UNDERSTANDING INSURANCE (Lisa Morell, @MorellKelly)

Morell Kelly Personal Injury Law

 

With thousands of Canadians finding out that their home insurance policies do not cover losses caused by overland flooding the importance of taking the time to inform yourself as to the details of your automobile insurance cannot be overlooked – as certainly you are more likely to have your life impacted by a motor vehicle collision than a flood.

While automobile insurance can certainly be purchased on line I recommend finding an insurance broker you can deal with directly. You should find an individual who you feel comfortable talking to and who will take the time to explain not only the available coverages but should also be able to explain to you how the coverages work should you have the misfortune of being involved in a motor vehicle collision. For example it is a common occurrence for clients to come into our office believing that they have access to $50,000 in medical rehabilitation benefits. Access to coverage through an automobile policy works completely differently than accessing collateral coverages through your own group insurer.

The primary difference is that access to medical rehabilitation through your automobile insurer is subject to compliance with the provisions of the Statutory Accident Benefit schedule which is a regulation enacted under the Insurance Act. Treatment requests must be submitted by treatment providers on prescribed forms and then they are subject to the insurer approving them on the basis of the prescribed treatment being reasonable and necessary. In the event the insurer does not agree that the treatment is reasonable and necessary there is a complex dispute resolution procedure available which starts with the insurer sending the claimant for an Insurer Exam.

Accessing medical benefits through your group insurer is much easier and generally requires only a receipt submitted with a claim form and the expense is then automatically reimbursed. Clients are often surprised to learn that they in fact must exhaust their collateral coverages before the automobile insurer is obligated to pay for medical rehabilitation benefits. While this seems manifestly unfair insomuch as this means the collateral coverages will not be available should they be needed in the future for treatment arising from an incident unrelated to the automobile accident this is the basis upon which the automobile insurance premium has been costed. This is only one of the many concessions that the insurers have been able to extract from the government under the ruse of keeping insurance premiums low.

Another major misconception is that the term “no fault” insurance means that persons injured in car accidents can no longer sue for damages. No fault insurance relates to coverages available to you through your own automobile insurer. This coverage is available to you except in certain circumstances regardless of whether the accident which caused your injuries was or was not your fault. Your access to coverage may be limited if you are convicted of impaired driving or driving with a suspended licence. Remember to take time to renew your licence on or before your birthday.

Don’t forget to talk to your insurance broker about additional coverages that may be available to you. There are additional coverages available at a reasonable cost but we are not seeing many clients coming in with these coverages in place. There are upgrades which include increasing access to medical rehabilitation benefits from $50,000 to $1 million, increasing the amount of your income replacement benefit and purchasing additional benefits such as housekeeping coverage.

 

Lisa Morell Kelly

Morell Kelly Personal Injury Law

515 Park Road North

Brantford, Ontario N3R 7K8 (519) 720-0110

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