"No-Fault" and "At fault"
What is what?
Ontario has a "no-fault" car insurance system. But this doesn't mean that no one is at-fault in an accident. The "no-fault" concept applies only to bodily injuries suffered by the drivers or passengers in the car accident. Benefits would be paid by the insurance company no matter who caused the accident. However, the damage to your automobile is assigned fault to one or other of the drivers even though you make your claim against your own company.
Similarly, if any of passengers in your car is injured, then he/she has a car insurance policy of his/her own will approach his/her own insurance company for benefits. If your passengers don't have a car insurance policy of their own, then your insurance company may pay benefits to them. The driver of the other car involved in the accident will claim benefits from his/her own insurance company.
In Ontario insurance companies assign the percentage of fault for each of the drivers involved in the accident by Fault Determination Rules. If you are involved in an accident and it is determined that you are at-fault - either completely or partially - it will go on your insurance record and you'll likely have to pay a lot more for your coverage.
FAQ: How does an At-Fault Accident Affect Me?
FAQ: How does an At-Fault Accident affect my insurance premium?
FAQ: How does my company determine whether I am at fault in an accident?
Rehabilitation benefits
Rehab Benefits are for the payment of expenses incurred by you or on your behalf, provided you have been injured in a motor vehicle accident. The coverage is for costs incurred for reasonable and necessary measures to:
i) reduce and eliminate the effects of the disability resulting from the injury or;
ii) assist you in reintegrating into a family role, or the labour market (if you had a labour force attachment) and also your community.
The coverage includes reasonable and necessary expenses for:
- life skills training,
- family, social rehabilitation, financial and employment counseling;
- vocational assessments;
- workplace, home and vehicle modification;
- transportation for the insured person and an attendant to and from various treatment sessions, training sessions, assessments and counseling sessions;
- other goods and services required that are rehabilitative in nature (physiotherapy, massage, acupunture, chiropractic, dental, medical supplies, etc.)
Your insurance company will usually require that the application include a treatment plan or a pre-approved framework treatment confirmation form prepared by a health professional.
Disability Certificate
In order to receive specified benefits including income replacement, caregiver non-earner benefits, housekeeping/home maintenance and/or lost educational benefits, you may require a certificate from a qualified medical person stating the cause and nature of your injuries with an estimate of how long your disability and treatment will last. Your insurer will pay for the cost of this certificate
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