Question: I was injured in a car accident while a passenger in my friend’s car driving through Whitby. I don’t want to sue him but I may need to get knee surgery and be out of work for a while. What if my accident benefits are not enough to cover my medical expenses? Do I submit my expenses to his auto insurance company then?
Answer: In terms of your accident benefits, Ontario law provides that only your OWN auto insurance company covers an injured insured’s accident benefits after a car accident. This means that you, as an insured, make a claim for accident benefits through your own car insurance company, up to the limits you purchased. There are different types of accident benefits you may receive, and some of them include medical and rehabilitation benefits and income replacement benefits.
In terms of medical and rehabilitation benefits, the amount you receive depends on the extent of your injuries. Your auto insurance will put you in one of three injury categories: minor, non-minor and catastrophic.
If you are in the minor injury group, you are only eligible to receive up to $3,500. If you are in the non-minor injury group, you may receive up to $50,000. If you are in the catastrophic injury group, then you may receive up to $1,000,000.
Let’s assume that your injuries put you in the non-minor injury group; therefore, you may receive up to $50,000 in medical and rehabilitation benefits. If your medical and rehabilitation costs are $75,000, you will still only receive $50,000 from your accident benefits coverage. The remaining amount of $25,000 cannot be submitted to your friend’s auto insurance company. The only way you can recover that from your friend is suing your friend in a car accident lawsuit.
The same thing goes for your lost wages. You will be able to receive income replacement benefits from your own auto insurance company. However, you do not receive 100% of your lost wages. Again, you can recover the amount not covered by your accident benefits by filing a lawsuit against your friend.
Filing a Tort Claim or Lawsuit
We know it is a difficult decision for many people to file a lawsuit against anyone, let alone a friend. This decision is something we cannot make for our clients. We can only offer information and answers for our potential clients about filing a tort claim.
One thing you should know is that “friendly lawsuits” are really just about getting access to insurance proceeds and not about your friend being “wrong” or a bad person. When you sue your friend, he is not going to lose his job, his house or his paycheque – his insurance company is going to step in and pay the claim for him.
Another thing you should think about is your medical prognosis. Do your injuries require extensive future treatments, such as surgery or rehabilitation? If you do not have catastrophic injuries and your expenses exceed the maximum medical and rehabilitation benefit amount of $50,000, how would you pay for those medical expenses?
You should talk to a lawyer to help you make an informed decision about whether you want to file a tort claim against your friend.
We offer FREE consultations. 866-384-5886