'Injured? In a Motor Vehicle Accident" Booklet Artwork sample
You also want an ePaper? Increase the reach of your titles
YUMPU automatically turns print PDFs into web optimized ePapers that Google loves.
INJURED?<br />
<strong>In</strong> a <strong>Motor</strong> <strong>Vehicle</strong> Accident?<br />
This booklet provides information<br />
about insurance benefits and other<br />
compensation available to you when you<br />
are injured in a motor vehicle accident<br />
in Ontario.
For immediate assistance call<br />
1.855.1234 TODAY!<br />
This booklet is for informational<br />
purposes only and is not intended<br />
to be a substitute for legal advice
Table of contents<br />
Am I entitled to benefits after a car accident?..................4<br />
Why are accident benefits important?......................................5<br />
Receipts .........................................................................................................4<br />
When and how do I obtain accident benefits?...................6<br />
Categories of injuries .........................................................................8<br />
What happens next? ............................................................................10<br />
Other insurance benefits/private health plans................11<br />
Do I have the right to sue at-fault persons?......................12<br />
Choosing a personal injury lawyer ..........................................13<br />
10 Questions To Ask Your Personal <strong>In</strong>jury Lawyer..........14<br />
What help can I get in the hospital?.......................................15<br />
your reference/contacts list.......................................................16<br />
Key facts/details of accident.......................................................17<br />
What to do AFTER an Accident Checklist...........................18<br />
p.a.c.e. centre contact info............................................................19
What you should know when<br />
you are injured in a motor vehicle<br />
accident...<br />
Q.<br />
Am I entitled to benefits after a car accident?<br />
A. YES. <strong>In</strong> the province of Ontario, there are two sources of<br />
compensation available:<br />
1. An Accident Benefit Claim:<br />
A claim against your own insurance company or the car<br />
insurance company of another vehicle involved in the accident.<br />
2. A Tort Claim:<br />
A lawsuit against the at-fault driver.<br />
What is “Accident Benefit”?<br />
If you or a loved one has been<br />
injured in a motor vehicle accident<br />
and has sustained physical and/or<br />
psychological injuries, you are<br />
entitled to “Accident Benefits.”<br />
These benefits are available to:<br />
drivers<br />
passengers<br />
pedestrians hit by a motor<br />
vehicle or other insurable<br />
vehicle<br />
cyclists hit by a motor<br />
vehicle or other insurable<br />
vehicle<br />
Even if the accident was your fault, you<br />
are still entitled to receive accident benefits.<br />
Even if you do not have your own<br />
motor vehicle insurance, you are entitled<br />
to receive accident benefits.<br />
- PAGE 4 -<br />
IMPORTANT!<br />
Receipts:<br />
Keep all of your receipts related<br />
to your treatments. The receipts<br />
help to prove to the insurance<br />
company what accident-related<br />
expenses you or your family has<br />
paid.
What is the purpose of<br />
accident benefits?<br />
Accident benefits have been put in place by the government to help you<br />
recover from your accident-related injuries. There are various benefits<br />
available to you while you are on the road to recovery. Some of the<br />
following benefits may be available to you depending upon your motor<br />
vehicle insurance coverage and your eligibility.<br />
possible Types of benefits:<br />
Medical and Rehabilitation<br />
Benefits<br />
Attendant Care<br />
Benefits<br />
<strong>In</strong>come Replacement<br />
Benefits<br />
Caregiver<br />
Benefits<br />
Visitation Expenses<br />
Housekeeping/Home<br />
Maintenance Expenses<br />
Additional benefits may<br />
include:<br />
Services of a Case<br />
Manager<br />
Loss of Education Expenses<br />
Non-Earner Benefits<br />
Dependent Care Benefits<br />
Damage to Clothing Expenses<br />
Death & Funeral Benefits in<br />
cases of death.<br />
Pays for your medical treatment, therapy,<br />
medication and required equipment, housing<br />
and transportation.<br />
Pays for “hands on” care during your recovery.<br />
Pays for a portion of income lost resulting from<br />
not being able to return to work due to injuries<br />
sustained. The amount of coverage is limited or<br />
a “capped benefit”.<br />
Pays for costs associated for childcare if you are<br />
unable to care for your children or other<br />
dependents. Coverage is limited/capped benefit.<br />
Reimburses immediate family members for<br />
visitation expenses including travel, parking,<br />
meals and accommodations.<br />
Assists with costs because of your inability to<br />
do your present and future housekeeping and<br />
maintenance chores.<br />
Pays for a rehabilitation coordinator to help<br />
assist with your recovery. (This benefit is only<br />
available in “catastrophic impairment” cases,<br />
see page 8).<br />
- PAGE 5 -
When and how<br />
do I obtain accident benefits?<br />
Within 7 days of the motor vehicle<br />
accident, you must call your motor<br />
vehicle insurer stating that you want<br />
to apply for accident benefits.<br />
The sooner you call the better.<br />
You may need therapy, equipment,<br />
assistive devices, or other medical<br />
services when you leave the<br />
hospital. If you call the insurer early,<br />
benefits can be coordinated so that<br />
you will have what you need when<br />
you get home.<br />
Either you or someone close to you should call the first insurer that applies to<br />
you based on the order of the list below (top down):<br />
1. insurer of your motor vehicle<br />
2. insurer of the motor vehicle under which you are insured<br />
3. the insurer of the motor vehicle in which you were an occupant<br />
4. insurer of the motor vehicle that struck you if you were a<br />
pedestrian or cyclist<br />
5. insurer of any other motor vehicle involved in the accident<br />
6. the <strong>Motor</strong> <strong>Vehicle</strong> Accident Claims Fund<br />
(in Canada, call 1-800-268-7188)<br />
When you call the insurer, tell them that<br />
you want to start an accident benefits claim.<br />
The insurer will ask you for some basic<br />
information including the following:<br />
name and age of the injured person<br />
the nature of the injuries<br />
your insurance policy number<br />
motor vehicle information<br />
basic details about the accident<br />
Some people may wish to consult a personal injury lawyer<br />
to advise them about their claim.<br />
- PAGE 6 -
IF YOU DON’T CALL...<br />
If you do not call the insurer within 7 days, the<br />
insurer has the right to delay providing you with<br />
benefits.<br />
An application for accident benefits will need to<br />
be completed. A copy of the application can be<br />
obtained from your social worker at the hospital,<br />
the insurance company or a personal injury<br />
lawyer.<br />
online list of<br />
auto insurance<br />
companies in<br />
canada:<br />
https://en.wikipedia.org/<br />
wiki/List_of_Canadian_<br />
insurance_companies<br />
Upon receipt of your<br />
completed Application...<br />
Upon receipt of your completed<br />
Application for Accident Benefits<br />
(OCF-1), your insurer will review your<br />
application and ask you to have a<br />
Disability Certificate completed by a<br />
health practitioner of your choice.<br />
Essentially, this form states the cause<br />
and nature of your impairment(s) and<br />
the estimated duration of your disability.<br />
- PAGE 7 -
what are the Levels of Benefits?<br />
There are 3 Levels of Benefits Based on Your <strong>In</strong>jury Classification which are<br />
based on your injuries, you are either classified as:<br />
1) Minor <strong>In</strong>jury Guideline (MIG)<br />
2) Non-Catastrophic <strong>In</strong>jury<br />
3) Catastrophic <strong>In</strong>jury<br />
How do insurance companies<br />
categorize different injuries?<br />
The following injuries will be classified as minor and will be treated<br />
within the Minor <strong>In</strong>jury Guideline (MIG):<br />
Sprain - means an injury to one or more tendons or ligaments,<br />
including a partial tear<br />
Strain – means an injury to one or more muscles, including<br />
a partial tear<br />
Whiplash<br />
Contusion<br />
Abrasion<br />
Subluxation – means a partial dislocation of a joint<br />
If your injury falls within this category, the maximum Medical/Rehabilitation<br />
Benefits payable are $3,500.00<br />
You can still qualify for either<br />
the <strong>In</strong>come Replacement Benefit or<br />
the Non-Earner Benefit if your<br />
injury is minor; however you<br />
will not be eligible to receive<br />
Attendant Care Benefits.<br />
- PAGE 8 -
If your injury is classified as a Non-Catastrophic <strong>In</strong>jury, that is,<br />
an injury falling neither under the MIG, nor under the<br />
“catastrophic” classification, then you can receive up to $65,000.00<br />
in Medical/Rehabilitation and Attendant Care Benefits in addition<br />
to any <strong>In</strong>come Replacement or Non-Earner Benefit.<br />
If you sustain a Catastrophic <strong>In</strong>jury, you can receive up to<br />
$1,000,000.00 in Medical/Rehabilitation and Attendant Care Benefits.<br />
As well, <strong>In</strong>come Replacement Benefits are available. You will<br />
be deemed to have sustained a Catastrophic <strong>In</strong>jury if you have<br />
sustained any of the following injuries: Paraplegia<br />
Tetraplegia<br />
Severe impairment of<br />
ambulatory mobility or use<br />
of an arm, or amputation<br />
Loss of vision of both eyes<br />
Traumatic brain impairment<br />
Certain types of<br />
marked impairment or<br />
severe impairment<br />
- PAGE 9 -
What happens next?<br />
The insurance company will assign an<br />
accident benefits adjuster to your file<br />
whose focus will be on your injuries and<br />
health care needs.<br />
A separate adjuster will be assigned to<br />
deal with motor vehicle damages, if<br />
appropriate. The adjuster will advise<br />
you regarding the application package<br />
and required information. If you decide<br />
to retain a personal injury lawyer, his or<br />
her office will deal directly with the<br />
adjuster and can assist you in<br />
completing the application.<br />
Within 30 days of getting an application for Accident Benefits, you must<br />
send the completed application to the accident benefit insurer. If the form<br />
is not filled out and sent in, you will not get any compensation. You<br />
may not get certain benefits like attendant care benefits before the date<br />
you submit the application.<br />
The application for accident benefits will include a disability certificate.<br />
Wherever possible, give the insurer an accident benefit application and a<br />
completed disability certificate as soon as possible in order that benefits can<br />
start being paid.<br />
IMPORTANT!<br />
Return your completed<br />
Accident Benefit application<br />
within 30 days<br />
of receiving it or you<br />
will not get any<br />
compensation.<br />
AND, attendant care<br />
benefits may not start<br />
before the date you<br />
submit your completed<br />
application. - PAGE 10 -
Other insurance benefits/private<br />
health plans<br />
You should apply for Accident Benefits even if you<br />
have a health plan that may cover some of your<br />
medical expenses and/or income loss.<br />
Private health plans are often more limited than<br />
Accident Benefits in the types of coverage and<br />
amounts available to be paid.<br />
IMPORTANT!<br />
If you are eligible for<br />
medical or disability<br />
benefits through a<br />
private or work-related<br />
health plan, that health<br />
plan will be the first<br />
insurance company<br />
in line to pay for<br />
certain expenses<br />
before the Accident<br />
Benefits insurer.<br />
However, you should apply to both insurance<br />
companies to get coverage for all your needs.<br />
- PAGE 11 -
what’s a tort claim...<br />
Q.<br />
A.<br />
Do I have the right to sue at-fault persons?<br />
YES. A claim against the at-fault driver is called a tort claim.<br />
This claim is usually paid by the auto insurance company of the<br />
at-fault driver. Tort law allows an injured person to obtain compensation<br />
from the person who caused the injury. More than 95% of these claims<br />
are settled before they go to trial.<br />
A personal injury lawyer can give you information about your rights and<br />
those of your family to obtain compensation from anyone potentially responsible<br />
for the accident. These claims are over and above any<br />
accident benefits you may be entitled to receive.<br />
<strong>In</strong> a claim, family members may recover income they have lost while<br />
caring for you, as well as other out-of-pocket expenses that have not<br />
otherwise been reimbursed.<br />
<strong>In</strong> some cases claims against at-fault persons will include claims for:<br />
future income loss or loss of opportunity that you suffer as a<br />
result of your injuries and<br />
future medical and rehabilitation expenses.<br />
pain and suffering<br />
<strong>In</strong> almost all cases you only have two years from the date of a motor<br />
vehicle accident to start a lawsuit. A personal injury lawyer can<br />
provide information about the deadlines that apply in your case.<br />
More than 95%<br />
of these claims<br />
are settled<br />
before they go<br />
to trial.<br />
- PAGE 12 -
Choosing a personal injury lawyer...<br />
helpful numbers...<br />
You may call the<br />
Patient Ambulatory Care<br />
Education Centre and be<br />
referred to a lawyer within<br />
your community with the<br />
appropriate expertise for:<br />
a FREE consultation<br />
a FREE document review<br />
a FREE second opinion.<br />
CONTACT US TODAY!<br />
1-855-123-4567<br />
or 416-947-3330<br />
You or your family member may wish to consult<br />
a personal injury lawyer following a serious<br />
personal injury. Finding the right lawyer to<br />
represent both your current and your future<br />
needs is an important decision, especially if your<br />
injuries are permanent or you need long term<br />
rehabilitation. Seeking compensation and<br />
applying for Accident Benefits is a complicated<br />
process with specific time lines. The decisions<br />
that you are being asked to make are happening<br />
at a very difficult time in your life. It is important<br />
that you are fully aware of all your rights.<br />
We recommend you contact more than one law<br />
firm before making your final choice. You may<br />
call the Patient Ambulatory Care Education Centre<br />
and be referred to a lawyer within your community<br />
with the appropriate expertise for a FREE<br />
consultation, a FREE document review, or a FREE<br />
second opinion.<br />
Call 1-855-123-4567 or 416-947-3330 or<br />
(*)HURT or (#)HURT.<br />
- PAGE 13 -
10 Questions To Ask Your<br />
Personal <strong>In</strong>jury Lawyer...<br />
Here is a handy checklist of basic questions to ask before you<br />
retain a lawyer:<br />
1. Does the law firm specialize in personal injury?<br />
2. Will the law firm provide a FREE consultation?<br />
How quickly can they schedule your free no-obligation<br />
personal injury evaluation?<br />
3. Will the lawyer come to you at the hospital or in your<br />
home?<br />
Are visits available free of charge anywhere in Ontario?<br />
4. Does the firm bill on a contingency basis?<br />
(This means that no fees are collected by the lawyer<br />
until the matter is settled. The personal injury lawyer<br />
will receive a percentage of what you recover.)<br />
5. Have you handled matters like mine?<br />
What are the possible outcomes of my case?<br />
6. Approximately how long will it take to resolve my<br />
matter?<br />
7. How will you keep me informed of progress?<br />
8. Do you return calls in a short period of time?<br />
9. What kind of approach will you take to resolve the<br />
matter – aggressive and unyielding, or will you be<br />
more inclined to reach a reasonable settlement?<br />
10. Does the law firm have online reviews and testimonials for<br />
you to read?<br />
- PAGE 14 -
What help can I get in the<br />
hospital?<br />
Specialists at the Patient Ambulatory Care<br />
Education (P.A.C.E.) Centre are trained to help<br />
patients injured in motor vehicle accidents with<br />
insurance matters.<br />
Ask to see a specialist to help you fill out the forms<br />
and certificates that you need to make your claim.<br />
Call 1-855-123-4567 or 416-947-3330.<br />
Email: info@gtapace.ca<br />
- PAGE 15 -
your reference/contacts list<br />
Name:<br />
Phone Number:<br />
Emergency Contact:<br />
Ph:<br />
Family Doctor Name:<br />
Family Doctor Address:<br />
Hospital Address with Postal Code:<br />
Hospital Ph:<br />
Room Number:<br />
Hospital physician:<br />
Social worker:<br />
Patient navigator:<br />
Medications:<br />
Main <strong>In</strong>formation Desk:<br />
Patient Relations:<br />
Helpful Websites:<br />
- PAGE 16 -
Key facts/details of accident<br />
Background of Accident:<br />
Date of accident:<br />
Follow up<br />
with your<br />
insurance<br />
company<br />
within<br />
7 days to<br />
avoid delays<br />
in getting<br />
all the<br />
benefits you<br />
deserve.<br />
<strong>In</strong>jured person’s full name:<br />
<strong>In</strong>jured person’s date of birth:<br />
<strong>In</strong>surance information<br />
<strong>In</strong>surance company:<br />
<strong>In</strong>surance company’s telephone number:<br />
<strong>In</strong>surance policy number:<br />
Accident benefit adjuster:<br />
Accident benefit adjuster’s telephone number:<br />
Accident benefit claim number:<br />
Accident investigating details<br />
Location of accident:<br />
<strong>In</strong>vestigating Police Officer name:<br />
Police Officer’s badge number:<br />
Police Officer’s telephone number:<br />
Personal injury lawyer information<br />
Law firms name:<br />
Lawyer’s name:<br />
Lawyer’s telephone number:<br />
Protect what you are entitled to by filling out this form<br />
accurately.<br />
- PAGE 17 -<br />
Month<br />
Day<br />
Year
CHECKLIST:<br />
WHAT TO DO AFTER AN ACCIDENT<br />
Seek required medical attention.<br />
<strong>In</strong>form the police that you have<br />
been involved in a motor vehicle or<br />
boating accident.<br />
Record the insurance information<br />
of any vehicles involved in the<br />
accident.<br />
Record the names and addresses of<br />
all involved parties and witnesses<br />
to the accident.<br />
<strong>In</strong>form your family doctor of the<br />
injury and keep track of the<br />
physicians and health care<br />
professionals you have seen.<br />
Contact one of our personal injury<br />
lawyers to find out about your legal<br />
rights.<br />
Notify the accident benefits<br />
insurance company within 7 days<br />
of your automobile accident.<br />
Notify your employer or school of<br />
your accident and injury.<br />
<strong>In</strong>form your bank manager and<br />
credit card company about your<br />
accident.<br />
Keep receipts of all accident<br />
related expenses. Family members<br />
should also record the dates and<br />
time spent caring for the injured<br />
person.<br />
slips & falls:<br />
For slips and falls on sidewalks and<br />
roadways, immediately notify the<br />
municipality where the fall occurred<br />
about your claim. You should contact<br />
one of our lawyers to do this on your<br />
behalf.<br />
For private property slips and falls,<br />
for example in a mall, make sure<br />
that the injury is reported to the<br />
management office and a report<br />
taken.<br />
Ask for a copy of the incident report.<br />
Ask if there is a security camera that<br />
may have recorded the fall.<br />
Track all your medication, rehabilitation,<br />
and other expenses related to<br />
your accident.<br />
Record the names and contact<br />
information of individuals you have<br />
discussed your injury with.<br />
Check for other insurance<br />
coverage (i.e., through your work,<br />
school, or private plans).<br />
- PAGE 18 -
Patient Ambulatory Care Education (P. A. C. E.) Centre<br />
we are here to help<br />
PERSONAL INJURIES HURT!<br />
What should you do?<br />
Do you know your Legal Rights?<br />
Contact Us Anytime!<br />
We are here to help you through this....<br />
Patient Ambulatory Care Education (P. A. C. E.) Centre<br />
520 Ellesmere Road.<br />
Scarborough, ON<br />
Call: 1-855-123-4567 or 416-947-3330<br />
Email: info@gtapace.ca<br />
WE OFFER<br />
FREE 1 Hour Case Evaluation<br />
(which includes a Q&A period)<br />
WHAT IMMEDIATE Action Steps?<br />
(info one should take to build a winning case<br />
FAST)<br />
FREE Document Review<br />
FREE Second Opinion<br />
FREE Hospital & Home Visits<br />
Take the first step to get the best medical attention<br />
and settlement you deserve.<br />
- PAGE 19 -
Patient Ambulatory Care Education (P. A. C. E.) Centre<br />
520 Ellesmere Road.<br />
Scarborough, ON<br />
Call 1-855-123-4567 or 416-947-3330.<br />
info@gtapace.ca