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Understanding Ontario's No-Fault Insurance
Date : 2009-03-20

Ontario car insurance law provides a 'no-fault' policy in cases of car accident injuries. But what exactly does no 'no-fault' mean?

First, it's important to understand that both the police and the insurance company will have their own definitions of who is at fault in a car accident. From a police standpoint, fault goes with a criminal act, such as drunk driving. It is possible the police will decide the accident was 'no-fault'; in this case they mean there will be no charges laid.

From an insurance standpoint, there are fault determination rules written in Ontario legislation. These are very clearly defined scenarios that will assign degrees of fault to the driver of each vehicle involved; fault can range from zero to 100%, and can be divided between the drivers of different cars. Determining who is at fault from an insurance standpoint impacts things like premiums when you renew your insurance.

So with all these faults floating around, how can car insurance in Ontario be ‘no-fault’? Simply put, it means that no matter who is at fault, anyone who is injured in an accident is entitled to accident benefits from their own insurance company. No-fault, in this sense, means whether the car accident is your own fault or not, you are covered if you are injured.

This means you can receive the medical care you need right away, rather than having to wait while insurance companies fight over who is at fault and who is responsible for paying the benefits.

Ontario has insurance rules in place that establish basic, mandatory accident benefits for all insurance policies; and there may be optional additional benefits that you can choose for your own policy. These mandatory benefits, called statutory accident benefits, are laid out in the Statutory Accident Benefits Schedule. They include coverage for prescribed medical costs related to the injury, compensation for lost wages, lost tuition, housekeeping expenses and home assistance where necessary, and some other expenses that can follow a car accident injury.

This is not the case across Canada – some provinces offer very few statutory accident benefits, and put the burden on a car accident victim to sue the person at fault to recover medical costs, lost wages, etc. In Ontario, however, a victim can both collect statutory accident benefits, and sue the person at fault. The injured person applies for accident benefits from their own insurance company. For example, if you are a passenger injured in a car accident, you apply to your own insurance company, not the driver’s. If you don’t have your own insurance, then you can apply to the driver’s. If no one involved in the accident has insurance, then you can claim benefits from the Motor Vehicle Accident Claims Fund, which was set up to provide for such situations.

Ontario's accident benefits coverage applies even if your car accident happens elsewhere in Canada or the United States; however, the Ontario laws that allow you to sue the at-fault driver for extra damages no longer apply, and you must follow the law of the jurisdiction where the accident took place.

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