The Ontario Automobile Insurance policy includes Accident Benefits coverage, which responds when you or your passengers are injured in an automobile accident. In 2016, reforms to the Accident Benefits portion of the policy were introduced by the provincial government and now affect all policies. Standard Accident Benefits are those provided by the basic policy, with optional increased or additional benefits available for purchase.

We encourage you to review the Accident Benefits provided by your policy and consider additional benefits available for purchase.

Medical, Rehabilitation and Attendant Care Benefit

Medical & Rehabilitation: Reimbursement for reasonable, necessary medical and rehab expenses not covered by OHIP.  If you have Employee Group benefits, the insurance provided by your employer responds first. Attendant Care: Reimbursement for an attendant to look after you at home or within a healthcare facility. As of June 1, 2016, payments are limited to 5 years for adults and 10 years for children (non-catastrophic).

Standard Benefits: $65,000 combined limit. Minor injuries are fixed at a maximum limit of $3,500

Optional Benefits: 

• Increase limit for serious but non-catastrophic injures to $130,000 or $1,000,000.
• Increase limit for catastrophic injuries from $1,000,000 to $2,000,000.

Caregiver Benefit

Reimbursement to hire someone to care for your dependant(s).

Standard Benefits: Up to $250/week for first dependant, $50 for each additional dependant. Available in catastrophic injuries only.

Optional Benefits: Extend this benefit to respond to non-catastrophic injuries.

Housekeeping & Home Maintenance Expenses

Reimbursement for someone to carry out your household responsibilities. Standard benefits provide coverage only in the case of a catastrophic injury.

Standard Benefits: Up to $100/week. Available in catastrophic injuries only.

Optional Benefits: Extend this benefit to respond to non-catastrophic injuries.

Income Replacement Benefit

A weekly income of 70% of your gross income up to the weekly limit, beginning one week after the accident occurs which prevents you from working. If your annual income is higher than $30,000 you should consider purchasing the increased limits.

Standard Benefits: Up to $400 per week. Non-earners are eligible for up to $185/week limited to 2 years.

Optional Benefits: Increase the weekly maximum to $600, $800, or $1,000.

Dependant Care Benefit

Not provided in the Standard Benefits, this optional coverage provides limited reimbursement for additional expenses to care for your dependant(s) if you are employed and injured in a car accident.

Standard Benefits: No coverage.

Optional Benefits: Up t $75/week for first dependant and $25/week for each additional up to max $150/week.

Death & Funeral Benefit

A lump sum payout to your spouse and dependant(s) in the event of your death, with a separate lump sum for funeral expenses.

Standard Benefits: $25,000 to spouse, $10,000 to each dependant; up to $6,000 for funeral expenses.

Optional Benefits: $50,000 to spouse, $20,000 to each dependant; up to $8,000 for funeral expenses.

Indexation Benefit

Not provided in the Standard Benefits, this optional coverage adjusts the sum of Accident Benefit payments for which you are eligible annually as per the CPI of Canada over the course of time for which you receive benefits.

Standard Benefits: Not included.

Optional Benefits: Adjust annually to CPI.

Tort Deductible

The amount deducted from a settlement or court award for pain & suffering.

Standard Benefits: $36,500 deductible applies to any settlement.

Optional Benefits: Reduced $20,000 deductible is available.

Injuries – Minor Injury Guidelines, Non-Catastrophic & Catastrophic Injuries

Some benefits are activated only when an injury is ‘catastrophic’. While the revised legal definition for ‘catastrophic’ is complex, the criteria includes traumatic brain injury, loss of ambulatory mobility, loss of vision, etc., injuries requiring extensive care and medical attention. Minor injuries include sprains, strains, whiplash, abrasion, etc., insured to a maximum limit of $3,500. Non-Catastrophic injuries lie in the area between the Minor Injury guidelines and the Catastrophic definition.

Third Party Liability Insurance

Your policy also provides Third Party Liability coverage to respond to claims brought against you for bodily injury and/or damage to property of others caused by an auto accident arising out of the ownership or use of your vehicle. With the new changes and reductions in the Standard Accident Benefits, we strongly recommend you also consider purchasing increased limits of Third Party Liability coverage under your auto policy and/or purchasing a Personal Umbrella Liability policy.

Contact our office to discuss your existing limits of insurance or to purchase additional optional coverages.

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Safety First
The safety of you and your passengers is the top priority after a collision. Turn off your car and check that everyone is safe. If you feel as though anyone’s safety is at risk, or if someone has been seriously injured, call the police and emergency services right away. Then take a moment to consider your vehicle – are you in an unsafe place; is your car drivable; is anything leaking from the vehicle? If your car can be moved, drive to a place of safety out of the way of traffic.

Who to Call
Once you are in a safe place, call us at (416) 234-9980. One of our brokers will help you through the next steps. After-hours, our voicemail or www.cadeinsurance.com/claims will tell you how to get in touch with us, or your Insurer directly, or you can look at your liability cards which will have your Insurer’s 24/7 claims number.

Gathering Information
Be sure to exchange information with other drivers that are involved in the collision. You should collect their contact information, insurance information (policy number, insurer), and type of vehicle. This needs to happen no matter who is ‘at fault’. If possible, take photos of the vehicles from all angles to help with the claim process.

Collision Reporting Centre & Towing
If the police did not attend the scene of the collision, or attended, but did not make a formal report, you will need to visit a Collision Reporting Centre within 24 hours if your vehicle is safe to drive. If a police report was already created at the scene, you can take your car home or directly to a repair shop.

However, in many cases, it is not safe to drive a car that was recently in a collision. If this is the case, you should arrange for your vehicle to be towed to the Collision Reporting Centre closest to your home or to your preferred auto repair shop. We do not recommend allowing the Tow Truck Operator to choose where your vehicle will be taken. Resources such as www.accsupport.com, or www.cadeinsurance.com/claims can help you select which Collision Reporting Centre is best for you. The tow truck driver should wait at the Collision Reporting Centre while you make your report, and then take you and your vehicle to your home or your preferred repair shop. 

Do not accept any supplementary services from the Tow Truck operator, such as a rental vehicle, before speaking to your broker or insurer. If you must take a rental right away, make sure it is from a large, reputable rental company (eg. Hertz, Enterprise, Discount, Budget, etc.)

Repairs
Once the claim has been reported to your Insurer, an adjuster will be assigned to your claim who will reach out to you to explain next steps about repairing your car.

Insurers often have ‘preferred shops’ which they have vetted for quality and service levels, and who are often able to work more quickly with the Insurer’s claims team. The work done by the Insurer’s preferred shops are typically guaranteed by the Insurer. However, you are completely free to choose where to send your vehicle for repairs.

Once you have chosen a repair facility, you may request they prepare an estimate for the work, but do not sign any work orders or authorize work to begin until you’ve discussed the claim with your insurer. If you are not working with a ‘preferred’ shop, your insurer may first need to send an appraiser to examine your vehicle to approve the garage’s estimate.

During the time your car is under repair, your policy may allow for a rental vehicle, which should be discussed with our office or the adjuster.

In some cases, the cost to repair might surpass the value of the vehicle. If this is the case, your insurance adjuster will contact you to discuss the details of the settlement. When considering ‘a total loss’ of a vehicle, the Insurer’s settlement will be calculated using industry standards and will include evaluation factors such as the comparison of vehicles available in the market of similar age, make, model, and use (km), and remaining salvage value.

Although we hope this is never a situation you find yourself in, remembering these key steps
can help simplify the process and avoid undue stress. The Cade Associates team is here to offer the best advice and service for you and your family, especially in tough times like these. To find out more about your coverage or the procedures you should take following a car accident, email us at clientservices@cadeinsurance.com.

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ACCIDENT BENEFITS

Following this change, certain benefits on your policy will now have lower limits.  For our clients, we will be maintaining on renewal the closest comparable benefits available in the new structure. However, it is important that all Ontario Auto policyholders take a few minutes to review the new schedule of optional benefits/increased limits and consider the potential need for changes to your policy.

In particular, we would call to your attention the changes related to the Medical Rehabilitation and Attendant Care Benefit. Prior to June 1^st, these were considered two separate benefits; one for Medical & Rehabilitation with a standard limit of $55,000 and another for Attendant Care with a standard limit of $36,000. These benefits have now been combined into one, with a single, lower standard limit of $65,000.  This limit is available to pay those expenses associated with medical, rehabilitation and attendant care costs if you or your passengers suffer non-catastrophic injuries in an auto accident. We recommend you consider purchasing increased limits, with up to $1,000,000 available in the new model.

Prior to June 1^st, each of the separate benefits also carried a $1,000,000 limit for catastrophic injuries. Following the merger into one benefit, there is now a single $1,000,000 limit for catastrophic injuries. We strongly recommend you consider purchasing the increased limits, raising this limit to $2,000,000.

We strongly recommend that you speak with your broker to understand these changes and to consider requesting these increased limits.

THIRD PARTY LIMITS:

With the reduction in Accident Benefits available to injured parties from their own automobile insurance policy, there is a growing reality that the injured party may now more readily sue the ‘at-fault’ driver for additional funds once their own accident benefits are exhausted.  We encourage you to consider the following to enhance your ability to respond to these legal actions:

• Increase the liability limits available under your Automobile Insurance policy and/or;
• Purchase a Personal Umbrella Liability policy, which expands coverage and increases limit of insurance.

Over the past several years, insurance companies have worked with the provincial government to reduce fraud and abuse of the benefits provided under the Ontario Automobile Insurance policy. As you have likely heard in the media, local organized crime and amateurs alike are fraudulently claiming over a billion dollars each year in accident benefits! The reduction in benefits has made little if any change to the Ontario Auto premiums. The Ontario government must make changes with respect to prevention, detection, enforcement and judicial enforcement in order to lower premiums and assist in the stabilizing of rates over the long term.

If you have any questions with respect to these changes, please do not hesitate to contact our office at (416) 234-9980 or at clientservices@cadeinsurance.com.

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These changes impact every auto policy in Ontario on their first renewal after June 1st, 2016. 

Accident Benefits are an important part of your insurance portfolio and should be carefully thought out by all auto insurance policyholders. While full details are available in the links below, we will be also be contacting you before your policy is affected by these changes in order to outline the specific impact on your policy and present options for your consideration.

DETAILS OF 2016 CHANGES TO AUTO INSURANCE POLICY

• 2015 Ontario Budget – Auto Reforms (Insurance Bureau of Canada)
• Amendments to Automobile Insurance Legislation and Regulations (Financial Securities Commission of Ontario)

Please keep an eye out for our mailing about these changes to your policy. If you have any questions in the meantime, please feel free to give us a call at (416) 234-9980.

The post Auto Policy Changes appeared first on Cade Associates Insurance Brokers Limited.

1. Combination of Medical/Rehab and Attendant Care Benefit Limits
   1. The maximum benefit level for medical/rehabilitation and attendant care services has been combined with a $65,000 limit. Previously, limits were $50,000 for medical/rehabilitation and $36,000 for attendant care. While this combined $65,000 limit represents a reduction in the overall limit, it remains the richest accident benefits product in Canada.
   2. Policyholders will have the option to upgrade these benefits, up to a total limit of $1,000,000.
2. Reducing the Maximum Duration of Medical & Rehabilitation Benefits from 10 years to 5 years
   1. A five year limit will apply to all medical & rehabilitation benefits with the exception of children claimants, who will have 10 years.
   2. This five year limit remains longer than the claim duration available in other provinces.
   3. Policyholders will have the option to increase this coverage.
3. Catastrophic Injury Definition Update and Change to Catastrophic Benefit Limits
   1. Updating the definition of a ‘catastrophic impairment’, which triggers a new maximum limit of $1,000,0000 for Medical/Rehabilitation and Attendant Care services. Previously, the limit was $1M for Medical/Rehab and $1M for Attendant Care.
   2. The government’s expert panel and the Superintendent of Insurance sought to change the definition to reflect updated medical knowledge and to provide a clear definition to apply in the case of serious injuries. In recent years, an unclear definition allowed many less serious injuries to be designated catastrophic, triggering these high benefit payouts and increasing the overall cost of auto insurance for all users.
   3. Policyholders will have the option of increasing their catastrophic benefit limit from $1,000,000 to $2,000,000.
4. Non-Earner Benefits
   1. The current six-month waiting period for non-earner benefits will be eliminated, with the duration of these benefits being limited to two years from the date of the accident.

There are other changes to the Ontario Auto product arising out of this budget, including the introduction of a “Winter Tire” discount in January 2016 for all Insurers. As more details on the premium implications of the optional benefits above and other changes to the policy become available, we will keep you informed.

For more details, visit:

• 2015 Ontario Budget – Auto Reforms (Insurance Bureau of Canada)
• Amendments to Automobile Insurance Legislation and Regulations (Financial Securities Commission of Ontario)

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