What is Personal Injury Protection (PIP) Explained

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You drive a car and believe to have sufficient coverage to cover for any kind of losses. Until you get into a collision and by your fault, a passenger in the other vehicle dies. Now, that is a serious matter with many concerns. You feel guilty and also very worried. You wonder what are the consequences of your unsafe driving that led to the collision. It is advised to check with your insurance company what to expect in a worst case scenario. The bereaved family may file a lawsuit against you and there are zillion things that you may have to deal with.

You wish you had sufficient personal injury protection through your car insurance provider. The mounting hospital bills, rehabilitative care are all very expensive to pay off. Car insurance is purchased to protect you from any losses due to an accident or sudden perils. But if you do not have sufficient coverage then it is of no use to you for that particular incident. Ontario follows a no-fault based insurance system. This means that it does not matter who was at fault. This means that if someone is injured in an accident and are at fault, they can still claim under this coverage.

What Are The Limitations For Claiming Under Personal Injury Protection In Ontario

In Ontario as per the Statute of Limitations Law, if you suffer a personal injury due to a collision, you may file a claim within two years from the date of the incident. If you don’t then you may not be eligible for any benefits from government based programs or from your insurance provider. There may be rare exceptions to this rule.

How To Claim For Personal Injury After An Accident In Ontario

When you are involved in an accident it is a big trauma. It is also important to file a claim under relevant coverage without reasonable delay. It is best advised to start your claims process within three months of the incident. If you do not notify the opposite party or the other driver within 120 days, it may affect your case. In case you spoke with your insurer but did not file a claim within the stipulated time then too, you may be barred from you compensation rights. Your insurance company may also have a 7-day time frame to notify about an accident. They may also need you to file an accident benefits claim within 30 days.

In case you were not at fault and would like to claim against the other party for your personal injury then that you may even seek the help of a personal injury specialist or lawyer. It is important to abide by the statute of limitations in Ontario for the best outcome.

What Can You Claim Under Personal Injury Protection Ontario

When you are involved in an accident and injured you may be eligible to claim for some past and foreseeable losses. This is claimed under the Statutory Accident Benefits coverage on your car insurance.  In case you are at fault for the accident you may not sue the other party for your losses but you may file a claim with your insurer.

The claims adjuster of your insurer will help you with the accident benefits application package. This would include forms for Accident benefits Application (OCF1), Confirmation from Employer (OCF2) and Certificate of Disability (OCF3). It would also include Health Disclosure Consent form (OCF5) and Confirmation of medical treatment form (OCF23).Personal Injury Protection is based on the premise that you have suffered personal injury due to someone’s negligence.

The following are losses under personal injury protection that you could sue another party for:

Financial

When you are injured in an accident you are unable to work. You may need time to recover from your injuries and lose your income. You may claim for up to 80% of the net income that you lost before the date of trial and 100% of future gross income after the date of trial. The final claim settlement amount would be subject to any other sources of benefits. Such as disability of accident benefits through your workplace.

Hospital Expenses

Any hospital bills and treatments to recover from the accident may be claimed. Serious deformity and injuries can also be very costly to treat and could be claimed. This would also include treatment expenses for any mental, psychological and physical motor damages. Again the other sources of benefit amounts would be deducted from the final claim.

Suffering and Pain

Any kind of non- economic losses such as the agony and trauma that the injured party goes through can be claimed for too. The deductible applicable could be at least $30,000 and may go up to $100,000 as per judgment.

Intangible Loss

These are losses due to the inability of the injured to provide emotional support, care and guidance that can be sued for under Family Law Act. To be eligible, the accident must result in death or serious disfigurement that is permanent. The deductible may be $15,000 and could be more than $50,000 as per judgment.

How Much Personal Injury Protection Costs For Car Insurance

It is not too expensive to add personal injury protection and you may be able to afford to get coverage up to a million with a monthly premium of around $10-$15. It is up to you to decide the coverage limit that you feel comfortable to deal with the risk in the event of an accident.

Does Ontario Government Help To Recover From Personal Injury Losses

In Ontario, if you are injured by your fault or someone else’s in an accident, the Ministry of Health and long-term care may intervene. The ministry can subrogate insurance companies for healthcare and treatment costs. This is enforced by the ministry through legislation in Ontario and includes personal injuries due to motor vehicle accidents. The injured party, their personal injury lawyer or liability insurer may notify the ministry about the personal injury. This legislation is not limited to any particular jurisdiction and also includes other provinces and foreign locations that allow such subrogation rights.


Resources :

http://contelawyers.ca/statutes-limitation-injuries-accident-ontario/

http://www.health.gov.on.ca/en/public/publications/ohip/injury.aspx

https://www.ontario.ca/laws/statute/02l24#BK4

https://www.fsco.gov.on.ca/en/auto/brochures/Pages/brochure_claims.aspx#accident

http://www.health.gov.on.ca/en/public/publications/ohip/motorvehicle.aspx