No one prepares themselves for an injury in a car accident. However, sometimes the unthinkable happens. Luckily, your auto insurance policy includes provisions in case injuries do occur. The Accident Benefits section of your policy provides compensation if you, one of your passengers, or a pedestrian suffers an injury in a car accident. This is regardless of who was at fault. Ontario’s legislation mandates that Accident Benefits are present in all auto insurance policies. This can help you cover expenses incurred as a result of your accident. But where do you start? Follow our simple guide on how to file an Accident Benefits claim below.
Before You File an Accident Benefits Claim
Even if you have the most experience as a driver, you are not immune to getting into an accident. You must make a police report to the nearest collision centre within 24 hours—it’s the law! Remember, if you suspect you or a passenger has been injured in an accident, do your best not to move anyone who has an injury in the accident, as this can cause further harm. For more information on the necessary steps to take in the event of an accident, take a look at our article on what to do if you’ve been in an accident.
Opening Your Accident Benefits Claim
After reporting your accident to the police or collision centre, call your insurance broker as soon as possible to begin the claims process. The faster you get in touch, the quicker your broker can begin your claim.
If applying for Accident Benefits, your insurer will assign a claims adjuster to handle your file. Guiding you through the claims process is what they do best. Adjusters handle your injury claim by:
- Taking your accident and injury details
- Checking the coverage list under your insurance policy
- Guiding you through the process of submitting your claim, including the explanation of any documents they require
- Giving a claim number for your reference
If you have injuries as a result of the accident, you will need to submit the forms within the Accident Benefits Application Package.
First, if you would like a quick and seamless process, please fill out the applicable form. Next, double-check your work and make sure you sign and date the forms. Lastly, if anyone else fills in portions of the form, such as your family physician, ensure they complete their portion and submit it as soon as possible.
What Does An Application Package Entail?
An Accident Benefits Application Package will include the following five forms:
- Application for Accident Benefits (OCF-1)
- Employer’s Confirmation of Income (OCF-2)
- Disability Certificate (OCF-3)
- Permission to Disclose Health Information (OCF-5)
- Treatment Confirmation Form (OCF-23)
Most minor claims do not require the submission of all forms. Your AB adjuster can help you determine which forms you need, depending on your unique situation. Once the insurance company has reviewed these forms, your benefit eligibility will be communicated to you in writing. However, you can always contact your isure broker to help you through the process. It is important to return the completed documents and forms to the address on the document page within 30 days. Forms must be returned by regular mail, courier, or personal delivery.
Seeking Treatment For Your Injuries
Having an assessment by your family doctor or a nearby clinic soon after the accident is significant. If you were taken by ambulance to the hospital, ensure you request that all tests and doctor’s notes be sent to your family doctor. If you seek treatment for your injuries, your treatment provider will request these documents to assess your condition and develop a personalized treatment plan.
After assessing your injuries, your treatment provider determines which of the three categories of injury you are in. These categories help determine what amount of coverage you are entitled to. Remember, you have several treatment options available to help you feel better, sooner. It’s essential to select a healthcare provider that’s convenient for you, whether close to your workplace or home.
- Your primary health care provider or family doctor can recommend a specialist or therapist.
- Your AB claims advisor can provide you with the contact information of their providers for accident-related care.
Claiming Your AB Expenses
In many cases, you can claim expenses for your accident. If you lose, damage, or have personal items destroyed as a result of your accident, you can claim them, as well. Expenses must also be seen as reasonable and/or necessary. They must meet your auto policy’s definition of “incurred.” Incurred expenses refer to any fees that have been paid or promised to be paid by an insured person for any goods or services provided.
If injuries from a car accident are serious enough to have you miss work or limit your daily activities, disability benefits are available. Your choice of benefits and the nature of your injuries will determine the coverage you receive. There are several categories of disability benefits, ranging from income replacement to caregiver services. For a full list, please refer to our article on your accident benefits package, which explains.
Your AB claims advisor is knowledgeable and can explain which benefits apply to your injury and policy coverage. If you are eligible for more than one type of disability benefit, your advisor can explain the process for making an election. If you need additional information or documents, they can assist you with these as well.
Payment of Your Benefits Claim
After reviewing all your forms, your isure broker will inform you in writing which benefits you’ll receive. Each month, an Explanation of Benefits Form detailing how your benefits are being spent is sent to you. However, if you’re not happy with the adjuster’s decision, call them for clarification. If you’re still not happy, you can dispute it.
Closing Your AB Claim
If you are satisfied with your adjuster’s decision, you will receive the benefits to which you are entitled and have your expenses paid out. Then, once all eligible benefits have been paid, your broker will close your claim and your file.
Accident Benefits: Critical Timelines
When it comes to Accident benefits, it is important to keep some critical dates in mind. Let’s take a look at what these are:
- Seven days: To notify your insurer that you intend to apply for Accident Benefits.
- 30 days: To submit your Accident Benefits Application Package.
- 120 days: From the date of the accident to notify of intention to sue.
Most auto accidents are traumatic events. Even with seemingly minor accidents, injuries may not be apparent immediately. Therefore, be sure to receive an assessment as soon as possible after your accident. If you require treatment, your auto policy has provisions built in to help you. Remember, don’t hesitate to reach out to us at isure if you have any questions. Contact us or request a quote today!
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