Car Insurance Claim After A Car Accident In Ontario
Following a car accident, you need to know what happens next with your car insurance claim. You'll find the basics of what you need to know about Ontario auto insurance claim settlement process after a car accident here. This article does not cover the steps to be done at the scene of a car accident, that information can be found in my article Car Accident? 10 Essential Things To Do Right After. Also, the information provided on automobile insurance is not legal advice; just useful information for your own knowledge, so that the whole car insurance claim process becomes not so confusing. As well, you may want to consider keeping a driver's emergency car kit in your car at all times, because you never know when a car accident may happen, and you may need one.
NOTE: It's important that you speak with your car insurance agent after your car accident to deal with and answer questions specific of your car accident situation.
Making a Car Insurance Claim
In Canada, after buying a car, you must insure it with at least the minimum insurance coverage. It is illegal to drive a car in Ontario without having auto insurance. After any car accident involving vehicle damage over $1000, or injury to any person, you can request accident benefits from your car insurance company. You must call your car insurance company within seven (7) days of the car accident to report the accident, and make a car insurance claim.
Making a claim means contacting your car insurance company to inform them of the accident, providing the details surrounding that car accident and requesting compensation for your losses and any personal injuries (including lost wages, damages to your car, etc.) based on your policy coverage.
If you do not call your car insurance company within seven days, or as soon as possible (up to 90 days after the car accident if there are reasonable circumstances for the delay), your car insurance company may not need to accept your claim.
Speaking With Your Car Insurance Company
When you call your car insurance company and inform them of your car accident, they will most likely ask you many questions about the accident including:
- when the car accident happened (date, time and location)
- your version of what happened to cause the accident
- the other driver's name and licence number
- the other driver’s insurance company name
- the car insurance policy number of the other driver
- the other driver’s car information (car model, year, licence plate, etc)
- the damage to your car if any; and
- the name and badge number of the investigating police officer
Remember when speaking with your insurance agent that he or she works for the car insurance company. It is their claim adjuster's job to investigate the details of the car accident and determine fault, settlement, and adherence to the policy terms. So, only proffer the information that is requested of you, don't claim fault and don't say more than asked or needed.
Once you answer all your auto insurance agent's questions, complete any forms required and provide them with any additional information that they may request, you have reported your car accident and begun the auto insurance claim settlement process.
Understanding No-fault Car Insurance
Ontario and most of the Canadian provinces have a "no-fault" car insurance system. This term is often misunderstood to mean that no-one is at fault. This of course is incorrect. Someone is always at fault; meaning someone is always responsible for the accident in a car accident.
No-fault car insurance simply means that each driver, despite who caused the car accident, can negotiate with their own auto insurance company for their car accident claim and compensation, rather than having to pursue each other for the money.
- Insurance Act - R.R.O. 1990, Reg. 668
Insurance Act-Loi Sur Les Assurances R.R.O. 1990, REGULATION 668 Fault Determination Rules
- Automobile Insurance Ontario-Financial Services Commission of Ontario Ministry of Finance
In Ontario, automobile insurance is regulated by the Financial Services Commission of Ontario, an arm's-length agency of the Ministry of Finance.
Auto Insurance Companies' Assessment of Fault
The claim process begun, it is now up to your auto insurance company to investigate the accident and determine how much fault, if any, to apportion to you and the other driver based on the Fault Determination Rules found in the Insurance Act.
The Fault Determination Rules is the tool all insurance companies must use to help them determine fault. These rules are a list of many different types of car collision situations against which the auto insurance companies must compare your claim to assign fault (responsibility) percentages.
Fault is allocated to each driver based on which accident scenario most closely matches the Fault Determination Rules. If the car accident does not fall into any of the scenarios, then the rules of negligence laws takes precedence. Usually, a 50-50 determination is concluded if your version of the car accident differs vastly from the other driver's, and there isn't any witness evidence.
You can be found to be anywhere between 0 percent and 100 per cent at fault. . If no agreement on fault can be reached, then a decision will have to be made by taking the claim to court. If you are found at fault for any amount (more than zero percent) of the auto accident, an “at-fault” mark will be attached to your automobile insurance record, and most likely your insurance premiums will go up on your renewal.
Accident Benefits - How Much and Who Pays?
Once fault percentage is determined, the claim adjuster assigned to your case will contact you and inform you of their decision concerning fault, and what benefits (also called no-fault or statutory accident benefits) are covered based on your car insurance policy. The extent that you are at fault is also what will be used to decide your future policy coverage and car insurance rates.
If you are deemed 100% NOT at fault, and you intend to sue the other driver for accepted losses such as severe injury, income loss, or passenger death, you should contact them and their insurance company to inform them of your decision to sue.
How much benefits you will be paid is based on your car insurance policy coverage conditions and options. In Ontario, only Direct Compensation - Property Damage, Third-Party Liability, Statutory Accident Benefits, and Uninsured Automobile coverages must be purchased by law. All other coverage offerings are optional and supplementary, based on what you want to pay for and how much coverage you desire in case of a car accident.
Statutory Accident Benefits
This coverage is one of the minimum car insurance coverages you must take under the laws of Ontario. Statutory accident benefits cover basic benefits including medical care, hospitalization, medicine, income replacement, funeral and death, and other benefits if you are injured in a car accident.
If you purchased optional collision coverage, your deductible will be based on your percentage of fault and the deductible amount you selected when you boughtyour car insurance policy. Collision covers damages to your vehicle in the event you hit (or are hit by) another vehicle or object.
Collision - Car Damaged Irreparable
If your car can't be repaired safely, or if repairing your car properly would cost more than its market (book) value at the time of the car accident, then your automobile insurance company will "write it off," and negotiate a cash payment minus the deductible with you, based on your car's condition before the accident and any haggling, convincing, proof of upgrade, etc. you provide. Market value is the price your car "could have reasonably sold for the day before your car insurance claim." The damaged car (called salvage) is now the property of the auto insurance company.
Collision - Car Damaged Repairable
If your car is repairable, your car insurance company will repair the vehicle based on the conditions agreed upon in your policy. The insurance company may let you choose the automobile repair shop, or select one themselves. Regardless of who chooses the repair shop, you are responsible for the repairs being done properly by the shop, ensuring the cost of the repairs is no more than the agreed upon repair price with the insurance company, and if improvements are made (called betterment), that solely you will pay for the price for those improvements. Your car insurance policy rights allows you to have "similar kind and quality" repairs done, which means that your car is repaired and returned to you in near same or in better condition as before the car accident.
If you opted for comprehensive coverage in your car insurance policy, your deductible will be based on your percentage of fault and your selected deductible amount. Comprehensive coverages covers damage to your car by non-vehicular accidents including, fire, theft, hail, flood, etc.
If your automobile accident was in Ontario with a car insured in Ontario, and you were found not to be at fault for the car accident, then there is no deductible to pay, unless you took out a deductible to reduce your car insurance premiums. Once you opt for a deductible in your policy, you must pay the full deductible even if you are not at fault. A deductible is the dollar amount you opted to pay in the event of an accident claim when you bought your insurance policy in order to lower the cost of the policy.
Direct Compensation - Property Damage
This coverage is one of the minimum car insurance coverages you must take under the laws. Direct Compensation - Property Damage coverage allows you to receive benefits through your insurance company from the other drivers insurance company if you were not at fault. If you were found at fault and did not buy collision coverage, all repairs to or replacement of your automobile would be your responsibility.
Despite having a no-fault car insurance system, there still exists a limited right to sue for additional costs and damages not covered by the regulated insurance benefits. Third-Party Liability coverage deals with the legal costs of being sued by the other driver, if you were fully at fault for the car accident.
Premiums are the amounts you agreed to pay yearly for car insurance coverage. At fault marks in your insurance record from any car accidents you were in could increase yearly car insurance rates.
Property In Car
Any personal property destroyed in or stolen from your car is not covered under car insurance policies. Therefore, no benefits apply. Tenant, Homeowners and Condominium Insurance are what covers any personal items like clothes, shoes, small electronics, fishing gear, and etc. lost in a car accident.
If you are injured or your car damaged by an uninsured driver or in a hit and run accident, Uninsured automobile coverage pays for the costs of repairs or assistance.
Once you receive the agreed upon payment amount from your insurance adjuster, your claim is considered settled, and then it is up to you to buy a replacement car and start driving again.
If you are reading this before you have been in a car accident, great! Now is a best time to really read over your automobile insurance policy to be sure you understand the coverages and deductions, and to make any changes to benefit you in the future. Forearmed is forewarned!
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