Accessing Ontario Accident Benefits for Motor Vehicle Accidents in the U.S.

When Ontario residents get into a motor vehicle accident in the United States (USA), they are still entitled to Accident Benefits under their own car insurance (Ontario Automobile Insurance Policy) (OAP1). These benefits can provide critical financial assistance for medical care, income replacement, rehabilitation, and more, regardless of fault.

Here are some key benefits available to Ontario residents involved in a USA accident:

1. Medical and Rehabilitation Benefits: Covers necessary medical treatment and rehabilitation services, such as physiotherapy, chiropractic care, and more, similar to what would be covered in Ontario.
2. Income Replacement Benefits: If the accident renders the individual unable to work, they can receive compensation to replace lost income. This is usually up to 70% of gross weekly earnings, with a maximum limit outlined in the policy.

3. Attendant Care Benefits: If the accident results in the need for personal care assistance, these benefits help cover the cost of hiring someone to provide care at home or in a healthcare facility.

4. Non-Earner Benefits: For those not employed at the time of the accident but are significantly affected in their daily activities, this benefit may offer financial support.

5. Catastrophic Impairment Benefits: In cases of severe injuries resulting in long-term impairment, enhanced benefits for medical, rehabilitation, and attendant care are available under catastrophic impairment classifications.

6. Optional Benefits: Policyholders who have purchased additional coverage options such as increased income replacement or enhanced medical coverage can also access these benefits.

Ontario residents must ensure that they report their USA accident to their own car insurer as soon as possible to access these benefits. Importantly, while these benefits are accessible, the process of coordinating between jurisdictions can sometimes be complex, requiring careful documentation and communication between Ontario car insurers and USA medical providers.

Having OPCF 44R Family Protection Coverage can also help if the USA driver is underinsured, ensuring that Ontario residents are protected even if the other party lacks sufficient insurance coverage. This is essential to safeguard against potential financial hardship when involved in an accident across the border. The liability policy limits of a car insured in the USA is substantially less (i.e. $25,000.00) than your own OPCF 44R Family Protection Coverage ($1 million). You are able to claim against your own car insurance company in Ontario for any damages over and above the USA policy limits. This is a large comfort to Ontario residents who are not adequately compensated in the USA.

If you or a loved one have been injured in an accident, you may be entitled to receive the help you deserve. Contact us at JEWELL RADIMISIS JORGE LL.P. and a member of our team will be happy to assist you.