You’ve Been injured in a Motor Vehicle Accident – Now What?

Applying for Accident Benefits

By Kevin Souch

Accidents happen. They are often unavoidable and can occur despite doing everything right. Sometimes you make a mistake or have a momentary lapse in attention and you cause an accident. If you are injured in either scenario you have rights and the steps you take following an accident can affect those rights.

The first thing you need to do if you are injured in an accident is seek medical attention as soon as possible. It is important to your health that you get timely treatment and important to your future claim as well.

The next step is to notify your insurance company of the accident if you have automobile insurance. It doesn’t matter who is at fault for an accident, if you are injured you must report the accident to your own insurance company even if you weren’t at fault or driving. This is part of the no-fault insurance system in Ontario. If you do not have insurance then you report it to an insurer for which you are a named insured (spouse or family member). If you are not a named insured, which is common for people that don’t drive or don’t own a vehicle, then you report it to the insurer of the vehicle you were a passenger in. If that insurance is not available or if you were a pedestrian or cyclist then you report it to the insurer of the vehicle that you were injured by. This aspect can be confusing for many and I advise you to consult with an experienced law firm like Sorbara Law. The good news is that if you open a claim with the wrong insurer it is the insurer’s responsibility to transfer the claim to the proper insurer and they have to continue providing benefits while it is sorted out. There are even benefits available if you are injured by an unidentified driver and can’t identify an insurance company to make a claim with.

Everyone is entitled to make an accident benefits claim and receive benefits if they are injured in or by an automobile. This applies even if you are uninsured or if you are at fault for the accident. If you have suffered serious injuries it is still important to consult with an experienced lawyer even if you are at fault for the accident.

After notifying the proper insurer and opening a claim you will receive a package of forms known as Ontario Change Forms (OCF). The most important forms to complete are the Application for Accident Benefits OCF1 and the Disability Certificate OCF3. For the OCF3 you can complete the personal information and then take the form to a medical treatment provider such as your family doctor or physiotherapist. If you are missing time from work you will also need to complete the Employer Confirmation Form OCF2. Just like the OCF3 you can complete the personal information and then take this form to your employer to complete the rest.

In addition to the above forms you will also be asked to complete a Permission to Disclose Health Information OCF5. This form allows your insurer to access your medical records to support your claim. If you complete this form the insurer will be entitled to get your medical records going back years which is unnecessary for it to assess your claim. If you choose to complete this form it is important to communicate to your adjuster that you are only authorizing them to get records from 1 year prior to the accident. In the alternative you can gather the records yourself and provide them directly.

There are a number of benefits available to an injured person that are included in the Statutory Accident Benefits Schedule (SABS). It can be difficult knowing which benefits you are entitled to and which to apply for. Again, it is important to consult with an experienced personal injury lawyer to know your rights. The insurance companies have hundreds, if not thousands, of lawyers that they consult with, it is important you level the playing field by consulting a lawyer. As always, we offer FREE CONSULTATIONS for personal injury clients.   

For information on Optional Accident Benefits see this article.