Insurance benefits are important because they assist with your finances and therapy costs, costs of caring in-hospital and at-home, and other needs while in-hospital and at-home. There are also additional benefits that may be available including:
- Services of a case manager
- Lost education expenses
- Non-earner benefits
- Dependent care benefits
- Damage to clothing expenses
- In fatality cases, death and funeral benefits are made available.
Keep all receipts related to treatment; receipts help to prove to the insurance company the incident-related expenses you or your family have paid for.
Injury Categories
There are two categories of injuries that insurance companies use. Depending on your classification of injuries, you are either deemed “non-catastrophic” or “catastrophic“. There are significant differences in the amount of insurance benefits that are available depending on how you are categorized. The maximums that are available increase significantly in cases of “catastrophic impairment”. Cases of “catastrophic impairment” generally involve:
- Serious head injuries
- Paralysis
- Complete loss of vision
- Other serious injuries
How do I start my Insurance Claim?
To claim insurance benefits, either you or someone close to you should call the first insurer that applies to your case, depending on:
- The insurer of your motor vehicle
- The insurer of the motor vehicle under which you are insured
- The insurer of the motor vehicle in which you were an occupant
- The insurer of the motor vehicle which struck you, if you were a pedestrian or cyclist
- The insurer of arty other motor vehicle involved in the collision
- The Motor Vehicle Accident Claims Fund (in Canada, call 1-800-268-7188)
When you call the insurer, tell them that you want to start an insurance benefits claim. The insurer will ask you for some basic information, including the following: -
Name and age of the injured person
- The nature of the injuries
- Your insurance policy number and motor vehicle information
- Basic details about the incident
_Most people rely on the assistance of a personal injury lawyer to assist with the completion of the forms required to start an insurance benefit claim. We recommend calling TSF Law at (905) 218-3668
The insurance company will assign an insurance benefits adjuster to your file whose focus will be on your injuries and health care needs. A separate adjuster will be assigned to deal with any motor vehicle damages, if appropriate. Your insurance benefits adjuster will provide you with an application package for insurance benefits. There is a 30 day requirement that you return the completed application to the insurance benefits adjuster (waiting period). The application will include a disability certificate.
The insurer has the right to delay or deny the provision of insurance benefits without having a completed package. If you decide to retain a personal injury lawyer, his or her office will deal directly with the adjuster and can assist you in completing the application.
You should apply for insurance benefits regardless of whether you have a health plan that may cover some of your medical expenses and/or income loss. Private health plans are often more limited than insurance benefits in the types of coverage and amounts available to be paid.
In the case of a Denied Claim or Long Term Disability Dispute, contact TSF Law at (905) 218-3668. We’re always there for you.
