• Introduction
• Motor vehicle accidents
• You need the right lawyer
• Other personal injury claims
• ‘Threshold’ requirement
• Accident benefit claims
• Tort claim

  Introduction

When you or a loved one have been injured, understanding the legal and insurance implications is critical to ensuring that you receive the compensation you need. Mann Law has created this brochure to inform you about the benefits that you may be entitled to and the process you must go through to receive those benefits.

  Motor vehicle accidents

If you are injured in an automobile accident, you may be entitled to compensation from 2 different sources:

• Accident Benefits Claim – claim against your own insurance company or against the insurance company of another vehicle that was involved in the accident. You are entitled to benefits regardless of the extent of your injuries or whether or not the accident was your fault.
• Tort Claim – claim against the driver who was at fault for the accident. You must first apply for accident benefits from your insurer before you can commence a claim in court.

  You need the right lawyer

Insurance law has undergone significant changes in the last 10 years. If you have been injured in an automobile accident, you need a personal injury lawyer with experience handling injury claims.At Mann Law you will meet lawyers who know their way around the insurance system. We will walk you through each step of the claims process and make sure that you receive the benefits that your injury entitles you to.

  Other personal injury claims

Claims can be made for other injuries that are not covered by insurance. These include:

• Injuries caused by defective products.
• Medical malpractice.
• Injuries suffered on public/private property.
• Compensation for criminal acts.

  Threshold’ requirement

In this brochure you will see the word ‘threshold’ appear several times. For the purposes of insurance-related cases, your injuries will meet the threshold for tort claims if you have a permanent serious disfigurement.

  Accident benefit claims

• Who Is My Insurer?


For a condition to be effective there are a number of elements required: Your benefits insurer is the first one in the list that applies to you:


• The insurer of your vehicle.
• The insurer of the vehicle in which you were injured.
• The insurer of any other vehicle that was involved in the accident.
• The Motor Vehicle Accident Claims Fund.


• What steps must I go through to claim accident benefits?



• Notify your insurer within 7 days after the accident.
• Complete the application forms that your insurer sends you within 30 days.
• If your insurer requests it, you must provide the following information within 14 days:
• Medical records.
• A sworn statement as to the events of the accident.
• If your insurer requires, you must:
• Submit a disability certificate within 21 days.
• Attend a medical examination.
• Attend an examination under oath where your insurer will ask you questions. It is strongly recommended that your lawyer represent you at the meeting.
• If your benefit is denied, you may be required to attend a Designated Assessment Centre (DAC) for additional medical examinations
• If you wish to dispute your insurer’s benefit decision, there is a dispute resolution process that you must go through.

The insurance process can be complicated and includes specific time limits that must be met. During your consultation with Mann Law, we will help you to fill out the insurance forms and make sure they are submitted on time so that your benefits are not delayed or denied.

• What benefits am I entitled to?

Income Replacement Benefit

• You must have been employed at the time of the accident OR you were previously employed for 26 weeks during the 52 weeks prior to the accident.
• You will earn 80% of your net income, to a maximum of $400 per week.
• The benefit is paid for the first 104 weeks of disability unless you are suffering a complete inability to engage in any employment.

Non-Earner Benefit

• You must suffer a complete inability to carry on a normal life within 104 weeks after the accident and you are unemployed.
• A student will earn $185 per week during the first 104 weeks and $320 per week thereafter. All others will continue to earn $185 per week
• Payments start 6 months after the accident.

Caregiver Benefit

• You must have been the primary caregiver and living with a person who was in need of care at the time of the accident and you were not paid for your services.
• You will earn $250 per week.

Medical and Rehabilitation Benefits

• Your insurer must pay for a wide range of your medical and rehabilitation expenses to a maximum of:
• $100,000 for up to 10 years.
• $1,000,000 for life if you suffer a permanent impairment.

Attendant care benefits

• Are available for reasonable and necessary services provided by an aide or attendant to a maximum of:
• $3,000 per month for up to 2 years
• $6,000 per month for life if you suffer a permanent impairment.

Death and funeral benefits

• If you died as a result of the accident or because of disabilities associated with it, the insurer must pay:
• $25,000 to your spouse.
• $10,000 to each of your dependants.
• $10,000 to each former spouse that you were obligated to support under a court order or domestic contract.
• $10,000 to a person that you were dependent upon.
• Your family will also be entitled to a maximum of $6,000 for funeral expenses.

Education benefits

• You are entitled to a maximum of $15,000 if you were enrolled in school at time of accident and cannot continue.

Housekeeping and home maintenance

• If you cannot perform housekeeping and home maintenance, then you are entitled to a maximum of $100 per week for up to 104 weeks if your injury is not permanent.

If you have purchased additional coverage with your insurance, these limits may be exceeded. Your insurance company will want to give you as little as possible under your insurance policy. They may tell you that you are not entitled to certain benefits or they might pay less than you feel you deserve. If you believe your insurer is wrong, Mann Law will support you to get you the benefits to which you are legally entitled.

  Tort Claim

If another driver caused the accident, you may be able to make a claim against them. You must start the action within 2 years of the accident.

• Apply for accident benefits from your insurer within 7 days of the accident.
• Serve written notice of your intention to sue within 120 days of the accident.
• Undergo medical examinations within 90 days if the at-fault driver requests them.

Income loss and loss of earning Capacity

• There is no recovery for income loss suffered in the first 7 days of the accident.
• Your loss more than 7 days after the accident but before the trial is restricted to 80% of your after-tax income.
• Future income loss will be 100% of your before-tax income.

Housekeeping and home maintenance

• You may be able to recover these expenses from the at-fault driver if your insurance company has not given you enough.

Health care expenses

• You can sue for medical expenses that are not covered by OHIP or your insurance plan if your injury has met the ‘threshold’ requirement.
• The entitlement will be reduced by a $30,000 deductible.

Claims made by family members

• If a person is injured or killed in an accident and was entitled to recover damages from the at-fault driver, certain family members may be entitled to sue the at-fault driver.
• There is a $15,000 deductible.

Pain and suffering

• To be entitled your injury must have met the ‘threshold’ requirement.
• The entitlement will be reduced by a $30,000 deductible.

Loss of financial support

• If you die in the accident your family may claim loss of financial support that will be based on your pre-accident income level.

• Call 911 for police assistance.
• Collect the following information about the accident:
• Names, addresses, telephone numbers and insurance data of those involved, including other drivers, passengers and witnesses.
• Driver's license number, insurance company and policy number of other drivers.
• Vehicle make and model, and license plate number of other involved vehicles.
• Name, department and badge numbers of responding police officers and a copy of the police report.
• Don’t sign anything except a ticket, citation or report issued by the police. Signing other documents may jeopardize your rights.
• Inform your insurance company.