 per week
4. Attendant care (or nursing) services provided to the injured person (your relative would qualify for this)
5. Other benefits best discussed on a case-by-case basis
We might not see eye to eye with the insurance company as to whether an expense is reasonable or whether you are able to return to work.
We don't have to accept whatever the insurance company says. We can ask for further medical assessments and if necessary go to the Ontario Insurance Commission in order to either mediate (i.e. negotiate – usually by phone) a settlement or to argue our case before an arbitrator. In most cases, going to the Ontario Insurance Commission is exactly what we do on behalf of our clients.
Pushing the File
We push your file at all times. We issue the claims as soon as possible, assemble all relevant documents, arrange for examinations for discoveries, set up medical examinations, etc. There is much behind the scenes work of which you are not aware. Call us if there are any questions at any time. Please use our voice mail if necessary – we do check it.
Doctors and Examinations
To obtain the best settlement, we will, in most cases, need our own specialists to examine you and prepare reports. The other driver's lawyer will ask you to submit to medical examinations as well. Finally, your own insurance company will have the same right.
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