Insurance claims, personal injury lawyers and lawsuits are essential for receiving the compensation you are owed for a car accident in Toronto. But who pays the medical bills right after your accident?

There is a great deal of confusion regarding that issue, and this article will try and answer some crucial questions.

Remember to always have your insurance details handy. In the event of a car accident, you will need that information to claim at fault insurance, accident benefits and more.

Indemnification is not the same as immediate payment. Read on to understand how you can minimize your exposure to medical bills that should be paid by insurers, the Ministry of Health and Long Term Care, and/or the party at fault.

Ontario is a no-fault province

You’ve heard it many times before: Ontario has a system of “no-fault insurance” (sometimes called “at- fault insurance”). This means in the event of a car accident, the respective insurance companies will make payments towards medical costs regardless of which party was at fault. In fact, it’s not just car accidents, motorcycle accidents, truck accidents and bus accidents are eligible for no-fault insurance.

The FSCO announced changes to the no-fault insurance regime went into effect in 2016. Since then, the amounts for Medical and Rehabilitation expenses, as well as Attendant Care have been set out as follows:

  • $3,500 maximum for minor injuries
  • $65,000 for non-catastrophic injuries
  • $1,000,000 for catastrophic injuries

Assessing injuries resulting from an accident accurately and as quickly as possible is an essential aspect of the insurance claims process. Consequently, you should consult with experienced car accident lawyers in Toronto immediately after your accident. The nature of your accident and its consequences must be represented accurately to ensure:

  • Your injuries are not unfairly downgraded, which will dramatically reduce the coverage your insurance company is compelled to provide.
  • The accident is correctly classified and fault is correctly attributed.

Did you know: most provinces in Canada have some type of no-fault insurance for car accidents.

Who pays my medical bills after an accident?

In the immediate aftermath of a car accident in Toronto, there are four avenues of payment you should be prepared for:

  • The Ontario Health Insurance Plan covers your hospital care
  • No-fault insurance (as explained supra) for costs that are not covered by OHIP
  • Ontario Ministry of Health and Long-Term Care (for treatment, rehabilitation and other medical costs)
  • Self-payment

No-fault insurance will typically cover ‘reasonable and necessary’ medical costs not provided for by OHIP. That’s why a team of lawyers is essential for advocating on your behalf after a car accident in Toronto.

Bills are not paid by the other driver’s insurers automatically

The party at fault and its insurer will not pay compensation automatically. If the other party is at fault, insurance companies must be compelled to pay compensation. Fault must be agreed to by the respective insurers, and making that determination can take months. It is essential that you have an aggressive, experienced team of car accident lawyers in Toronto to represent your interests properly during your insurance claim process.

No-fault insurance will not cover all your medical expenses, nor will it penalize negligent and reckless drivers. In order to pursue those remedies, victims file tort claims (lawsuits) which indemnify them more fully for their injuries and losses (loss of income, pain and suffering, long term rehabilitation and more).

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Will my insurance cover me in a car accident?

Under Ontario’s no-fault insurance regime, yes, your insurance will cover you to set amounts. However, that coverage is limited to that which the insurer deems to be reasonable expenses.  Unfortunately, it is likely that you will incur numerous additional expenses. There are options you should consider adding on to your insurance to enhance coverage. Opting for the least expensive car insurance coverage may seem appealing; however, doing so will likely exclude numerous no-fault options that can be vital in times of need. Your health insurance should provide coverage too.

The downside of the less expensive insurance packages will also include hefty deductibles. Check your insurance policy to determine your deductibles, as well as identifying the coverage your family members have in the event of a car accident.

Do I have to pay medical bills from my settlement?

Yes, your settlement and compensation awarded by the court are there to help pay your medical bills. The sums agreed to in a settlement or that the court awards will reimburse you for medical expenses you had to bear (that were not covered under insurance), provide for caregiving services, your loss of income, pain and suffering and more.

Safeguarding long term rehabilitation is essential, and settlements help do just that. Moreover, settlements will help pay for your insurance deductible and the property damage you have suffered.

Is my family covered by my insurance?

No-fault insurance will cover your passengers, be it family members or anyone else. However, that amount is limited, and you should look beyond cheap car insurance to ensure adequate coverage. Coverage such as the Dependent Care benefit is not included in the default no-fault insurance plan, and it is not part of the cheaper insurance options.

Again, it is important to understand how your car insurance, home and health insurance offers you and your family protection. Some insurance policies will become secondary payees in the presence of primary insurers. Contact an experienced team of personal injury lawyers in Toronto to ensure that you maximize your compensation and are fairly represented in the insurance claims process.


Contact Pace Law Firm today for a free consultation about your car accident. Our lawyers help clients receive compensation as soon as possible after an accident – reducing the financial burden of medical costs you have to bear.

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