When you are involved in an accident with a motor vehicle, whether involving two or more vehicles, a single vehicle accident, a pedestrian struck by a car or a bicyclist struck by a car, regardless of fault, all parties are entitled to receive accident benefits from the auto insurer. The accident benefits are provided by the insured’s own policy. If you are not covered under an auto insurance policy, then you will be able to received accident benefits from either the auto policy of a person upon whom you are dependent or under the auto policy of the vehicle that struck you. If you are a pedestrian or bicycle rider, hit by a car, and you are not connected to any auto insurance policy, then you will be able to obtain medical benefits from the auto insurance policy of the vehicle that struck you. In the event that there is no car insurance policy available to provide medical coverage, then the province has established a fund to provide medical and rehabilitation benefits for car accident victims.
There are three basic levels of medical coverage. The lowest level is for those accident victims that have a sprain or strain type injury which puts them in the level of injury treatment that is governed by the Minor Injury Guideline (MIG). The MIG provides the car accident victims with $3,500.00 of medical benefit coverage. If you have a more serious injury, like a fracture, then you will put into the next level of medical benefit coverage. At this level you are entitled to up to $50,000.00 in medical and rehabilitation benefits. The third and final category is for those people hurt in a car accident that have suffered a Catastrophic Injury. Catastrophic Impairment has a specific and detailed definition outlining how an injured accident victim can be found to be catastrophically impaired. If the car accident victim is found to be catastrophically impaired then there are entitled to $1,000,000.00 in medical and rehabilitation benefits and up to $1,000,000.00 in attendant care benefits. The determination of catastrophic impairment can be a very complicated process and there are medical practitioners who are specialized in the area of catastrophic determinations under the Statutory Accident Benefits schedule. Accident benefits also include income replacement benefits where the car accident victim is unable to complete substantially all of the duties of their pre-accident employment. It is important to note that the car insurer will only pay for medical and rehabilitation treatment that is considered to be reasonable and necessary. Where there is a dispute between your treatment providers and the car insurer regarding the approval of treatment, then the matter will have to be dealt with through the mediation and arbitration process that is governed by the Financial Services Commission of Ontario. It is important that when you are hurt in a car crash that you contact a personal injury lawyer to discuss your rights. Auto insurance can be complicated and a little overwhelming, especially for someone that is dealing with injuries from the car accident.