Accident benefits are available to anyone involved in an automobile accident. It does not matter if you were at fault. The criteria to be eligible for accident benefits depend on certain facts surrounding your life and the medical evidence supporting your physical and psychological injuries. Our lawyers have the experience necessary to navigate you through the claim or dispute process.
Income Replacement Benefits (IRB):
Your eligibility for Income Replacement Benefits is determined based on the following criteria:
You were employed at the time of the accident and, within 2 years following the accident, you suffer a substantial inability to perform the essential task of that employment; or
You were not employed at the time of the accident but you held employment for at least 26 weeks during the 52 weeks prior to the accident or were receiving employment insurance benefits at the time of the accident; or
You were not employed at the time of the accident but were at least 16 years of age or was excused from attending school under the Education Act at the time of the accident and, as a result of and within two years after the accident, you suffer a substantial inability to perform the essential tasks of the employment in which you spent the most time during the 52 weeks prior to the accident; or
You were self-employed at the time of the accident and suffered, due to and within two years of the accident, a substantial inability to perform the essential tasks of his or her self-employment
The income replacement benefit is calculated based on 70% of your gross income up to a maximum of $400 per week (unless optional benefits have been purchased).
You will be eligible for Non-Earner Benefits if you satisfy any of the following conditions:
You suffer a complete inability to carry on a normal life as a result of and within 2 years after the accident and does not qualify for an income replacement benefit, or
You suffer a complete inability to carry on a normal life as a result of and within 2 years after the accident and,
You were enrolled on a full-time basis in elementary, secondary or post-secondary education at the time of the accident, or
Completed your education less than one year before the accident and was neither employed nor a self-employed person after completing your education and before the accident, in a capacity that reflected your education and training.
The Non-Earner Benefit is payable four weeks after the accident at the rate of $185 or $320 per week depending on the facts of your case.
As of June 1, 2016, the Caregiver Benefits are only available for catastrophic injuries, unless you purchase optional benefits. If you suffer a catastrophic impairment, you will be eligible to receive Caregiver Benefits if, at the time of the accident, you were the primary caregiver for the person in need of care, resided with the person and did not pay for such caregiver activities. The Caregiver Benefits are payable at a rate of $250 per week for the first person in need of care and $50 per week for each additional person in your need of care.
Housekeeping and Home Maintenance Benefit:
As of June 1, 2016, the Housekeeping and Home Maintenance Benefits are only available for catastrophic injuries, unless you purchase optional benefits. If you suffer a catastrophic impairment and a substantial inability to perform the housekeeping and home maintenance services that you normally performed before the accident, you will be eligible for Housekeeping and Home Maintenance Benefits up to $100 per week for life.
Attendant Care Benefits:
You will be eligible for Attendant Care Benefits if, as a result of your injuries, you are unable to carry out certain personal care tasks. You must demonstrate that the expense was incurred and your members suffered an economic loss in providing care to you. As of June 1, 2016, the Attendant Care and Medical and Rehabilitation Benefits have been combined for a total of $65,000 for non-catastrophic injuries. For catastrophic injuries, the combined total is $1,000,000.
Medical and Rehabilitation Benefits:
Medical and Rehabilitation Benefits are available so that you can receive the necessary treatment and services to reach optimal recovery. The following services are covered:
Medical, surgical, dental, optometric, hospital, nursing, ambulance, audiometric and speech-language pathology services
Chiropractic, psychological, occupational therapy and physiotherapy services
As of June 1, 2016, the Medical, Rehabilitation and Attendant Care Benefits have been combined for a total of $65,000 for non-catastrophic injuries. For catastrophic injuries, the combined total is $1,000,000. If your injury falls under the Minor Injury Guidelines, the Medical, Rehabilitation and Attendant Care benefits are limited to $3,500.
Death & Funeral Benefit:
Death benefits of $25,000 are payable to the deceased’s spouse and an additional $10,000 to each of the deceased’s dependents. Funeral expenses are paid to a maximum of $6,000.
A tort or negligence claim is a lawsuit against the person responsible for the accident to compensate you for pain and suffering, loss of competitive advantage or diminished work capacity, home maintenance expenses, caregiver expenses, medical expenses or any other out-of-pocket expenses incurred as a result of being involved in the accident. In order to maintain a tort claim in Ontario you must prove that you have suffered:
Permanent serious disfigurement (i.e. Scarring); or
Permanent serious impairment of an important physical, mental or psychological function
A claim for pain and suffering (i.e. general damages) for any amount below $124,616.21 is subject to a Statutory Deductible of $37,385.17 in the year 2017. This amount of the deductible increases each year to reflect inflation.
This Statutory Deductible or the threshold of Serious and Permanent do not apply to claim for economic loss. Economic loss can take different forms:
Inability to return to work
Loss of overtime or second job
Loss of efficiency or ability to only work modified hours or duties
You are also eligible to claim for out of pocket expenses incurred as a result of the accident. The limitation period for a tort claim is two years from the date of the accident or from the date the injuries were deemed to be serious and permanent.
Slip and Fall
If you have slipped or tripped on someone’s property as a result of snow, ice, water, holes, cracks, poor lighting or some other hazard you could be entitled to compensation. Each slip and fall case must be decided individually and depends on whether the property owner acted carefully (so that slipping or tripping was not likely to happen) and whether or not you were careless in not seeing or avoiding the thing you fell on.
To be legally responsible for an injury you suffered from slip/trip and fall, the owner of the premises or the owner's employee:
Must have caused the spill, worn or torn spot, or other slippery or dangerous surface or item
Must have known of the dangerous surface but did nothing about it, or
Should have known of the dangerous surface because a "reasonable" person taking care of the property would have discovered and removed or repaired it.