Psychological and PTSD Claims

Toronto Psychological and PTSD Claims Lawyers

 

Many people experience some level of depression, stress or anxiety at various times in their lives.But if your stress, anxiety or depression was caused by an accident or injury, can you recover compensation for your psychological condition if it impairs your ability to perform your job or to engage in normal, routine activities? Is it necessary that a physical injury be the cause or trigger for a legal claim of psychological injury or post-traumatic stress disorder? These are all questions, issues, and considerations that an experienced Toronto psychological damages lawyer from Affinity Law can address for you.

Claims for Mental Distress or Anguish

In many personal injury lawsuits where an injured person is bringing a claim based on the negligent conduct of another person or entity, the claimant will allege damages for medical expenses, lost income, diminished quality of life, pain and suffering, and psychological or mental distress. Mental distress claims can include a wide array of symptoms:

  • Anxiety and stress
  • Depression
  • Phobias
  • Changes in mood and personality
  • Post-traumatic stress disorders (PTSD)
  • Sleeping problems or disturbances
  • Weight fluctuations or inconsistent eating patterns
  • Nausea
  • Diarrhea
  • Chronic fatigue
  • Lack of sexual desire
  • Mood swings, irritability and aggression
  • Lack of interest in social activities
  • Chronic pain

It is necessary that a medical professional relate these symptoms to mental distress so as to prove a causal connection to the accident or incident as being the direct cause of your distress.

Types of Lawsuits Involving Mental Distress

Any personal injury lawsuit can include a claim for mental anguish, anxiety, or distress such as:

  • Car accidents
  • Pedestrian accidents
  • Medical malpractice
  • Product liability
  • Premises liability
  • Wrongful death
  • False arrest
  • Intentional torts—sexual assault, sexual abuse, unlawful imprisonment
  • Sexual harassment

Although not essential to sustaining a viable claim for psychological harm, the more severe the incident or accident, the more credible your claim. Your psychological damages lawyer from Affinity Law can help with proving the seriousness of your injury so that you can collect the benefits to which you are entitled.

Is Physical Injury a Prerequisite?

Physical injuries are not a prerequisite for alleging psychological damages though most cases do involve a physical injury that leads to emotional distress or other psychological harm. You can bring a claim for psychological distress harm against a negligent party if it meets a two-part test:

  1. The emotional or psychological injury was a foreseeable consequence of the defendant’s wrongful or negligent conduct; and,
  2. The psychological injury you are suffering fromis serious enough to be a recognizable psychological condition or illness

A recognizable psychological injury or condition is typically one found in the Diagnostic Statistical Manual (DSM)-VI used by psychologists and psychiatrists when diagnosing patients. If your symptoms fit the criteria of a condition such as post-traumatic stress disorder that is severe or critical enough, you can be awarded certain benefits and your claim can go forward toward collecting additional compensation in a third-party claim. The threshold or standard to pursue a third-party claim for a physical or psychological injury is “a serious and permanent impairment of an important physical, psychological or mental function,” or one that has severely affected your ability to engage in your daily living activities.

Some unusual cases of psychological distress claims that Canadian courts have allowed to continue include:

  • Prison inmates sued the federal government for “uncomfortable detention” wherein they allegedly were denied lack of access to sunlight, a barber, sufficient library resources, and adequate sleep resulting in extreme depression, erosion of self-worth, feelings of hopelessness, and nervous shock.
  • A Calgary resident who sued a grocery co-op after she was banned for shoplifting alleged defamation, shame, loss of family honor, and which led to her husband’s suicide.
  • An Ontario motorist who was allegedly speeding, texting and under the influence of alcohol sued 3 bicyclists whom she ran over and caused serious injuries to one and fatal injuries to another alleged her own psychological suffering including PTSD, extreme depression, and catastrophic impairment and anxiety. She did claim the cyclists did not have lights on their bikes, were not wearing helmets, and were not riding in a “prudent manner.”

Although these claims may seem extreme, there are often issues that news reports do not include that would justify or support reasonable and highly plausible allegations of mental distress. In the majority of accident cases where psychological harm is alleged, there are serious and credible factors that cause injured victims severe distress that diminishes their enjoyment of life and ability to function normally.

How to Prove Emotional Distress

While Canadian courts allow a claim for emotional distress without an accompanying allegation of a physical injury, your opportunity for receiving substantial compensation is heightened if there is a physical injury element. Usually, the more serious or traumatizing the injury, the better chance the claimant has to prove that he/she did suffer emotional distress. For example, a person who suffered a permanent disfiguring scar on her face, or who is permanently impaired and in chronic pain and may never work in his chosen career or pursue a favorite activity has a much more provable claim of depression, anxiety, and distress than someone who alleges a strained back or repairable torn cartilage in his knee has caused him or her extreme anxiety.

While Canadian courts allow a claim for emotional distress without an accompanying allegation of a physical injury, your opportunity for receiving substantial compensation is heightened if there is a physical injury element. Usually, the more serious or traumatizing the injury, the better chance the claimant has to prove that he/she did suffer emotional distress. For example, a person who suffered a permanent disfiguring scar on her face, or who is permanently impaired and in chronic pain and may never work in his chosen career or pursue a favorite activity has a much more provable claim of depression, anxiety, and distress than someone who alleges a strained back or repairable torn cartilage in his knee has caused him or her extreme anxiety.

Other factors that can demonstrate severe distress include:

  • Duration of the condition—the longer you suffer on-going and chronic pain, the more credible is your claim that you are suffering severe emotional distress
  • Related bodily harm or condition—your distress is accompanied by physical signs of distress
  • An extreme underlying cause—you were a victim of a bombing, robbery where you were shot or stabbed, kidnapped, raped, or survived a car accident where one or more persons in your vehicle died or suffered gruesome injuries
  • Loss of employment—you lost your job as a result of your physical injuries
  • Medical records confirming nature and extent of your injuries
  • Psychiatric or psychologist’s records confirming visits, medications, and therapies
  • Physician’s report confirming your symptoms

If you demonstrate certain physical signs, this can be essential in proving that your psychological distress is real and sustainable. These are difficult claims to pursue that will require the skills of an experienced psychological damages lawyer from Affinity Law or an insurer will likely deny your claim.

Family Law Act

Immediate family membersthat includes spouses, children, siblings, parents, and grandparents can also pursue a separate claim for pain and suffering or emotional harm if a loved one suffered serious and permanent injuries or was killed in an accident. These damages are for the loss of the loved one’s guidance, comfort, care, or companionship.

Post-Traumatic Stress Disorder (PTSD)

A consequence of a particularly distressing or traumatic accident or incident such as a serious car accident,combat, a horrific natural disaster, sexual assault,pervasive sexual abuse or harassment is the onset of PTSD. This is a recognized psychological disorder characterized by feelings of anxiety, panic or fear from a triggering factor that can cause them to re-experience the trauma even if they are not in imminent danger of physical harm.  PTSD can present as intense or serious an impairment as any physical injury.

Assault victims can sue their assailants for emotional distress or PTSD if they exhibit the recognized symptoms in civil court, even if the defendants are not prosecuted in criminal courts. The civil standard for holding a defendant liable for civil damages is less than that for criminal defendants and is not dependent on the defendant being found criminally responsible. Along with seeking damages for emotional distress, a victim can also pursue damages for lost income, medical expenses, and any other financial losses attributed to the defendant’s negligence or criminal conduct.

Mental health professionals have classified PTSD and its symptoms into 3 distinct categories:

  1. Re-experiencing symptoms and suffer flashbacks and nightmares
  2. Intentionally avoiding symptoms—staying away from triggering events that can revive the traumatic incident, experiencing memory loss, emotional numbness, avoiding social contacts
  3. Hyper-sensitivity—overly sensitive, quick to anger, being constantly on edge, trouble sleeping

Car accident victims may suffer injuries that extend beyond the physical ones. It is not uncommon for an injured claimant to experience panic, anxiety, an extreme reluctance to drive a car or even be a passenger. This can cause substantially interfere with a person’s enjoyment of life or ability to engage in routine, daily activities. However, insurers typically are skeptical of PTSD claims and will require significant proof and medical or psychiatric documentation that you are indeed suffering form this condition and that it is severe enough to interfere with your ability to perform your job or to engage in routine, daily activities. For this reason, retaining a PTSD lawyer from Affinity Law soon after your accident can prevent any rejection or delay in receiving benefits.

Car accidents are the most prevalent incident that leads to PTSD in those claiming emotional harm in lawsuits or claims since they are the most common personal injury claims. This is unsurprising given the millions of cars on our highways and roads every day. Some estimates are that 10% of car injury victims experience PTSD to some degree. Risk factors that can precipitate PTSD from a car accident include:

  • Severe or traumatic car accidents
  • A serious physical injury
  • Other vehicle occupants were severely injured or killed
  • You felt that your life was threatened
  • You may have had a prior traumatic experience
  • There is a history of mental illness
  • You mentally re-experienced the trauma shortly after the accident
  • There is a history of drug and substance abuse that has unduly influenced your mood and behavior

There is a family history of PTSD

Limits on Damages for Pain and Suffering or Emotional Distress

Damages for pain and suffering, which includes psychological or emotional distress, in Canadian courts are limited. Before your claim is even eligible for a non-pecuniary (non-economic) award, you must prove that your psychological injury in this case has resulted in “a serious and permanent impairment of an important physical, psychological or mental function.”

If your claim meets this threshold test, then your non-pecuniary damages award is statutorily limited to a current cap of $380,912, a figure that fluctuates annually depending on the rate of inflation. However, your award in an Ontario court is subject to a deductible of $38,818 unless your award for pain and suffering is at least $129,395.49 as it currently sits. For example, if you are awarded $100,000 for emotional distress, it will be reduced to $61,182.00. If your award was $40,000, you would receive only $1,182.00. Any award that does not exceed the deductible will result in your not receiving any non-pecuniary damages. There is no cap or limits on economic losses, which includes lost income and medical expenses.

For family members who are able to claim non-pecuniary damages for their loved one’s catastrophic injuries, their damages are subject to a current deductible of $19,409.49, unless their loved one died in which case the deductible does not apply to reduce the award. Their claims, however, must exceed a floor of $64,697.21 before the deductible can be waived. These deductibles increase by a rate of 1.6% annually.

Retain a Toronto Psychological Damages Lawyer

Obtaining benefits for emotional distress or for suffering from PTSD as a result of the negligent or wrongful conduct of another person can be difficult. There are significant barriers to overcome, complicated applications to complete for benefits, deadlines to meet, and medical and other documents to obtain. Having an experienced and dedicated Toronto personal injury lawyer from Affinity Law to handle your case from the outset can significantly increase your opportunity to receive benefits and reasonable compensation for your damages.

Call us today for a free consultation

at 1 844 786 LAW 1 (5291).

Wrongful Death

There is nothing more devastating than losing someone you love in an accident. These lethal accidents can occur as a result of someone else’s negligence in a variety of situations such as a car, truck, pedestrian or motorcycle accidents to name a few. If you have lost someone you love, it is imperative you do not hesitate to consult with an experienced Toronto wrongful death lawyer.

 

WHAT QUALIFIES AS WRONGFUL DEATH?

Unfortunately, thousands of wrongful deaths occur every year, and many lead to lawsuits. When a person’s negligence or intentional acts lead to the death of another, the family of the victim has a right to expect compensation. The family members often need an experienced lawyer to protect their rights and to investigate the circumstances of the accident, to determine whether it was preventable and to protect the rights of the surviving family members. A wrongful death claim can be made by family members who have lost a loved one due to the unlawful behaviors of someone else.

 

TYPES OF INCIDENTS THAT MAY QUALIFY AS WRONGFUL DEATH

Wrongful death does not include just any kind of incident that causes the death of another. The negligent or intentional behavior of a 3rd party must have caused the death. This requirement can make some cases more obvious than others and cover a wide range of incidents.

For example, the following can potentially qualify as wrongful death claims:

  • Workplace accidents due to deficient training or oversight
  • Unlawful actions like stabbings, assaults or other forms of attacks causing death
  • Motor vehicle accidents caused by impaired driving, texting or recklessness
  • Drowning accidents under premises liability
  • Medical malpractice by doctors failing to treat an illness correctly
  • Defective products or drugs causing death

 

CAN I FILE A TORONTO WRONGFUL DEATH CLAIM?

If you have lost someone in an accident caused by another party, you may be able to bring a wrongful death claim against that individual or business. Those eligible for compensation include the spouse, children, grandchildren, parents, grandparents and siblings of the deceased person. There is no requirement for a person to have been financially dependent on the deceased person to be eligible for compensation. To determine if you are eligible to file a wrongful death claim, you should consult with a lawyer about the circumstances of your case.

At Affinity law, our lawyers have over 30 years of combined experience in helping families who have suffered the most tragic losses.  We have real experience in advocating claims arising from fatal accidents and in helping recover the benefits and financial compensation for families. We have dedicated resources, for conducting appropriate investigations, to root cause the incidents and determine who is responsible.

It is important to note that a statute of limitations exists in cases of wrongful death claims. This means that there is a time limit before filing a wrongful death claim.  You must act quickly if you wish to obtain compensation. We help families navigate the complex legal claims that often follow from the loss of a loved one.

 

WHAT DAMAGES ARE RECOVERABLE IN A TORONTO WRONGFUL DEATH CLAIM?

While no amount of money will bring back your loved one, a person filing a wrongful death claim may be able to recover financial compensation for three general types of damages.

Economic Damages – These include funeral and medical expenses related to the death, loss of the deceased’s future earnings, and loss of the deceased’s future benefits.

Non-Economic Damages – These damages are things that have less tangible value. This includes pain and suffering, mental anguish, loss of inheritance, and loss of consortium.

Punitive Damages – Punitive damages are sometimes awarded in addition to economic and non-economic damages as a way of punishing the responsible party for willful or grossly negligent acts.

 

CONTACT OUR TORONTO LAWYERS FOR A FREE & CONFIDENTIAL CONSULTATION

We intimately know the criteria that is applied in the legal and insurance claims process and we effectively advocate for our client’s best interests. No matter whether the incident involved a motor vehicle crash or the use of a defective product or drug, we have the experience you need to investigate your claim and take the necessary legal steps properly.

If you would like to discuss your case, give us a call today at 1 844 786 LAW 1 (5291) or email us at info@affinitylawyers.ca. We offer a completely free and confidential consultation of your case. We are here to help you and your family.

Accident Benefits

Accident benefits, also referred to as Statutory Accident Benefits (SABS), are for motor vehicle accident victims and are a no-fault insurance benefit that is a compulsory part of every automobile insurance policy in Ontario. Benefits are paid to eligible individuals regardless of who was at fault in a car accident. These payments compensate victims for lost earnings, medical expenses, and other economic losses incurred as a result of the accident. The amount of SABS funds and the categories under which an individual can claim benefits largely depends on the nature and extent of the injury, if the insured was employed, and other factors. To receive full accident benefits for your accident, you will need the assistance of an experienced accident benefits lawyer from Affinity Law.

Who is Eligible for SABS?

A person who suffers an impairment as a consequence of the use or operation of a motor vehicle is eligible for benefits. This includes the insured’s spouse, children and any other dependent under the applicable policy of insurance. You are not eligible for income replacement, non-earner benefits, lost educational expenses, visitor expenses, house-keeping and home maintenance expenses, however, if you were driving and lacked a valid driver’s license at the time of the accident, did not possess auto liability insurance, were driving while intoxicated or otherwise impaired or were found guilty of any other criminal offense while driving.

Which Policy Pays the SABS Benefits?

Normally, the applicable policy to seek SABS benefits is the one covering the injured person. This can include a family member within the household such as a spouse or child. If you are a passenger and not insured, you look to the policy of the owner of the car in which you were riding. If that person was uninsured, then you can still seek benefits from the policy of any other car involved in the accident.

If no accident insurance is available, then you can still collect benefits under the Motor Vehicle Accident Claims Fund or MVACF. This program provides compensation for SABS as well as for property damage and personal injury. MVACF is only available if you are a resident of Ontario and the accident occurred in this province.

How an Accidents Benefits Lawyer Can Help

The SABS application process is a complex one. Your accident benefits lawyer from Affinity Law can assist you with completing the application and ensuring that all documentation has been provided. The process has continuing obligations, meaning that you need to continually provide receipts, medical bills, employment and medical records if you are to continue receiving benefits. There are deadlines as well that your Affinity personal injury lawyer can keep you apprised of and to assure are timely met.

Your lawyer can also ensure that your full benefits to which you are entitled are being paid by the insurer. It is not unusual for an insurer to suddenly dispute a benefit or claim that your impairment or condition is not as serious as alleged or that you sufficiently recovered so that benefits may be reduced or terminated. There are significant differences in the available coverage depending on how your injury has been classified. Having an experienced accident benefits lawyer advocating for you is essential to meeting any challenge or dispute from the insured and to prevent any delay in receiving income replacement, non-earner benefits and for paying for essential medical services.

Another consideration is if your car accident occurred in the United States. If so, you can elect to receive benefits under SABS or those of the state in which your accident occurred. Your election of benefits can have a significant effect on the benefits available to you. Having a personal injury lawyer from Affinity Law to represent you is vital to receiving all the benefits and compensation to which you are entitled.

How to Apply for SABS Benefits

Insured Benefits

To apply for SBS benefits from your own or the applicable insured’s policy, follow these steps:

  1. Complete an OCF-1 form, or Application for Accident Benefits Form and submit it to the insurer
  2. Submit an OCF-3 form, or Disability Certificate that must be completed by a physician or health care professional as defined in the SABS who confirms and certifies that the insured was in an accident and that his/her injuries fit the criteria for the disability tests as set forth in the Statutory Accident Benefits Schedule
  3. Your employer submits an OCF-2 or Employer’s Confirmation of Income for income replacement benefits that sets forth the amounts you were paid over the 4 to 52 weeks before the accident. If you were self-employed, submit your business records for proof of income to the insurer who will confirm your gross income
  4. Keep all receipts for visits and all other out-of-pocket expenses related to your care and submit them to the insurer as soon as possible and on a regular basis

MVACF Benefits

To apply for MVACF benefits, take the following steps:

  1. Complete the OCF-1 form, or Application for Accident Benefits
  2. Sign a Consent for collection, use, and disclosure of personal information
  3. Complete Form 3 or Application for Statutory Accident Benefits
  4. Obtain and submit a police report confirming the accident
  5. Submit a letter confirming that you are not a named insured or spouse or dependent of an insured

What are the SABS Benefits?

The available benefits are listed below:

Non-Catastrophic Injuries

  • Medical and Rehabilitation Benefits: $50,000 payable over 10-years
  • Attendant Care Benefits: Up to $3,000 per month to a maximum of $36,000 payable over no more than 104 weeks or until the $36,000 is exhausted, whichever occurs first

However, the combination of these benefits cannot exceed a total of $65,000

  • Income replacement benefit of up to $400 weekly or 70% of weekly gross income, whichever is lower, to be paid until age 65 at which time the benefit will be reduced
  • Lost educational benefits of up to $15,000
  • Visitor expenses for up to 104 weeks
  • Non-earner benefits of $185 per week with a 4-week waiting period with payments up to 2-years

Optional benefits for non-catastrophic injuries are:

  • Medical and Rehabilitation Benefits: $100,000 for up to 5-years for adults
  • Attendant Care Benefits: $72,000 for up to 5-years for adults
  • Income replacement coverage can be increased to $600, $800, or $1,000 per week

However, the combination of these benefits cannot exceed a total of $130,000. An option is to purchase $1,000,000 coverage for all injuries, but you cannot purchase non-catastrophic and all injuries coverage together.

Non-earner benefits (NEB) are for those insureds who are not employed and do not qualify for income replacement benefits but who are unable to “completely carry on a normal life” because of their injuries. To be completely unable to carry on a normal life does not necessarily mean that you must be a paraplegic, bed-ridden, or suffer from some other totally incapacitating injury or illness. Rather, you must suffer from an impairment that continuously prevents you from engaging in substantially all of the activities for which you normally engaged in before the accident.Statutory Accident BenefitsSchedule Section 3 (7)(a). An impairment can also be a high level or degree of pain that prevents you from practically engaging in those activities.

Catastrophic Injuries

Catastrophic injuries are for the most serious and permanently injured persons such as paraplegics, quadriplegics, the blind, amputees, and persons with significant brain trauma and psychological impairments. You can be classified as having a catastrophic injury that qualifies you for enhanced benefits by combining impairments that results in a 55% whole body impairment. A psychological impairment can be used in combination with others to determine a whole-body impairment.

Total blindness is not required to be considered catastrophic. If your loss of vision is extensive enough so that you are unable to perform your usual employment, it qualifies.

Other examples are second and third degree burns that cover more than 25% of your body, or third degree burns that cover more than 5% of your face and hands.

Catastrophic injury victims are entitled to the following:

  • Medical and Rehabilitation Benefits: $1,000,000 over the recipient’s lifetime
  • Attendant Care Benefits: $1,000,000 with payments of up to $6,000 per month until the benefit is exhausted. However, the combined total for these benefits cannot exceed $1,000,000
  • Housekeeping and home maintenance: $100 per month over the recipient’s lifetime
  • Caregiver benefit of $250 per week for the first-person needing care and $50 per week for the second and subsequent persons needing care. This is available for 104 weeks unless the insured sufferer is totally incapacitated or unable to continue living a normal life at which point the benefit is paid for life
  • Visitor expenses for life
  • Lost educational expenses up to $15,000
  • Non-earner benefits of $185 per week with 4-week waiting period with payments up to 2-years

Optional Coverage for Catastrophic Injuries

  • All injuries coverage–$2,000,000
  • A combination of all injuries and catastrophic coverage–$3,000,000
  • Income replacement coverage may be increased to $600, $800, or $1,000 per week

Minor Injuries (MIG)

If your injuries are minor, you are still entitled to limited benefits. These include $3,500 for medical and rehabilitation expenses only. No attendant care benefits apply. You may still be eligible for income replacement if you meet the SABS test, which requires that you be substantially unable to engage in your employment tasks.

Under some circumstances, you can be removed from this category and into the non-catastrophic where you are eligible for more and higher benefits. For instance, your medical provider could find that the accident has caused you deep depression and anxiety, post-traumatic stress disorder, and other non-physical conditions that are the predominate cause of your disability rather than the minor physical injuries you sustained.

Death Benefits

Eligible surviving family members may receive:

  • $25,000 to the spouse
  • $10,000 to each dependent
  • $10,000 to be split among those persons in respect of whom the decedent was a dependent
  • $6,000 as a funeral benefit

These can be increased with the purchase of optional coverage to:

  • $50,000 to the spouse
  • $25,000 to each dependent
  • $25,000 to be split among those persons in respect of whom the decedent was a dependent
  • $8,000 funeral benefit

Treatment Team

Depending on the seriousness of your injuries, you may have a team of medical and care providers to care and support you. Medical providers and those providing therapy and other services should be advocates for you and be willing and available to communicate with you, your other providers on the team, and your lawyer. Reports and records are vital to establishing the nature and extent of your injuries, what care is needed, and if you are substantially unable to perform your pre-injury work duties so as to be eligible for income replacement or non-earner benefits.

Case managers are assigned for catastrophic injury cases to coordinate care and services for the injured party. For non-catastrophic cases, an occupational therapist or OT takes care of services and support and assesses the need for attendant services and home maintenance requirements. The OT does need to first submit a Treatment and Assessment Plan, form OCF-18, to the insurer before beginning the process. Once received, the insurer has the right to have the client examined by a physician of their choosing, referred to as a Section 44 Insurer’s Examination, to determine if the client needs to be assessed and if the requested treatment and care is reasonable and necessary. The cost of the assessment by an OT and of the examination cannot exceed $2,000. This cost is deducted from the $50,000 available for medical and rehabilitation benefits for non-catastrophic injuries.

There can be other medical and rehabilitation providers as part of a treatment team. Any assessment done by a professional must first be approved and the request submitted through a Treatment and Assessment Plan. The inclusion of these professionals depends on the nature and extent of your injuries. These individuals may include:

  • Social worker—who handles the emotional and psychological issues following a traumatic accident
  • Chiropractor—deals with physical issues such as back and neck pain
  • Psychologist—if depression and anxiety are especially severe
  • Personal support worker—person who handles attendant care
  • Massage therapist—for ongoing or chronic physical issues that massage can alleviate
  • Speech and Language therapist—if brain damage caused cognitive issues

Rehabilitation Support worker—person who assists with the implementation of various care and for re-integration into the community

The OT or case manager can determine with the assistance of these professionals what assistive devices are necessary and what workplace and home modifications are needed to accommodate the client. The insurer is obligated to pay for any modifications or assistive devices. Examples are walkers, canes, guardrails, handheld showerheads, ergonomic keyboards, ramps, wheelchairs, and other specially designed chairs.

Disputes

It is not unusual for an insurer to categorize your injuries as non-catastrophic or as minor even if you and your medical provider dispute this. Insurers will also dispute the reasonableness or necessity of certain treatments and deny consent or refuse to provide payment for care already rendered. Your Toronto car accident injury lawyer from Affinity Law can help by ensuring that your medical provider and treatment team offer the necessary documentation to support your injury. But if the dispute is unresolved, you can bring the issue before the License Appeal Tribunal (LAT) for resolution.

Settlements

If you have been receiving SABS benefits for some time, the insurer may approach you with a settlement offer. Any settlement offers, though, cannot be extended until one year after your accident that precipitated the payments. Any offer will be for a fixed amount. If you do decide to accept it, you will not be able to collect any further SABS benefits from this accident regardless if your injuries worsen or further medical treatment is necessary such as surgery and therapy. You should be cognizant that any settlement you do accept could affect any third party claim you have against the party or parties who were responsible for your accident.

RETAIN AFFINITY LAW

It is highly recommended that if you do not have a lawyer already, you at least consult with a Toronto Accident Benefits lawyer from Affinity Law to understand what options you have and what would be a fair and reasonable settlement amount. One of our knowledgeable Toronto personal injury lawyers can negotiate a reasonable settlement for you and represent you on a third party claim. Most accident benefits claims are settled after the one-year period.

Call us today for a free consultation at 1 844 786 LAW 1 (5291).
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All motorists in Ontario and throughout Canada are required to maintain auto liability insurance coverage.

Uninsured Motorist Claims in Ontario

Third-Party and Uninsured Motorist Requirements

All motorists in Ontario and throughout Canada are required to maintain auto liability insurance coverage. As an Ontario motorist, you must carry a minimum of $200,000 in third-party coverage in case of an accident with a pedestrian or other motorist where you are deemed liable or responsible for the accident. This amount applies to uninsured coverage as well where an at-fault motorist lacked any liability insurance or is unidentified.

The minimum amount will usually be sufficient to cover damages for minor injuries but not for more serious ones where a victim has sustained multiple injuries such as broken limbs, disfigurement, traumatic head injuries, or death. If the victim is out of work for an extended period, is unable to return to work, must be re-trained, or has succumbed, then the damages will be significantly higher. Most commentators recommend third-party coverage of $1,000,000, if you are able to afford it, in the event of a catastrophic accident where a victim’s expenses and damages are hundreds of thousands of dollars or more. Fortunately, the law mandates that you also carry uninsured motorist coverage of at least $200,000 in the event you are injured by an uninsured motorist.

This same warning to maintain sufficient coverage applies to accidents where the at-fault motorist is uninsured. If you sustained serious injuries where medical and its attendant costs are substantial, and you are unable to work for months or at all, your failure in not carrying sufficient uninsured motorist coverage can be devastating to you and your family.

There are approximately 2,100 accidents per year in Ontario involving uninsured drivers but that about 400,000 motorists are driving without insurance coverage. If a motorist who is driving while uninsured is caught, the penalties are stiff. They face a fine of $5,000 to $25,000, suspension of their driver’s license for up to one year, impoundment of their vehicle for 3-months, and a 25% fine surcharge paid to any victim injured by their negligent driving. Should the individual apply for insurance when eligible, the premiums will undoubtedly be substantial, or coverage may be denied altogether.

What Happens in an Uninsured Motorist Accident?

Statutory Accident Benefits

If you are injured in an accident, you must report the accident to your own insurer even if you suspect the other driver was uninsured. Regardless of fault, you are entitled to statutory accident benefits such as supplementary medical, rehabilitation, attendant care, caregiver, and non-earner and income-replacement benefits. These are benefits that you collect from your own insurer or from the insurer for the at-fault driver if you were a pedestrian or passenger and had no coverage. If you are a “person under the contract” such as a spouse or dependent relative or a passenger in the vehicle, you may claim those benefits under that policy. A Toronto injury lawyer from Affinity Law can explain your eligibility for these benefits and what you can expect.

You are required to first seek statutory accident benefits before claiming any additional compensation from a responsible motorist by providing written notice of your intention to commence a lawsuit against the tortfeasor within 120-days following the accident. Your notice must include your statutory benefits file, disclosure of all  your income sources,  and submission of all medical records and reports concerning all care you received for your accident injuries. Have a Toronto car accident lawyer from Affinity Law handle this as well as all other aspects of your claim.

You are limited in an accident benefit case to $400 per week for lost income unless you purchased optional benefits. If your injury was minor, you receive only up to $3,500 for physical therapy or other rehabilitation costs.

Hit-and-Run or Unidentified Driver

If the accident was a hit-and-run and the responsible motorist is unidentified so that the uninsured provision of your auto policy would apply, then follow these steps:

  1. Report the accident to police within 24-hours or as soon as practicable
  2. Report the accident to your own insurer within 24-hours
  3. Provide a written statement to your own insured within 30-days of the accident or as soon as practicable and provide the accident details, that an unidentified driver caused the accident, and whether you were injured
  4. Make your vehicle available for inspection by your insurer

In a hit-and-run incident, you have the burden of proving that an uninsured motorist caused the accident by introducing physical evidence of a collision in order to access the $200,000 limits. Your request to bring an uninsured motorist claim is under the purview of s. 265 and is dependent on their being no other auto policies available to compensate the insured.

When purchasing auto liability coverage, you have the option of obtaining coverage in excess of the minimum $200,000, called Family Protection Coverage under OPCF 44R of up to $1,000,000. If you wish to access the additional compensation of $800,000, then you must present “other material evidence” to corroborate the existence of the uninsured or unidentified motorist. This should include corroborating testimony of an independent witness (not a relative or spouse) or physical evidence of the involvement of an unidentified vehicle. This can include tire tracks left by the fleeing driver near the collision site.

Requirement of a Serious and Permanent Injury

You can only assert a claim for additional compensation against the tortfeasor or your own insurer if you have an uninsured motorist claim if your injury is a “permanent serious disfigurement or permanent impairment of an important physical, mental or psychological function.” You will need a medical provider to provide evidence of the nature and extent of your injury to the satisfaction of a judge before your claim against the responsible driver may go forward.

If you met the threshold for having sustained a serious and permanent injury and you collected non-pecuniary general damages, the insurer is entitled to a credit or a reduction in the amount it paid out in the amount of $37,833.33, a sum that increases each year. But if those damages exceeded $100,000, there is no deduction. You are, however, presently limited to non-pecuniary general damages in the amount of $367,000.

Your Own Insurer as Adversary

If the other motorist was uninsured or it was a hit-and-run accident where the driver is unidentified and you are looking towards your own insurer, then your insurer becomes your adversary and stands in the shoes of the uninsured or unidentified motorist. In such cases, your insurer may assert that the other party was insured, or that you were responsible for the accident or contributorily at fault. The nature and extent of your injuries will also be at issue including the permanency of your injuries, the reasonableness and necessity of your medical care, and the diminished quality of your life. Your insurer may also question your claim for lost earnings, lost earning capacity, or your ability to perform your current occupation.

Be aware that the uninsured coverage that you possess applies to all persons making an uninsured motorist claim. If your limit is $200,000, then this amount is shared pro rata among all claimants in a case involving multiple parties.

Retain Affinity Law

Handling your own car accident case can be difficult and which does not become easier if you were injured by an uninsured motorist. Ontario law has certain requirements regarding notice and disclosures, especially if your injury is a serious one and you are seeking compensation in addition to your statutory accident benefits. You will also have to address possible allegations that you contributed to the accident or that your injuries are not as serious as you claim.

Consult with one of our Toronto personal injury lawyers at Affinity Law if you or a loved one was injured in a car accident. We have obtained millions of dollars in compensation for our injured clients and can ensure that you receive the best opportunity to collect the most compensation for your claim.

Call us today for a free consultation at 1 844 786 LAW 1 (5291).

Our unique and experienced immigration team helps individuals, families and businesses settle in Canada whether

Citizenship Application

What are the requirements for becoming a Canadian citizen?
Your eligibility for citizenship depends on your situation, such as

1 – permanent residents of Canada applying for:
yourself
your minor (under 18) child

2 – past Canadian citizens who want to get your Canadian citizenship back
this includes current and former Canadian Armed Forces (CAF) members

3-Canadians applying for citizenship for your adopted child born outside Canada

4- current or former CAF members applying under the fast-track process

Spouses of Canadian citizens

You don’t automatically become a citizen when you marry a Canadian. If you’re a spouse of a Canadian citizen, you:

  • don’t need to meet any special requirements
  • must meet the same eligibility requirements as other adults

Next steps

Let’s get your documents ready

Some documents take a long time to get, so you should get them ready now.

We can assist with submitting your profile. Contact a Toronto Immigration Lawyer today at Affinity Law and let us make things easy and less confusing for you.

Avoiding conflicts, disputes and litigation is a primary object of any contract.

Commercial Agreements

Avoiding conflicts, disputes and litigation is a primary object of any contract. Affinity lawyers ensure that agreements are clear and specific in its terms and accurately reflects the intentions of the parties. Our lawyers will counsel you on such diverse matters as:

  • Commercial leases
  • Joint ventures
  • Financial service contracts
  • Service and supply agreements
  • Construction and development
  • Nonpayment disagreements
  • Partnership and corporate disputes