Frequently Asked Questions
What are “Accident Benefits”?
Following is a summary of the most commonly-accessed accident benefits. It is not a complete list of all available benefits.
- Income replacement. You are entitled to 80% of your net income to a maximum of $400 per week if you are substantially unable to perform the essential tasks of your occupation or employment during the first 104 weeks. Thereafter, you can continue to receive these benefits as long as you are continuously disabled from any occupation for which you are reasonably suited by education, training and experience for up to $400 a week or 80% of your net income.
- You may receive non-earner benefits of up to $185 a week if you are not employed. If you suffer a complete inability to carry on a normal life as a result of the injuries from the accident. No benefits are payable under this category for the first six months after the accident.
- Caregiver costs of up to $250 a week, if you were the primary caregiver of a person in need (with whom you were residing), plus $50 for each additional person in need of care
- Medical and rehabilitation costs (above OHIP) to a maximum of $100,000 for up to 10 years for a non-catastrophic injury, and up to $1,000,000 for the rest of the victim's life in the case of a catastrophic injury.
- Special Attendant Care of up to $3,000 a month for two years for a non-catastrophic injury, and up to $6,000 a month for the victim's lifetime for a catastrophic injury.
- Housekeeping and Home Maintenance of up to $100 per week.
- Death Benefits of $25,000 for the spouse of the victim; $10,000 for each of the victim's dependents; $10,000 to the person who cared for the victim; up to $6,000 for funeral expenses.
- Travel Expenses for family members or those living with the accident victim for their visiting costs during treatment or recovery.
- Lost Education benefits for students to a maximum of $15,000.
The above benefits are subject to specific policy Terms and Conditions.
You should know that you can elect, as part of your own automobile insurance policy, to purchase optional increased coverage amounts for income replacement benefits at additional cost.
Are all personal injuries subject to the same rules and processes?
No. This is where it starts to get complicated. For example, if you are injured in a motor vehicle accident, there are very particular rules and processes that apply. They are discussed elsewhere in this brochure under a separate heading.
Even in the case of motor vehicle accidents, there are special situations that are confusing. For example, if you are injured in a motor vehicle accident, if you are a driver in the course of your employment duties, you may have to seek recovery through the Workplace Safety and Insurance Board, rather than through the "normal" process described here. An early determination of these jurisdiction and forum issues is critical in order that you take the steps necessary within the many prescribed time limits because in every case the injured party is responsible for making application for the benefits and compensation they are entitled to.
Even apart from the "special" situations noted above, each type of injury can have limitation and notice requirements, the missing of which can be fatal to your ability to pursue the claim.
I had a refugee claim denied. Does the work experience I gained in Canada while waiting for a decision on my application as a refugee make me eligible to apply for permanent residence under the Canadian Experience Class?
No. Refugee claimants are not considered to be authorized temporary residents, one of the requirements for eligibility.
Why do I sometimes feel like I am being given the third degree when I try to enter the United States at the port of entry? Why are the immigration officers so rough?
The immigration officials at the border crossings to the United States must sift through thousands of persons entering to stop supporters of Osama Bin Laden, terrorists, criminals, drug lords, pimps, prostitutes and other undesirables from entering.
Frankly, there is no way for them to know who is who other than to ask a lot of questions and to be suspicious. The border is the only place in American jurisprudence where you are guilty until proven innocent so-to-speak. In other words, the border officials assume you are coming to the US to stay permanently unless you can satisfy them otherwise. You need to show them you have stronger ties to your home country than to the United States.