Toronto Injury Lawyer Blog
It may be your first time being involved in a serious car accident where you have sustained serious injuries. These are not common events. And because these are not common events, few people know exactly what to after the accident, or how to deal with their car insurer.
The purpose of this edition of the Toronto Injury Lawyer Blog is to provide you with quick tips dealing with your Car Insurance Company after a serious collision.
1.You deal with your own car insurer first. Ontario has a no fault system of accident benefits for car accident cases. That means that regardless of fault, the first insurer you will deal with is your own insurer. This seems counter intuitive, but this is how the law works. So, the at fault driver could have been drunk driving, high on drugs, texting on his phone, and ran multiple red lights. It does not matter. The first insurer you will deal with is your own insurer regardless of fault. Weird huh!
2. Watch what you say to the insurance adjuster. When you call most insurers, there is a recorded message saying that the call will be recorded for training and customer service. The call is being recorded so that if you put your foot in your mouth, and say something which is helpful to the insurer, but hurtful to your case; it can and will be used against you moving forward. Many claimants put their feet in their mouths and cause more harm than good in these recorded phone calls with their insurance adjusters. It’s much wiser to let an experienced personal injury lawyer handle it.
3. You are NOT required to sign any paperwork, or meet with the insurer without a personal injury lawyer. Once you have reported a claim, insurers are eager to have you sign paperwork, and meet with them to take a statement. This is all under the guise of explaining to you how things work, and getting you to sign forms. The reality is that one of the things which the insurer wants to gather as much information as possible before you have retained counsel. It’s their hope that you will put your foot in your mouth and say something which will hurt your case more than help it. See tip #2 above. It’s ok to say “no“, or to hold off on that meeting until you have retained a personal injury lawyer. Some adjusters are very aggressive and persistent to meet with injured accident victims before they know their rights. I’ve seen adjusters meet people in hospital while connected to an IV drip and sedated. It was cringe worthy. It was like they were paid by the statement or paid by the signature. It was almost like a race to get whatever information they could before the person got a lawyer. You have to wonder why that was.
4. If the insurer tells you to go to a clinic for treatment, you do NOT have to go there. Just because the insurer tells you to go to a clinic for treatment, does NOT mean that you need to attend at that clinic. You’re free to attend at any clinic you like for treatment. Simply because the insurer’s clinic is described as one of their preferred clinics, does not mean that it’s right for you. You also need to ask why that clinic is on their preferred list of clinics to begin with. In our experience, clinics which are on insurer’s lists tend to view cases through the lens of an insurance company instead of through the lens of an accident victim. The clinic does not want to bite the hand that feeds them so to say. Our advice is to find a clinic which is near your home, and which is not affiliated with any insurance company. The closer the clinic is to your home, the greater the chance that you will attend for treatment with regularity and the easier it will be for you to attend for treatment. Sometimes, this is not realistic if you live in a remote area. But finding a clinic which is close to home tends to be a good idea.
5. Make sure that you receive, and complete the OCF Accident Benefit Claim Forms. Once you have reported your car accident to your own insurer, they should send you an accident benefit package in the mail (or email). This accident benefit package will contain a variety of OCF Claim forms to start your claim. Do NOT sit on those forms. It’s important that you complete them. If you do not complete the OCF Claim forms, your claim might be denied for delayed, questioned as to why it was not completed in a timely manner, or simply won’t get started because the forms haven’t been completed or submitted. You will be able to complete some forms on your own. Other forms, such as the OCF-2 Employer’s Confirmation of Income Form, or the OCF-3 Disability Certificate will need to be completed by people other than yourself (your employer and your doctor or health practitioner). Getting other people to sit down and complete forms which they likely aren’t familiar with can take time. That’s why it’s important to get an early start on the completion of these OCF Claim forms.
6. Don’t expect money to fall from the sky. Insurance companies are great at taking your premiums. They are less good at paying out benefits in a timely manner. You will NOT get the benefit of the doubt from your insurance company, even if you have been a loyal customer of theirs for years and years. Car accident cases are hotly contested, and getting insurers to approve benefits takes time. I wish this was not the case but it’s simply the reality of car accident cases in Ontario. If an item is in dispute (like physiotherapy treatment), the accident victim will need to make an application to the License Appeals Tribunal to contest the dispute. Getting a hearing date at the License Appeals Tribunal takes time. By the time the case is heard, many months will have passed whereby the treatment has not been paid for by the insurance company. There is no instantaneous relief for the accident victim. The system makes the insured combat his/her own insurance company and vice versa in what can become a very bitter relationship between customer and insurer.
