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STATUTORY ACCIDENT BENEFITS TIME PERIODS

Transport Truck AccidentIn Ontario, when you have suffered a motor vehicle accident, whether a car accident, motorcycle accident, truck accident, or other accident covered by your motor vehicle insurance, you are entitled to receive certain payments (called ‘accident benefits’) from your own insurance company that are intended to help you recover from or manage your injuries. You need to take specific steps within certain timelines in order to be entitled to receive accident benefits relating to your injuries.

When in a motor vehicle accident, you must notify your insurer that you intend to apply for an accident benefit within seven days after the accident. If you don’t notify the insurer within that time period, your insurer may delay payment of your accident benefits. To make an application for accident benefits you must submit a completed application for accident benefits to the insurer within 30 days after receiving the forms from your insurer. Your insurer should provide you with the appropriate application forms.

It is important to know that your insurer is required to provide you with payment or refuse the accident benefits within certain timelines provided you have supplied the insurer with the properly completed applications and information, and treatment plans.

The chart below describes some types of accident benefits, the insurer’s obligations to you, and the timelines the insurer must meet their obligations according to the relevant legislation and regulations in Ontario.

***The below chart is intended as a general guideline only. Accuracy of the chart is not guaranteed. You should contact a lawyer at Murray Ralston Lawyers to obtain legal advice specific to your situation.

Type of Benefit

Insurer’s Obligation

Time Period

Death Benefit

Pay the death benefit for an insured who dies as a result of a motor vehicle accident

Within 180 days after the accident

Medical and Rehabilitation Benefits

  • Must notify of the devices, services, assessments, and examinations (described in a treatment plan submitted by your medical provider) that the insurer agrees to pay or refuses to pay and the reasons.
  • Pay expenses the insurer has notified it will pay without the requirement for submission of a treatment plan
  • Within 10 days after receiving the treatment plan / assessment
  • 30 days after receiving the invoice

Attendant Care Benefits

  • Must give notice to the injured insured advising which attendant care expenses the insurer agrees to pay and reasons and must pay attendant care benefits
  • Within 10 days after receiving the assessment of attendant care needs

If a benefit is denied, an insured person has the right to commence mediation to resolve the dispute. An insured must apply for mediation within two years after the insurer’s denial to pay the benefit or the right to mediate the dispute will be lost. If the results of the mediation are not satisfactory there is a right to arbitration. The application for arbitration must be filed by the insured person within 90 days of the mediator’s report or the right to arbitrate will be lost.

***The information above is not intended to be legal advice. Each situation is different and the information provided above may not provide you with all law applicable to your facts. To ensure you are properly protected under the law applicable to your facts, please contact Murray Ralston Lawyers for a free consultation.

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