How Does Ontario No-Fault Insurance Affect Your Right To Sue?

Ontario No-Fault Insurance

With Ontario no-fault insurance your insurance company will cover you and your passengers for damages and injuries from a car accident. The rationale is that you will get compensation quicker so that you can move on with your life faster.

In some cases, however, you can’t move on with your life because the injuries that you have sustained are permanent and disabling. In the case of serious injuries, you can still sue an at-fault driver for pain and suffering, loss of income not covered by your auto insurer, and other expenses not covered by your auto insurer, such as medical rehabilitation expenses.

No-fault insurance is structured to keep minor injuries from a car accident out of the court system. The right to sue for damages from a car accident is meant to be for people who have suffered seriously.

Pain and Suffering

In order to sue the at-fault driver for pain and suffering, which your auto insurer will not provide you compensation, you have to prove that you have suffered as a result of the car accident a permanent serious disfigurement or a permanent serious impairment of an important physical, mental or psychological function. This is known as the Threshold.

In addition to proving that you meet the Threshold, to get compensation for pain and suffering, you have to prove that your pain and suffering are valued more than the statutory deductible on pain and suffering of $39,556.53. The deductible is not applied if pain and suffering are valued at $131,854.01 or more. The deductible is adjusted for inflation every year.

For most victims of car accidents, the deductible will apply. For example, if a jury values your pain and suffering at $50,000.00, you will be compensated $10,443.47 provided that the judge determines that your injuries meet the Threshold.

You may be wondering with no-fault insurance in Ontario, who pays the deductible. No one pays it technically, it is a deduction from any award for pain and suffering you might get. For example, if a jury determines that your pain and suffering is worth $35,000.00, then the at-fault driver won’t have to pay you anything for pain and suffering.

Medical and Rehabilitation Expenses

In order to receive compensation for medical and rehabilitation expenses over and above what your auto insurer will cover, you will also have to meet the Threshold.

The basic medical coverage from your auto insurer is as follows:

• Minor Injury Guideline $3,500.00
• Non-Catastrophic Injuries $65,000.00
• Catastrophic Impairment $1,000,000.00

The basic medical coverage can be increased at an additional cost.

Loss of Income

If your injuries from a car accident keep you from working or working to your full potential, you can sue the at-fault driver for loss of income. If you were working at the time of the accident, your auto insurer will likely provide you with an Income Replacement Benefit representing 70% of your gross weekly earnings, up to a maximum of $400, $600, $800, or $1,000 per week, depending on the type of coverage you purchased. The at-fault-driver will get a credit for the Income Replacement Benefit that your auto insurer has paid you.

Get Help

Getting help to get through the auto claims process is as easy as contacting an experienced motor vehicle accident lawyer.