Who Pays For Treatments and Medical Expenses if I’m in a Car Accident?

Ryan Findlay | June 1, 2021 | Car Accidents

Accident Benefit Coverage After A Car Accident

Your auto insurance contract includes accident benefits coverage that your own insurer pays if you are hurt in a car accident. This coverage is mandatory and is included on every auto insurance policy issued in Ontario. These benefits are commonly known as “no-fault” benefits because anyone injured in an accident involving a motor vehicle automatically qualifies for these benefits, even if the accident was their fault. If you are a cyclist or a pedestrian who is injured by a vehicle and you don’t have your own auto policy, you can access these benefits from the insurer of the vehicle that hit you or any other vehicle involved in the accident.

What Does an Accident Policy Cover?

The accident benefits coverage through the auto insurer provides funding for all reasonable and necessary medical treatment expenses that are not covered by OHIP or any other plan, subject to certain limits and rules. OHIP usually covers the cost of hospitalization and surgeries, appointments with family doctors and specialists, as well as diagnostic tests such as X-Rays, MRIs, Ultrasounds, and CT scans. The auto insurer will pay for things not covered by OHIP, such as physiotherapy, massage therapy, chiropractic treatment, psychological counselling, prescription medication, private nursing care, and medical devices like splints, casts, crutches, wheelchairs, and canes.

Find More Information About the Ontario Automobile Policy

Extended Health Benefits

Suppose you have extended health benefits through a private plan, your employer, or a family member’s employer. In that case, you are required to use these benefits first before accessing the accident benefits coverage. These plans may cover services such as physiotherapy and other paramedical services, ambulance fees and prescription medication. The funds from private plans tend to be relatively limited and usually only cover a fraction of your expenses. However, the auto insurer will not pay until you have completely exhausted the coverage available to you from these other sources.

Call Us for a Free Consultation

If you or a loved one has been injured in a car accident, contact our team of experienced personal injury lawyers for a no-obligation consultation regarding your claim. There may be time constraints, as well as critical information that needs to be collected as soon as possible to help your case.

Live outside of Hamilton? We serve Hamilton, Brantford, Burlington, St. Catharines, Niagara, and other nearby areas of Ontario. Call 905-522-9799 to set up a virtual meeting for a free initial case review. We are here to help and will fund your case from the start. If we don’t win you don’t pay.

For more information, the Ontario Automobile Policy (OAP 1) outlines the types of benefits injured persons will be entitled to receive through the auto policy. Additionally, the details of those benefits are set out in the Statutory Accident Benefits Schedule (SABS). These documents are to be used as guides, as they only provide summaries of the benefits available to you specifically. As there are various options for adding categories of benefits and increasing the limits of coverage available, you should always check your own auto policy for details of the coverage you’ve purchased.

Findlay Personal Injury Lawyers – Hamilton, ON
20 Hughson St S #510, Hamilton, ON L8N 2A1
(905) 522 9799

Findlay Personal Injury Lawyers – Brantford, ON
325 West St #102a, Brantford, ON N3R 3V6
(519) 751-9169

Findlay Personal Injury Lawyers – Burlington, ON
2349 Fairview St, Burlington, ON L7R 2E3
(905) 522-9799

Findlay Personal Injury Lawyers – St Catharines, ON
55 King St Suite 207, St. Catharines, ON L2R 3H5
(905) 685-3085