Benefits and damages for torts are two different things.
When our clients come to us, many of them are very confused about questions of fault and what they are entitled to. Many are afraid that if they were in any way responsible, they will get no help for their injuries. Many are also confused as to whether the benefits they get from their own insurance company will be added on to or deducted from what they get from the other party's insurance company.
When Fault Matters
If there are criminal charges, or if there is a tort claim for damages against another party, fault will have to be determined.
The insurance company for the other party has no duty to treat you in good faith. In fact, it has a duty to its own client — and to its shareholders — to pay out as little as possible, and to fight you on damages.
If you can prove the other party was partially or entirely at fault, you can receive compensation for income loss, home care expenses and other losses.
When Fault Doesn't Matter
Happily, Ontario has no-fault insurance. This means that, even if an accident is completely your fault, you are still entitled to have many of your expenses covered by your insurance company. These are called benefits, and they are automatic. They can cover things like:
- Income replacement
- Cost of caregivers
- Medical expenses
Your insurance company has a duty to treat you in good faith, and give you the benefit of the doubt.
This does not mean that you will automatically get what you deserve. Insurance companies may still fight you on whether you are as injured as you say you are or whether you are able to work.
One of the areas in which we may have to fight your insurance company concerns the Minor Injury Guidelines (MIG), which cap out benefits for injuries such as mild whiplash and sprains at $3,500. If your injury is classified as "minor" when you are first injured, it may make it difficult to get more compensation later down the line if your healing takes longer than expected.
If this has happened to you, our lawyers can work to convince your insurance company that your injury was wrongfully classified, or that your situation has changed.
Contact Bergeron Clifford LLP
Let us help you claim benefits and damages as appropriate. Contact us at 877-391-2923 or fill out our online form. We can meet you at any of our offices in Eastern Ontario, including Kingston, Whitby, Perth or Ottawa, or wherever is most convenient for you.