Car Accident Insurance Claims in Ontario – Process, Do’s and Don’ts

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Should I File Auto Insurance Claim Or Not

Vehicle accidents have been very common recently and most of them are serious. Dealing with an accident is a very stressful and traumatic experience. As per law, it is mandatory to purchase automobile insurance for your vehicle in Canada. Depending on your situation you may also take additional liability coverage. You may top up basic coverage for better financial protection.  Let us discuss whether to file an auto insurance claim in Ontario or not.

How Long After A Car Accident Can You File A Claim

When an accident causes damage to property or persons there are questions about filing a claim. Most of the auto insurance companies suggest that you may file a claim as soon as possible. Or at least within seven days of the collision. The time frame could extend up to two years depending on your policy terms and conditions. Not filing a claim within the reasonable amount of time may affect the outcome. Delay in filing claim may affect result too.

What Happens If You Don’t Report A Car Accident

As per law, reporting a collision to the police is required. Some may think of not reporting a car accident at all assuming the other party will do the same. Then neither will see an increase in their insurance premiums. But, the other party involved in the collision may report the accident later. This could raise your insurance premiums. Even worse, the insurance company may refuse to renew your policy.

Should I File A Claim With My Auto Insurance Or Theirs

You may contact your own insurance provider in order to file a claim. They are the best people who could give you counsel and guide you through the claims procedure. It is suggested to follow their directions for collision reporting and claims. This will help to get the best result for your claim situation.

Can I File An Auto Insurance Claim Without A Police Report

Yes. In Ontario, it is not mandatory to report to the police if the collision causes damages costing less than $2000. This is true when there is no injury and no property damage other than the vehicles involved. While reporting the collision to your insurance company, the loss adjuster may ask you to inform the police or the Collision Reporting Centre.

If you believe that hiding accident details could help you stay clear this may cause issues. The other party involved in the accident may report it and also file a claim against you. This could affect your insurance premiums once the car accident shows up on your driving records. Your insurance premiums may increase. It will also be non-disclosure.

There may be other factors such as the extent and severity of the damage itself and the ownership of the fault. It does not matter if the other party filed a claim initially or not. They may do so later. Hence, it is recommended to file an auto insurance claim in Ontario so that you have the best result for your claim.

Understanding the Claims Process

insurance claim

Regardless of the person at fault for an accident involving injury or property damage, you must inform your broker, agent or insurance company within seven days. If it is not possible in seven days, report it as soon as possible. If this is not done within a reasonable amount of time, your insurance company may not honour your claim. You are required to report your claim within a period of one year.

You should do the following:

  • Complete a “proof of loss” within 90 days of the collision
  • Notify the other driver’s insurance company (if applicable)
  • Notify the other driver of claim against them (if applicable)
  • You may need to review your contract term limits and policy if you are going to sue your insurer

Have the Facts in Hand!

Your insurance company representative will probably require that you supply some facts about the accident, so have them ready.

Some information includes the following:

  • The registered owner’s insurance company as well as the driver’s auto insurance policy number
  • The model, year, make, registration and license plate number of the vehicle.

Other details about the accident:

  • The name of the driver and license plate number
  • Time, date and location of the accident
  • Severity of the injuries and number of passengers involved (if any)
  • Level of damage to the vehicle
  • Vivid description of the accident
  • The names, driver’s license numbers, insurance company names, and policy numbers of the other drivers involved
  • The identification number of other vehicles involved
  • The name as well as the badge number of the police officer investigating the accident

Once you file the claim with your insurance company, the claim is processed leading up to settlement. The procedure that the insurance company follows to investigate claims varies depending on the following factors:

  • The nature and extent of the accident
  • The policy of your insurance company on accidents
  • Whether the accident involved injuries, property damage or both

What Happens After the Claim is Filed

Once you file your claim, you will be assigned a claim adjustor. The claim adjuster will review your policy to ensure that you are covered. The adjuster may contact you during the investigation.

The adjuster may…

  • Demand that you send a copy of the police report for review
  • Talk to witnesses listed as present during the accident
  • Check out the location of the accident
  • Ask that you contact the other driver
  • Check your medical records
  • Take photos of your cars
  • Ascertain the level of damage to your car
  • Find out information about the expenses of your injury from your medical providers

Medical Care and Vehicle Repair

Injury and repair expenses will be covered by your insurance company until the fault is determined, after which there will be negotiations with the other driver’s insurance company to decide who will pay. If the other driver is responsible for the accident, your insurance company will seek payment from their insurance company through a process called subrogation.

Do All Accident-Related Claims Affect Auto Insurance?

At some point in your life, it’s likely that you will be involved in a car accident. Whether it’s your fault or the fault of the other driver, you may find yourself having to make an insurance claim. If you need to make a claim, you may be wondering if all accident-related claims affect auto insurance. The answer depends on the type of loss, the insurer, and the province in which the accident occurred. Generally speaking, there are several times when a person’s auto insurance won’t be affected at all, and some laws prohibit insurers from cancelling, not renewing, or increasing premiums for certain types of losses.

Comprehensive Claims

Most insurance companies will not raise premiums due to a claim made under the comprehensive portion of the policy. The exception is if multiple claims are made under the comprehensive coverages in a short timeframe. Comprehensive auto insurance covers losses from theft, vandalism, falling objects, and other sources. These types of damages are out of the control of the owner, and some areas have laws in place that prevent this type of claim from adding a surcharge to a policy.

Consumer Protections for Claims

Consumer protection laws have been put in place in the past few years which outline what events are and are not surchargeable. This makes it easier for drivers to choose the most affordable auto insurance available since they know they will be protected in the most common settings. Speak to your insurance company for a list of non-surchargeable events and a timetable for when surcharges start dropping off your insurance policy.

Claims That Will Increase Premiums

There are some events that will make auto insurance rise, or that may cause your policy to be cancelled. Driving in an illegal or unsafe way is one of the main reasons a claim is denied. If you’re found to have been in violation of the law at the time the damage was done to the vehicle, you’ll face a rise in your premium or risk having your policy cancelled.

If you’re careful and observe the laws of the road, you’ll be less likely to have an accident and will maintain lower premiums overall. By driving carefully, you can avoid the negative effects of claims while keeping rates affordable.

Fighting a Low Car Insurance Claim Settlement

The process of battling a car insurance company over the payment of a claim may not be a pleasant experience, especially when fighting a claim settlement that is too low. This is usually because insurance carriers have much more experience and resources at their disposal when dealing with claims compared to the client. However, if you apply the right steps you can successfully obtain what is rightfully yours from the insurance company.

Prepare Yourself

When it comes to car insurance settlements, you need to find out all you can about your policy and claim. Your car insurance company will offer you an initial settlement after making a claim, but before responding make sure you understand your policy. Find out what your car insurance claim is worth.

Keep all the receipts and add up all the expenses and bills, then calculate all the costs that you have incurred as a result of the car accident. The total of this cost will help you determine if the offer you have received is too low or not. The next thing is to figure out your acceptable settlement range. This is an amount that you are willing to accept from the insurance company for the settlement of the claim. You should be prepared to reject any amount lower than your limit. Equally important is the need to know when to consult a car insurance attorney for legal help.

Talk with the Insurance Adjuster

If the amount offered by your insurance company is low, tell the adjuster exactly how you feel. Explain to the insurance adjuster that the amount is inadequate, clearly stating your reasons in a calm but firm manner.

Note: Insurance claims adjusters are paid to settle claims for the least amount of money possible. There is a range of money they are willing to part with to settle car accident claims, and they will naturally start from the lowest figure. So, do not be afraid to reject the initial offer and negotiate a higher settlement deal on your car insurance.

If, despite your best effort, the adjuster fails to satisfy you, then you need to speak to a supervisor or ask to speak to someone in a higher position. It is often helpful to send written documentation to the individual, logically presenting your case.

Should all these attempts fail, you may need to file a complaint with your province’s Department of Insurance. Hire an attorney who is experienced in negotiating car insurance claims. If you need to talk with an attorney before rejecting a claim, inform the insurance company that you need time to consider the offer, then meet with an attorney as soon as possible. The negotiations may go on for quite a while, so you need to exercise patience in order to wait for the settlement you truly deserve.

Why Do Car Insurance Claims Go to Court?

Many people are aware that car insurance in Ontario is partially a no-fault system. There’s a lot of confusion about what this means and one of the biggest misconceptions is that there is no blame assigned in an accident. This isn’t the case at all, as police may lay charges in their investigation, and insurance companies use a standard collection of accident scenarios to assign fault for settlement purposes. The no-fault portion of car insurance refers to the benefits that are paid by your insurance company to you, regardless of who is to blame in the accident. Ontario’s no-fault provisions do not prevent insurance claims from going to court, though it is rare that car insurance claims ever see the inside of a courtroom.

Fault for Car Insurance Claims

As mentioned above, fault is indeed assigned in car accidents. Police look at traffic rule violations and determine guilt based on those. There are situations where no charges are laid, however. Insurance companies, on the other hand, always determine fault in an accident using the Ontario Insurance Act and its Fault Determination Rules. This is a collection of accident situations which are applied by insurance company investigators to determine which driver was at fault, or if fault is shared. If you disagree with fault determination, you can formally complain through your insuring company after bringing forth any further information that may influence fault determination with your claims adjuster. This resolution is handled internally by your insurer.

Accident Benefits Claims

This type of claims settlement has the highest chance of ending up in court. However, accident settlements are usually arranged prior to the trial stage. The at-fault driver can be sued by victims of the accident for pain and suffering, loss of income and loss of future earnings. Pain and suffering only comes into play in cases of death or serious mental and physical injury.

As mentioned, most lawsuits of this nature are settled in lawyers’ boardrooms, rather than court. If both sides in a suit are not able to come to an agreement, then the claim would go to court, though there may be attempts to have third-party mediator help settle the suit.

Disagreeing with Your Insurance Company About Benefits

The situation may arise where you disagree with your insurance company about entitlement to or amount of benefits resulting from an accident. The Financial Services Commission of Ontario has a dispute resolution process to replace court proceedings. The FSCO considers this faster and more effective than lawsuits. The process involves mediation, evaluation, arbitration and appeals processes, so it is thorough and impartial. Drivers pursuing claims resolution through the FSCO can obtain a copy of the Dispute Resolution Practice Code through the FSCO’s website at https://www.fsco.gov.on.ca/.

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