| Posted by Stevenson Whelton LLP
October 20, 2019
If an Ontario resident is injured in an automobile accident and is not covered for accident benefits under any vehicle insurance policies, they may apply for accident benefits through a provincial government plan called the Motor Vehicle Accident Claims Fund (MVACF). For example, a pedestrian who was injured in a hit-and-run accident and who is not covered under any existing vehicle insurance plans may seek coverage under MVACF.
Persons injured in a motor vehicle accident may apply for accident benefits from the following sources, in order of priority:
- Your own vehicle insurance company, as an insured person or a dependent.
- The vehicle owner’s insurer, if you were a passenger or occupant in the vehicle.
- The insurance company for any vehicle involved in the accident.
MVACF is essentially the “payer of last resort” and its main purpose is to:
- Provide statutory accident benefits to Ontario residents who are injured in a motor vehicle accident and have no other options for obtaining coverage.
- Provide accident victims with compensation for injuries or property damage when they are involved in an accident in Ontario, where there is no access to liability insurance, such as accidents involving an unidentified or uninsured driver or a stolen vehicle.
- Recover money from the owners or drivers of uninsured vehicles that was paid out on behalf of the injured person.
The amount of statutory accident benefits (SABS) that a person is eligible to receive depends on their level of injury. Persons who sustained a catastrophic impairment are eligible for the greatest maximum benefits, followed by a non-catastrophic injury and finally, persons with the lowest level of injury according to SABS are eligible to benefits under the Minor Injury Guideline (MIG). Benefits to which an injured person may be eligible include: income replacement benefit; non-earner benefit; caregiver benefit; medical, rehabilitation and attendant care benefit; housekeeping and home maintenance; and funeral and death benefit.
A person injured in an accident caused by an unidentified or uninsured driver may also bring a lawsuit against the MVACF. However, the MVACF is not required to pay unless it is first provided a Notice of Default to signify the uninsured driver’s failure to defend the court action. The third-party liability limit available to injured persons bringing a lawsuit against MVACF is $200,000, and this amount will be reduced by any property damage that is being claimed. The accident victim may also sue for general and special damages, as well as damages under the Family Law Act (FLA).
If your claim for accident benefits was unfairly denied or you wish to commence a lawsuit against MVACP, obtain representation from a respected Oakville personal injury lawyer to help you get any owed compensation.
In 16-000058 v Motor Vehicle Accident Claims Fund, a man applied to have his dispute with MVCAP resolved by the Licence Appeal Tribunal after he was denied non-earner accident benefits. The applicant was unemployed when he was injured in a car accident. And, because he had no access to liability insurance, he applied to MVCAP for the non-earner benefit. MVCAP sent a letter to the Applicant’s home asking him to attend an insurer’s examination, but the Applicant was participating in an addiction treatment program and not living in his parent’s home and never received the letter, so he did not attend the examination. MVACP then terminated his non-earner benefit, after which the Applicant learned about the missed examination from his lawyer. He immediately requested a rescheduled appointment, which was held two months later and which the Applicant attended.
According to the Insurance Act, if an insured person fails to attend an insurer’s examination, the insurer (in this case, MVACP) may refuse to pay benefits during the period of non-compliance. However, if the insured later complies with the examination and has a reasonable explanation for their failure to attend, the insurer must pay the amounts that were previously withheld. In the current case, the Tribunal decided that the Applicant had a reasonable explanation for not attending the examination and therefore, MVCAP was ordered to pay non-earner benefits in the amount of $185/weekly for the period of alleged ‘non-compliance’ when the Applicant’s benefits had been
Disclaimer: Our blog is intended to inform our existing and prospective clients about topics pertinent to their lives. While our goal is to provide accurate and factual information, this in no way should be taken as legal advice or applied to specific cases. It is in your best interest to contact a licenced and practising lawyer for legal representation, as matters of the law are often complicated and cannot be fully assessed without knowing all of the details of a case.