Who Is Entitled to Accident Benefits After a Motor Vehicle Accident?

Auto insurance policies in Ontario provide for a standard level of accident benefits, which are defined by a Regulation under the Insurance Act. Additional benefits can be purchased to increase the level of coverage available. These benefits exist to provide compensation for drivers, passengers, pedestrians, and family members who suffer personal injury or death as a result of a motor vehicle accident, and they are available irrespective of fault.

If you or a loved one has been injured in a motor vehicle accident, it’s crucial that you speak with a lawyer right away to begin building your case in a timely manner.

The question is: after being involved in a motor vehicle accident, to whom do you send your accident benefits application package? The first, straightforward scenario is that if you are involved in an accident and hold a policy of auto insurance in your own name, then you must apply to that insurance policy for coverage. If you do not own your own vehicle, but are listed on someone else’s policy of insurance (a spouse or parent for example), then you would apply to that policy for coverage. If you happen to have been driving a company car at the time of the accident, then you would submit your application to the insurer of the company vehicle.

However, what if you were a passenger in a vehicle, or you were struck by a vehicle as a pedestrian: where do you apply then? The good news is that you can still make a claim for accident benefits; however, the circumstances of the accident may well determine which insurance company will respond.

Should you be involved in an accident while a passenger in an insured vehicle, then you would apply to the insurance company of the vehicle in which you were passenger. If you were a passenger in a vehicle that was not insured, and there was an additional vehicle(s) involved in the collision, then you would apply to the insurance company of another involved vehicle. If you were a pedestrian or a cyclist and were struck by a vehicle, then you would send your application to the insurance company of the vehicle that struck you.

If you have been involved in an accident that does not fall under any of these scenarios (i.e. you do not have auto insurance; you are not listed on someone else’s policy; and no other vehicle involved in the accident has auto insurance or can be identified) then you may still have recourse. You may be entitled to obtain accident benefits from Ontario’s Motor Vehicle Accident Claims Fund (MVACF). In order to claim under MVACF, you must first exhaust all other avenues. Should that investigation confirm that there is no other insurance policy under which you can claim, then MVACF would provide accident benefits, essentially stepping into the shoes of another insurance company.

The Statutory Accident Benefits regime is extremely confusing at the best of times, let alone when you are suffering after a motor vehicle accident. This is why it is critical that you choose one of the experienced motor vehicle accident lawyers at Himelfarb Proszanski to help you navigate through these murky waters, and ensure that your rights are protected and your benefits are maximized.

For more information, visit our motor vehicle lawyer section. If you have any questions, book a free consultation or call 1-855-446-7765 for immediate assistance.