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Ontario elected a socialist Government (NDP) in September, 1992 which promised
to fully restore the right to sue and bring in government owned public auto insurance. After intense pressure was applied by the insurance industry the Government backed
down. Starting with the calendar year 1994 they brought in a more generous system of accident benefits and increased the right to sue but limited
possible proceeds of a law suit.
The right to sue the at-fault driver's insurer was extended from just physical injuries to include psychological injuries so long as they were serious but without the need for permanency. In most cases it is now too late to start such a claim because of the two year time limit for suing. There is an exception for injured children and people under disabilities. Compensation is limited to damages for pain and suffering less a deductible on all claims of $10,000.00. That amount is money the insurer simply does not have to pay at all and does prevent minor claims from proceeding. With an index to inflation the deductible is rising to about $13,000 now. There is a threshold requirement but it is not as restrictive as the one in effect from 1990 to 1993. It reads: The injured person has died or has sustained:
a) serious disfigurement; or Accident disability benefits are paid for employed people, students, homemakers and unemployed. Indexed benefits are paid for 90% of net income to a maximum of $1,000.00 per week. After 2 years of receiving such benefits a person may be eligible for a pension benefit based on loss of earning capacity (LEC). LEC is determined by deducting the post-accident Residual Earning Capacity (REC) from Pre-accident Earning Capacity (PEC). A system of Government approved Designated Assessment Centres (DAC) was set up to assess these disability issues plus within two years of the accident if a person is well enough to return to work and also assess medical and rehabilitation needs. Normally where there is an issue between the insurer and insured a D.A.C. may resolve it prior to mediation. Medical and rehabilitation expenses to a maximum of one million dollars are payable for life if the expenses are "reasonable and necessary" and due to the motor vehicle accident. This is often in dispute. With this generous system of benefits insurers are anxious to settle and obtain a final release of accident benefits. Never agree to this without legal advice from a lawyer knowledgeable in the auto insurance area. Disputes over accident benefits must go to Mediation at the Financial Services Commission before you have a right to either sue or Arbitrate before an independent arbitrator of the Financial Services Commission. There are very few existing claims under this system which was brought to an end in November 1996. Our office settled its last major case under this system on March 30, 2005. |