Eligible Ontario citizens are entitled to a recurring disability pay or income-replacement under various schemes, such as the Ontario Disability Support Program (ODSP). In case of accidents or workplace injury, you are eligible for a claim for injuries and damages.

Why might disability payments or insurance settlements not be enough?

Despite all the different options for provincial help and compensation, victims are at risk of missing out on treatment due to a lack of adequate compensation. There are various reasons for this:

• The injured party did not file a timely claim.
• An injury or disability was mis-assessed and, consequently, the required medical treatment is more expensive than the original estimate.
• The prescribed medical treatment and caregiving needs often change with time, and there might be a need for an unexpected treatment/procedure.
• Often, the insurance company denies the claim or only agrees to a partial settlement.

Read more

How insurance companies can reduce your claim | Battle for treatment | Insurance claims

What can you do?

Victims of an accident who have sustained an injury are often incapable of returning to their daily work, either temporarily or permanently. When faced with a shortfall in the compensation agreed to as a result of an insurance settlement, income replacement, or disability payment, individuals often struggle to support themselves or to meet their basic living expenses, and they cannot afford the required medical treatment.

Challenge the insurance claim

Accident victims who have been injured do not always hire a personal lawyer — as they believe that the insurance company will adhere to the appropriate standards and procedures, and will provide them with the appropriate compensation. They may even accept the insurance company’s initial offer, which will result in the payment of compensation that is much less than that necessary to pay for the required medical and living expenses. However, in such circumstances, you may consult with your personal injury lawyer to challenge a denial of an insurance claim.

Delayed claim

In Ontario, for certain claims, injured parties have a window of just 10 days within which they can file a claim or serve a Notice of Claim; generally, a two-year limitation period applies to most civil claims. However, in the event that the extent of the damage resulting from your injuries is discovered after the limitation period, you can still make a case for compensation. Contact a personal injury lawyer as soon as possible in order to learn about the nature of the claim you are entitled to file, as well as the timing associated with that option.

Settlement v claim

Victims of an injury often accept the first settlement offered, but soon realize that the agreed-upon settlement is inadequate to cover the expenses involved in the expected course of medical treatment, as well as recovery and rehabilitation. Signing an Accident Benefit settlement, which stipulates the amount of compensation, is considered, legally, to be a full and final resolution. However, a regulation to the Insurance Act allows the claimant to rescind an Accident Benefit settlement within two business days of it being entered into. If, after the two-day period, you discover that the amount you have agreed to in the settlement is not sufficient, you can contact your personal injury lawyer to explore how can you cancel the agreement, and demand a more appropriate claim amount.

Move to claim a higher settlement

If the initial settlement was based on an incomplete assessment of the injuries, the victim has the right to go to court and demand a larger amount of compensation from the insurer.

Syed Farhat v Roxana Monteanu (2015): Initially, Mr. Farhat, the victim of a car accident, did not appear to have suffered any injuries — but subsequent examination revealed serious and possibly permanent injuries. He filed a claim two years and 32 days after the accident, which the Superior Court of Justice approved.

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How long do you have to sue? | Rescinding settlement agreement | Overturning an insurance claim

Getting the disability benefits you deserve

Do you struggle to meet your bills with your current disability pay or claim amount? Contact us so that we can fight on your behalf and get you the compensation you deserve.