After an Accident: Understanding the Claims Process | Financial Services Regulatory Authority of Ontario
Understand your policy
It ‘s a good theme to sit down and read over your Ontario car Policy ( OAP 1 ) to understand your coverages, rights, and responsibilities .
If you do not have a copy of the Ontario Automobile Policy ( OAP 1 ), ask your insurance agentive role, broke, or claims adjuster for one, or download a copy now .
How and when to file an accident report
Following an accident, you must file a report with your broke, agent or insurance company within seven days—or deoxyadenosine monophosphate quickly as possible after that. Failing to report within a reasonable measure of time may result in your claim not being honoured.
You will need to provide the stick to when making your report :
- Your policy number
- Make, model, year, registration and licence plate number of the vehicle
- Accident details – driver’s name and licence number (if the driver was not the registered owner)
- Date, time and location of the accident
- Extent of any injuries
- Number of passengers involved
- Extent of damage to the vehicle
- Your description of the accident
- Names and driver’s licence numbers of all drivers involved
- Names of insurance companies, and auto insurance policies of all drivers involved
- The name and badge number of the investigating officer – if the accident was reported to police
What happens after you file a claim
once your call is filed, you will be contacted by a claims adjuster. They may require that you complete a Proof of Loss form. The adjuster will determine how much of your claim your insurance company will cover, and guide you through the claims procedure .
How fault is determined
After you report an accident, your insurance company will determine blame by following the Insurance Act and Fault Determination Rules. These rules :
- Use diagrams to cover more than 40 accident situations that can be applied to almost every possible road collision scenario
- Are applied regardless of road or weather conditions, visibility, point of impact on the vehicles, or the actions of pedestrians
note that in some cases, mistake may be shared between multiple parties involved in an accident .
How fault affects you as a driver
As a driver you can be found anywhere from zero to 100 per penny at-fault following an accident. If you are found at-fault, this will be recorded on your indemnity record. If you are found to be 50 per penny, or more, at-fault, there is a good chance your premium will go up the following time you renew your policy .
note that if you lend your fomite to person and they are found to be 50 per cent, or more, at-fault for an accident in your vehicle, their accident will go on your record. ”
What to do if you disagree with your insurance company’s assessment of fault
If you believe your policy company made an erroneousness in settling your claim, ask your claims adjuster which Fault Determination principle was applied in your case. If your insurance company refuses to revise their decision and you calm disagree, contact your policy company ’ second complaint policeman .
Police charges, convictions and at-fault determination
If you are charged with an crime, it does not necessarily mean you will be found at-fault for insurance purposes. similarly, if you are not charged with an offense, it doesn ’ t necessarily mean you will be found not at-fault. fault will be determined through the Fault Determination Rules .
What to expect if your vehicle has been damaged
The sum you receive in compensation will depend on the extent to which you were found at-fault for the damage, and the type of indemnity coverage you purchased. Ask your claims adjuster for full details .
What to expect if you file a claim with mandatory coverage only
In Ontario, your compulsory coverage includes direct Compensation-Property damage ( DC-PD ). Depending on the extent to which you were found at demerit, you may be eligible to receive costs for :
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- A temporary rental vehicle
- Damaged personal contents inside the vehicle
note that if you were found 50 per cent, or more, at-fault for your accident, and consequently 50 per cent not-at-fault, your company will pay 50 per penny of any loss, less the deductible .
What to do if the other driver involved has no insurance
If any other vehicle in the accident was uninsured, you can make a claim under the mandatary Uninsured Motorist Coverage of your policy. coverage is astir to $ 25,000, less the first $ 300. You must be able to identify the owner or driver of the other fomite in order to qualify .
What to expect if you file a claim with mandatory plus optional coverage
Specified Perils Coverage
If you purchased Specified Perils Coverage you will be covered for :
- Fire
- Theft or attempted theft
- Lightning, windstorm or hail
- Rising water
- Earthquake or explosion
- Riot or civil disturbance
- Falling or forced landing of an aircraft or parts of an aircraft
- The stranding, sinking, burning, derailment, or collision of any kind of transport in, or on which, your vehicle was being carried on land or water, regardless of fault, less the deductible you chose at the time you purchased the coverage
Comprehensive Coverage
If you purchased Comprehensive Coverage you will be covered for the rectify or successor of your fomite due to a non-collision loss, including those perils listed under Specified Perils, falling or flying objects, missiles and vandalism, careless of blame, less the deductible you chose at the time you purchased the coverage .
Collision or Upset Coverage:
If you purchased Collision or Upset Coverage, your indemnity company will pay to fix or replace your vehicle if it is damaged in an accident, regardless of demerit, less the deductible you chose at the time you purchased the coverage. This besides includes cases where an uninsured driver can not be identified, or damaged your vehicle .
All Perils Coverage
If you purchased All Perils Coverage, your insurance company will pay for all losses noted above, less the deductible you chose at the time you purchased the coverage .
How insurance companies decide whether to repair or write off your vehicle
When you make a claim, your indemnity company will pay the lower of the two options :
- The cost to repair the loss or damage
- The “actual cash value” of your vehicle at the time it was damaged
- Your insurance company will not pay more to repair your vehicle than its actual cash value.
How deductibles work
When you file a title, you may be responsible for a deductible—the total of the claim you will have to pay. You can expect to pay your full deductible unless the accident was not your mistake, or was only partially your fault .
What to expect if you’ve been injured
In Ontario, Statutory Accident Benefits Coverages are provided by jurisprudence under every car policy policy. These benefits provide compensation, careless of fault, if you, your passengers, or pedestrians are injured, or die as the result of your accident.
If you are injured in an car accident, you may be entitled to the follow benefits :
- Income replacement: replaces job income you cannot earn while recovering
- Caregiver: provides compensation if you are required to leave work to care for an injured member of your household
- Non-earner: provides compensation if you are completely unable to carry on a normal life, and do not qualify for an income replacement or caregiver benefit
- Medical: pays for medical expenses incurred through your injury
- Rehabilitation: pays costs incurred during rehabilitation
- Attendant Care: pays some of the costs of an aide or attendant
- Compensation for Other Expenses: may pay for the cost of family visits during treatment or recovery, some housekeeping and home maintenance, the repair or replacement of some items lost or damaged in the accident, or lost educational expenses.
What your family can expect if you die as the result of an accident
If you die as a result of the accident, members of your class may besides be entitled to the following benefits :
- Death: pays money to members of your family
- Funeral: pays for some funeral expenses
Exclusions
In some cases, your indemnity caller may deny payment of Income Replacement, Non-earner and Compensation for early Expenses. Cases include :
- Driving without valid insurance
- Driving without a valid driver’s licence
- Driving while specifically excluded from driving under your insurance policy
- Driving a vehicle without the owner’s consent
- Cases of fraud
- Driving a vehicle while committing a crime (whether or not the crime is related to the operation of the vehicle)