Articles Posted in Deductible

Car insurance, and making a claim after a car accident in Ontario should be simple and straight forward.

But, as a personal injury lawyer with two decades of experience in the field, I can tell you that it’s not. Far from it! In fact, car insurance and accident benefit claims are complex and defy common sense.

Here are a few items that our lawyers at Goldfinger Injury Lawyers along with our clients have always found rather strange when it comes to car accident claims in Ontario.

Item #1 Regardless of fault, the first insurer to respond to the claim is your own car insurance company. Ontario has a “no fault” system of accident benefits. This means that your own car insurer, regardless of fault, is the first insurer to make a payment of the claim. The at fault driver could have been drunk, high on drugs, on his cell phone having run a red light. It doesn’t matter. Your own car insurer, regardless of fault, is the first insurer to pay. This is what “no fault” is all about. How the accident happened and the degree of liability for the at fault driver is not even a thought when it comes to no fault accident benefits which defies common logic when non lawyers think about car accident cases.

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The law, above all else, ought to be transparent.

It should NOT be a secret society whereby only industry insiders have knowledge, power and insight that the general public does not have.

When a personal injury case goes to trial, the jury should be informed of how things work, so that they can make a fair and just decision. The jury should never be kept in the dark about how the law works, so that they can make an informed decision which will invariably impact the lives of the parties to the litigation.

Yet, the practice of personal injury law in Ontario has many secrets. You would think that it’s neither nice, nor fair to have secrets which are withheld from a jury during the course of a personal injury trial.

Yet there are secrets which personal injury lawyers and judges cannot share with the Jury until only after the Jury has made up their mind.

What are these secrets you ask? Let me share them with you.

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If you asked personal injury lawyer what are some of the most common issues they face with car accident cases in Ontario; without a doubt the issue of the threshold and the deductible will be very high on their lists. Likely the number 1 issue which personal injury lawyers face for car accident cases in Ontario.

What are the threshold and the deductible?

Good question, because so few people know what they are, or how they work.

Let’s start with the deductible, because that’s the most concrete of the two concepts. The deductible acts as a secret credit which the insurance company doesn’t want you or the general public to know about. For every pain and suffering case involving a car or motor vehicle; the insurance company which acts for the Defendant is entitled to a LARGE CREDIT for pain and suffering award which falls below $138,343.86. The deductible for 2022 sits at $41,503.50. It’s the $41,503.50 elephant in the room for any car accident case. This means that if a Judge and Jury award an injured Plaintiff $50,000; after the $41,503.50 deductible is applied; it leaves the injured Plaintiff with only $8,496.50 in their pocket. This seems unfair. But that’s the law in Ontario.

The at fault driver could have been drunk, ran a stop light, while texting on his/her cell phone. The extent of fault will not matter. The deductible applies nonetheless regardless of fault.

It would appear that Ontario’s system affords the at fault Defendant with a $41,503.50 security blanket for each car accident. And that $41,503.50 security blanket only grows larger with time. The reason for this is that $41,503.50 figure increases each year with inflation. The deductible sat at $39,754.31 in 2021 and grew to $41,503.50 in 2022. Where will it be in 2030? Near $50,000? Near $55,000? It will only go up. I am not aware of any provision in the legislation which permits for deflation of the deductible. Only inflation.

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This edition of the Toronto Injury Lawyer Blog is coming out a bit early because I have the time to write now before I have to start homeschooling my children given the recent announced lockdown measures in Ontario. It’s rather difficult being a lawyer and educator for your young children at the same time. There’s a reason why kids go to school and aren’t taught at home by their parents who have full time careers.

I don’t need to tell you that Ontario is all messed up right now. Just tune into the news and it’s all doom, gloom, lockdowns and restrictions. It’s enough to make one cringe.

I’m just a personal injury lawyer, so it’s not my lane to comment on the health and safety of Ontario’s population. But what I can tell you is that I’m an optimist and I strongly believe that we will get through this. There is light at the end of the tunnel. This is the storm before the calm. If were were able to get through the Black Plague and Spanish Flu with nothing more than rubbing alcohol, spoonfuls of castor oil, other whacky home remedies and bandanas for face coverings; I think we will be able to get through COVID and all of its variations. What scientific belief is all of this optimism founded upon you ask? NONE! Just the fighting spirit of humankind and a positive belief that we all want the same thing which is for our health, happiness and our basic human freedoms.

A topic that is within my education, training and expertise is the area of personal injury law. This is the field of law I’ve been practicing in for basically my entire legal career.

Ontario has a really complicated system of car insurance. Each car accident case has two cases. The first case is a no fault accident benefit case with your own car insurer. Regardless of fault, the first claim is with your OWN CAR INSURER for accident benefits. These accident benefits cover such things as med/rehab benefits for physio, massage, chiropractic care, psychological counselling and anything else under the sun not covered by OHIP for your wellness and rehabilitation which is deemed to be both reasonable and necessary. Accident benefits also cover an income replacement benefit which under a standard policy of insurance is up to $400/week; and non-earner benefits for those unemployed or retired people of up to $185/week for up to two years; along with an attendant care benefit of up to $3,000/month for non catatrophic claims; which is then increased to up to $6,000/month for catastrophic claims.

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