When an individual is injured in an automobile accident there are two separate sources of compensation which may be available; these include accident benefits from the injured person's own insurance company and tort damages from the individuals responsible for the accident.

(a) Accident Benefits
These benefits are payable by an injured person's own insurance company pursuant to the provisions of a policy of motor vehicle insurance. An injured person's entitlement to accident benefits does not depend upon whether or not the injured person was "at-fault" for the accident, consequently these benefits are often referred to as "no-fault" benefits.

An injured person is entitled to receive a broad range of benefits from the Accident Benefit Insurer. These include income replacement benefits (a weekly benefit which replaces some of your lost income), supplementary medical benefits (ie. medications and assistive devices), rehabilitation benefits, attendant care benefits, death and funeral benefits and other expense benefits (ie. payment for mileage, travel).

Accident benefits are administered directly as between an insurer and the injured person. It is often useful to speak with a lawyer shortly after an accident occurs to gain a better understanding of the full range of benefits available to you.

Where there is a dispute between an injured victim and his or her insurance company, this dispute can be resolved by proceedings before the Financial Services Commission of Ontario (FSCO). The primary objective of this dispute resolution process is to provide a forum for the efficient resolution of disputes between the insurer and its insured. If your insurance company has denied you benefits to which you believe you are entitled, one of our lawyers will be able to assist you in resolving this dispute through the Financial Services Commission of Ontario.

(b) Tort Claim
As of October 1, 2003, the Ontario Government enacted new insurance legislation that governs all motor vehicle accidents occurring in Ontario after October 1, 2003. This is the fourth major revision to Ontario's Insurance Act since 1990.

This legislation established a "threshold". In order for a victim to make a claim for general damages (i.e. pain and suffering) caused by another person in a motor vehicle accident, the injured victim must have sustained injuries deemed to be in excess of the threshold. The threshold states that no claim can be made except in cases of:

a) death
b) a permanent serious disfigurement; or
c) a permanent serious impairment of an important physical, mental or psychological function.

In addition, Bill 198 legislation establishes a $30,000.00 deductible which applies to any general damages of the injured party and a $15,000.00 deductible which applies to any claims under the Family Law Act for members of an injured or deceased person's family.

Further, under Bill 198 an injured party's right to sue for economic losses resulting from the motor vehicle accident (that is lost wages, future lost wages, and medical expenses) has been restored. There is no threshold to be applied to a claim for economic loss. Therefore, a person who has sustained a loss of income as a result of the accident can recover, through tort, their lost income. There are some restrictions that apply.

Some of the injuries that accident victims may be compensated for are as follows:

· Brain and head injury;
· Spinal injury;
· Fractures;
· Scarring;
· Soft tissue damage;
· Chronic pain;
· Damages to teeth, eyes or internal organs;
· Death of a spouse or child

The types of damages which you may be entitled to receive are as follows:

· General damages (pain and suffering);
· Lost income (past and future);
· Loss of pension;
· Reimbursement for out-of-pocket expenses;
· Future care costs;
· Punitive damages.