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Understanding No-Fault Insurance in Ontario: A Guide for Motor Vehicle Claims

You deserve compensation if you have been hurt in a motor vehicle accident caused by someone else’s fault. But you’ve also heard that Ontario is a no-fault jurisdiction. Does that mean you can’t sue for your injuries?   


You Can Sue for Injuries Caused By Another Driver 


no fault insurance

Despite its somewhat confusing name, Ontario’s no-fault insurance scheme for motor vehicle accident claims does indeed allow accident victims to sue for personal injury damages.  


In fact, Ontario’s no-fault system offers two ways for an injured person to seek compensation:  

  1. A Statutory Accident Benefits Schedule (“SABs”) claim with your own insurance company.  

  1. A lawsuit or tort claim against the at-fault party.   


If you have been hurt in a car accident caused by someone else’s negligence, you are entitled to bring both types of claims. Let’s have a look at these two avenues for securing personal injury compensation in more detail.   


Statutory Accident Benefits Claim 

Statutory Accident Benefits—also called no-fault benefits—are available to all insured people injured in a car accident, regardless of who caused the accident. So, if you are injured in a motor vehicle collision, your insurance company is obligated to pay certain benefits to you through a no-fault benefits claim. It doesn’t matter if you were 100% at fault or 0% at fault for the accident that caused your injuries.  


A no-fault accident benefit claim gives you quick access to coverage for several types of benefits:  

  • Income replacement benefits if you are missing work because of your injuries;  

  • Reasonable and necessary treatments (e.g., physiotherapy, massage therapy, chiropractic treatment, acupuncture, psychological treatment and counselling, rehabilitation therapy, occupational therapy);  

  • Medication costs;   

  • Caregiver benefits if you aren’t able to engage in the caregiving activities due to your injuries; and  

  • Other expenses such as attendant care, housekeeping, and home maintenance.  


The limits and specific no-fault benefits you are entitled to will depend on the severity of the injuries you sustained and the level of coverage you obtained when you purchased your auto insurance policy. A motor vehicle accident lawyer can review your insurance policy, advise you on your coverage entitlements, and help you file your no-fault accident benefits claim.  


Tort Claim Against the At-Fault Party  

If someone else’s fault or negligence caused the motor vehicle accident, you have the right to bring a lawsuit against them—also known as a tort claim, negligence claim, or a personal injury lawsuit—in addition to the no-fault SABs claim against your own insurer. You can bring a tort claim even if you were partially at-fault for the accident. A successful tort claim is paid out by the other party’s insurance company (assuming they had valid auto insurance in place when the accident occurred).  


You would want to pursue a tort claim against the wrongdoer to obtain compensation for losses and damages that aren’t covered by a no-fault benefits claim. Pain and suffering, loss of enjoyment of life, future care expenses, and future wage losses are all types of damages you can’t get in a no-fault accident benefits claim, but you can get by bringing a successful lawsuit against the at-fault party.  


Determination of fault is a major component of a tort claim. To succeed in your lawsuit, it’s necessary to prove liability (i.e., that the other party’s fault or negligence caused the car accident, and that the accident caused your injuries and losses). No compensation will be paid out in a tort claim unless and until liability has been determined, whether it’s by way of direct negotiation with the defendant and their insurer, mediation, or a trial if settlement is not possible.   


Why Does Ontario Have A No-Fault Insurance System?  

Some other provinces in Canada use a traditional fault-based insurance system. In a fault-based jurisdiction, the accident victim must sue the wrong-doer to obtain compensation for injuries and damages, including all treatment expenses, lost wages, etc. That means the accident victim is out of pocket for all losses and expenses until their legal claim is resolved. It can take several months if not years for a fault determination to be made, damages to be assessed, and for legal disputes to be concluded.  


In comparison, Ontario's no-fault system is designed to simplify and speed up the process so that an injured person can claim against their own insurance policy to get certain benefits such as income replacement and rehabilitation support as soon as possible. The idea is to make the process less adversarial, to promote recovery, and to help lessen the immediate financial repercussions for a person who has been hurt in an auto accident.  

 

Reach Out to An Experienced Car Accident Lawyer for Advice 


An experienced car accident lawyer can help you understand your rights and all the types of compensation you can claim. Your lawyer will help you navigate the confusing insurance documents, claims forms, and court processes to ensure you get the compensation you’re entitled to, in a timely manner. 


Call Littlejohn Barristers today at 705-725-7355 to find out how a car accident lawyer or truck accident lawyer from our firm can help you in your fight for justice. For your convenience, we’re located just minutes from the County Courthouse in Barrie. 

Our office is in Barrie, but our motor vehicle accident lawyers are proud to serve Midland, Collingwood, Orillia and surrounding Ontario areas. 

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