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Understanding No-Fault Insurance in Ontario - Zayouna Law Firm
Jun 26 2024 | Zayouna Admin

Understanding No-Fault Insurance in Ontario: What You Should Know

Back in the 1980s, if you got in a car accident, you would be stuck paying out of pocket for the car repairs, medical treatments, and other damages until the insurance companies could decide who was at fault. Sometimes this meant going months before you received any benefits or coverage. So, in 1990, Ontario switched to a no-fault insurance system.

Since then, a lot of Ontarians have been confused about what no-fault insurance means and how it affects their coverage. In this article, we will answer your questions and explain everything you need to know about no-fault insurance in Ontario.

How Does No-Fault Insurance Work in Ontario

No-fault insurance simply means that, after an accident, each party files a claim and receives benefits from their own insurance provider, regardless of who is at fault. However, the extent of the coverage will still depend on the fault determination. Fortunately, in Ontario’s no-fault system, those injured in an accident can receive benefits regardless of the fault determination.

No-fault insurance was introduced in Ontario to allow insured Ontarians to access coverage and benefits in a timely manner after a car accident. With no-fault insurance, if you are injured in an accident, you can receive accident benefits in a matter of days to help pay for your medical expenses.

Ontario Insurance requirements

In Ontario, all insurance policies are required to meet the province’s minimum insurance requirements. This includes:

  • Third-party liability: A minimum of $200,000 coverage to protect you if you are sued because someone is injured or killed in the accident.
  • Statutory accident benefits: Provides benefits to drivers, passengers, and pedestrians injured in the accident, regardless of fault.
  • Direct compensation – Property damage (DC-PD) coverage: Pays for damages to your vehicle and property in the vehicle if another party is at fault for the accident.
  • Uninsured automobile coverage: Covers you in case you are in an accident with an uninsured driver.

No-Fault Insurance Is Not No Fault Insurance

The most common misconception about no-fault insurance is that it creates a system where no one is at fault in an accident. That is not the case. Insurance companies will always investigate the accident to determine the extent to which each driver is at fault.

How Is Fault Determined in Ontario?

In Ontario, fault is determined using the Fault Determination Rules outlined in the Insurance Act. These rules include over 40 scenarios to cover almost every possible accident. In each of these scenarios, each driver involved is assigned a fault percentage. Drivers can be deemed 0%, 25%, 50%, 75%, or 100% at fault, depending on the situation.

In situations where both parties are found 0% at fault, it becomes a 50/50 fault determination. In the rare case where your accident does not fit under any of the scenarios, fault is determined using case law.

What No-Fault Insurance Means For Your Policy

Understanding Ontario’s no-fault insurance system may influence how you build your insurance policy. You may want to add additional coverage or change your deductible to suit your preferences and risk tolerance.

Who Pays For The Damage to Your Vehicle

Who pays for the damage to your vehicle depends on the fault determination. The DC-PD coverage on your policy will pay for the damages to your vehicle for the portion of the accident that is not your fault.

So, if you are deemed 50% at fault, the DC-PD coverage will pay for 50% of the damage, less the deductible. You would therefore be responsible for paying for 50% of the damages out of pocket unless you add collision coverage or all perils coverage to your policy.

If you opt for collision coverage, it covers the damages for the at-fault portion of the accident. So, if you are deemed 75% at fault in an accident. The DC-PD coverage would cover 25% of the damages and collision coverage would pay for 75% of the damages, less the deductible.

Who Pays the Deductible?

Unless you are determined to be 25% or less at fault, you will have to pay the deductible for the DC-PD coverage. Fortunately, the deductible on DC-PD coverage is often $0. For the damages covered under collision coverage, you will have to pay the deductible that you chose when purchasing your policy.

Will My Premium Increase After an Accident?

For any accident where you are 50% or more at fault, you can expect your premiums to increase when your policy renews. If you added accident forgiveness to your policy, then your first accident may be “forgiven” and not affect your policy.

Even accidents where you are 0% at fault will likely be added to your driving record. While it won’t increase your premiums, you may lose your eligibility for a claims-free discount, if offered.

Benefits and Limitations of No-Fault Insurance

Benefits of No-Fault Insurance

The main benefit of a no-fault insurance system is that it expedites the process of getting payment to those who need it. You don’t have to wait for the fault determination to conclude before receiving accident benefits to cover medical expenses.

It also makes the claims process a little easier since you always file with your insurance company.

Limitations of No-Fault Insurance

No-fault insurance is not perfect, but then again what insurance policy is? The main drawback of no-fault insurance is that caps on coverage might limit the benefits for certain injuries, pain and suffering, and property damage.

You may also end up in an accident where you don’t agree with the fault determination. The scenarios outlined in the Insurance Act are thorough, but they can fail to accurately represent the fault in the accident as you perceive it. You can challenge the fault determination if you disagree with the result, but the process can be long and complicated.

Get Help Negotiating With Insurance Companies From a Trusted Ontario and Toronto Car Accident Lawyer

If you need help understanding the claims process, challenging fault determination, or negotiating a fair settlement, don’t hesitate to reach out to an Ontario And Toronto car accident lawyer. The lawyers at Zayouna Law Firm are here to guide you through the insurance process, represent you in negotiations with insurance companies, and help you understand your options for pursuing further compensation.

If you or a loved one has been in a car accident in Toronto or Southern Ontario, contact Zayouna Law Firm today to book a free consultation.

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