A motor vehicle accident causing a personal injury is not only highly traumatic but can make for a complicated claims process. In fact, it’s not uncommon to see an accident claim go on for two years or longer. In order to save time and money, it’s in the interest of all parties to negotiate a settlement before a claim has to progress to court.
Rather than fighting it out in litigation, achieving a settlement is certainly preferred and still nets you the same result.
While insurance companies will often try to settle on the lowest possible amount, with an experienced car accident lawyer at your side, you can skillfully counter offers and negotiate terms to ensure that fair compensation is provided.
Receive guidance on the ins and outs of navigating a settlement. Ensure you get the information you need before putting your signature to a settlement offer. When you reach out to an expert at Joshua Goldberg Law, rest assured that you will be taken care of.
Essentials Of Car Accident Insurance Claims
A car accident benefits claim is made to provide compensation to a victim of a car accident or for the surviving family in the case of a loved one having died in a motor vehicle accident.
If the other driver is responsible for the car accident, with the help of a legal representative, you can pursue a personal injury case.
The statutory accident benefits coverages used in Ontario auto insurance policies is mandatory, meaning benefits are provided for any and all injuries sustained in car accidents. This is regardless of if you are a pedestrian, a driver at fault, or purely the victim.
In addition to accident benefits, there may be additional benefits to claim, such as disability benefits if you are left disabled from the car accident or tort-based claims. A tort claim is if there was another party at fault and you’re filing a claim against that party to recover damages. This may mean filing a claim against another driver, the auto manufacturer, the owner of the vehicle, or another negligent party.
In addition to standard accident benefits, they may include attendant care benefits, caregiver benefits, funeral benefits, and lost wages.
Key Roles: Personal Injury Lawyers And Insurance Agents
A personal injury lawyer is there to help you be aware of all your legal options as you pursue a car accident insurance claim.
While your lawyer is there to represent you and submit the strongest legal case possible, insurance agents are tasked with ensuring the corporation pays as little as they can under the letter of the law. They will attempt to question your injuries and the details of what happened. Even so, insurance companies know when the writing is on the wall and it’s in their best interest to settle quickly.
Where you start with a lawyer is with an initial consultation. With you, we will review the details of your motor vehicle accident to determine the merits of your case, while looking at the extent of your injuries, treatment received, and prognosis.
In this consultation, a lawyer will also explain what accident benefits may be available to you, such as no fault accident benefits, caregiver benefits, income replacement, and benefits that cover necessary medical expenses.
Overview Of Accident Benefits In Ontario
Ontario utilizes a no-fault auto insurance system that provides basic statutory accident benefits.
A personal injury victim may be entitled to a higher amount in no fault accident benefits depending on the insurance policy and the nature of the injury sustained.
If the victim has suffered a catastrophic injury, for example, they are entitled to more comprehensive benefits than someone who has only experienced minor injuries. This is due to many of these injuries being permanent or near-permanent, greatly affecting a person’s daily activities. Catastrophic injuries include severe brain injuries, spinal injuries, and even psychological injuries. It often leads to a permanent disability.
What you can expect in terms of amounts for no-fault accident benefits within the scope of car accident settlements are as follows:
- $3,500 for a minor injury sustained in an auto accident.
- Up to $65,000 for non-catastrophic injuries sustained in an automobile accident.
- Up to $1,000,000 for more severe injuries and catastrophic impairments sustained in a car accident.
Understanding No-Fault And Statutory Accident Benefits
As a part of mandatory insurance coverage provided to all drivers, accident benefits have mandatory limits with regard to income replacement benefits, medical and rehabilitation benefits, and funeral and death benefits for a dependent person or surviving family.
To enter in a full and final settlement on statutory accident benefits, in most cases, you cannot enter it within the first year.
After a year, however, you are allowed to proceed with a settlement. It is typically proposed as a cash offer made by the insurance company that you will receive as a lump sum as opposed to regular payments for one or more of your benefits.
Strategies For Effective Accident Benefits Claim
All accident benefits claims are decided on their own merit.
The best strategy to use is to pursue the amount of compensation you are rightfully owed based on the unique circumstances of your accident and the injuries.
All personal injury claims must prove circumstance and the extent of the injury. Depending on the complexity of the case, an accident benefits settlement may take some time to resolve disputes between parties and to complete any additional investigations that are needed.
In motor vehicle accident claims, there are many steps a lawyer will take to strengthen their case, such as providing expert witness testimony, medical records, accident reconstructions, and witness statements.
Don’t be discouraged if the process of trying to settle your personal injury case is taking a long time. It’s not necessarily a bad sign. Every case is unique and delays can happen for any number of reasons, such as pending responses from other parties, waiting on medical reviews, or something of this sort.
Keep in mind that you cannot force an insurer to agree to a car accident settlement and an insurer cannot force you to agree to a settlement either.
Calculating Compensation For Lost Income And Wages
A personal injury claim can cover lost income and wages. If you are unable to earn an income, income replacement benefits can be provided for up to two years following the auto accident and even beyond in some circumstances.
The purpose of income replacement benefits is to ensure you aren’t left destitute after an injury.
It is structured to provide an injured person with 70% of their gross income capped at a maximum of $1,000/week.
Ensure in any settlement that a clause is entered that states plainly that for as long as you are still losing income, those benefits are to continue with additional compensation. Insurers may try to enter in a clause that limits benefits to two years, however, you don’t have to accept this.
It also is worth stating that if you do not qualify for income replacement benefits, there are non-earner benefits. These are for individuals who are at least sixteen years of age and a full-time student or graduate without employment at the time of the crash. Non-earner benefits and income replacement benefits cannot be combined.
Furthermore, if, prior to the accident, the victim acted as a primary caregiver to a dependent child or adult, there are caregiver benefits as well. If their injuries prevent them from carrying out caregiver duties and the dependent lived with them at the time of the collision, you may try to claim the caregiver benefit which provides $250/week for the first dependent and $50/week for each additional person.
A legal professional with expertise in personal injury law can assist you to pursue all available compensation for income replacement.
Medical Expenses And Rehabilitation Costs: A Detailed Look
Understandably, what often costs the most following a personal injury from a motor vehicle accident is the medical and rehabilitation expenses.
What is not covered under your private health plan or provincial health plan can be covered under an accident benefit claim. This falls under medical and rehabilitation benefits.
With regards to medical expenses, for non-catastrophic injuries, the mandatory coverage for a claim is $65,000 which can be extended to up to $130,000 in some cases. For catastrophic injuries, mandatory coverage increases to $1 million with the possibility of it being extended up to $2 million.
Meanwhile, rehabilitation expenses depend on the insurance plan you have and are designed to cover physiotherapy, prescription medications, counseling, and other services not covered on any existing health plan you’re under.
If your injuries are particularly severe, you may require attendant care which is covered under the Statutory Accident Benefits Schedule. Assuming there is a reasonable cause for attendant care, compensation can be sought to help cover in-home care by an attendant or personal aide, or long-term facility convalescent care.
Settlement Negotiations: Techniques And Best Practices
When you come to launch an accident benefit claim, a settlement is faster and less expensive than litigation.
Don’t under-settle and accept a lower amount than what you are rightfully owed. Under-settling on an accident benefits claim can have a negative impact on a tort claim.
Always make a counter-offer to what an insurance company offers. Never accept the first offer as the only offer.
Don’t be misled by what your insurance company tells you who may suggest an offer is their ‘one and only offer’ or their ‘final offer’.
Know your burn rate. This is the rate at which you consume your accident benefits. An insurer will assess how much money from the total policy limits you use each year post-accident, using it to determine what you will spend on future expenses and then adjust your claim accordingly.
Carefully navigate the settlement negotiation process as when you agree to a car accident settlement, you agree to three things – you give up the right to receive additional benefits even if your injuries worsen, you forfeit your right to appeal or challenge the amount provided by the insurer, and your settlement may be the only form of compensation received if you do not have a tort claim.
Role Of Insurance Companies In Personal Injury Settlements
While understanding that accident benefits for an auto claim are mandatory, the role of an insurance company is to reduce the personal injury settlement to the lowest amount they can. They may challenge the veracity of the claim, request additional documents or evidence, and will be thorough in evaluating what you present.
If you’ve not hired a legal team or lawyer to represent you, you may not know how much compensation you may be entitled to and accept a settlement offer below par.
Don’t go into settlement negotiations unrepresented. Receive the compensation you deserve with an experienced personal injury lawyer at your side.
Insurance companies deal with personal injury cases every day and understand where a settlement can be advantageous to them, in terms of saving time and resources. If they are willing to agree with the severity of your injury, key details of the case, and the nature of the injury, they may make a reasonable settlement offer without having to be prompted.
It is only when they don’t that a personal injury lawyer will recommend pursuing a formal lawsuit against the accused. That said, only 10-15% of personal injury claims go to trial in Ontario. It is fairly rarer, with most resolved by form of a settlement.
The Claims Process: From Application To Settlement
When you submit an application for compensation under an accident benefit claim, what any insurance company will want when they know they can’t beat the claim is to negotiate and close the case with a fair settlement before it reaches the litigation process.
Use this to your advantage and navigate your claim with an expert personal injury lawyer in Toronto at your disposal.
When you pursue a car accident insurance claim settlement, rest assured that your lawyer will keep you involved every step of the way and help you negotiate the agreed-upon final amount. We know the ins and outs of the car accident settlement process, how to interpret existing statutes, and know what’s a fair amount of compensation as it pertains to your specific details.
When you are faced with an opportunity to reach an accident benefits claim settlement, don’t go it alone. It’s best to have an experienced legal team at your side. Call us today at Joshua Goldberg Law for more information on how we can help and schedule a free consultation.