Scenario 2: You are driving and hit some black ice on a curve, go over the embankment and hit a tree.

Transcription

1 Optional Accident Benefits Needs Standard Accident Benefits coverage in the Ontario auto policy were changed in There are a number of optional coverages available to motorists. The following explanations are designed to assist you in determining if you might require any of these optional coverages. This is not an exhaustive list and should be used as a guide only. It is not meant as a replacement for discussing your individual situation in depth with an insurance broker. Potential Accident Scenarios Scenario 1: You are driving through a green light at an intersection and a 17 year old, texting on their cell phone, runs the red light and hits you broadside on the driver s side door. Scenario 2: You are driving and hit some black ice on a curve, go over the embankment and hit a tree. If you are injured in either of those circumstances, there are three levels of benefits available to you under the standard accident benefits section of your auto policy. Your injuries may be considered: 1. Minor if you suffer a sprain, strain, whiplash associated disorder, contusion, abrasion, laceration or subluxation (a partial but not complete dislocation of a joint). Your injury is considered minor if you sustain any one or more of these injuries. If your injuries are determined to be minor *, the maximum rehabilitation benefit available to you is $3,500 and there are specific limits for the various stages of your rehabilitation. 2. Serious if your injuries are more than minor but not considered catastrophic. Your policy provides for additional standard benefits. Many of these benefits were reduced on Sept. 1/2010 to help control the cost of auto insurance. You now have the option of increasing the benefits to suit your own personal needs. 3. Catastrophic if you suffer a permanent and serious injury to an important bodily function. Essentially, you have to lose a limb, be in a wheelchair or a coma to be considered to have a catastrophic injury. If the injury qualifies as catastrophic you are eligible for an increased level of benefits. * In extremely limited instances where there is compelling evidence provided by a health practitioner that a pre-existing condition will prevent a person from achieving maximal recovery from the minor injury, you may apply to have the injury considered as not minor. To determine what optional benefits may be required by you, if any, you should consider the following: Optional Benefits Increased Income Replacement If you cannot work as the result of an auto accident, you may be eligible for basic weekly income replacement benefits of up to $400. This benefit commences after one week.

2 The standard level of income replacement provided in the policy ($400 per week max.) can be increased by purchasing optional coverage so that the weekly limit is up to $600, $800 or $1,000. All income replacement benefits are based on 70% of your gross weekly income. You should consider purchasing additional Increased Income Replacement benefits if: 1. You do not have Short Term & Long Term disability insurance 2. You make in excess of $30,000 a year If both above apply, then you should consider: Recommended Limit under $30,000 Base limit $30,000 - $45,000 $600 $45,001 - $60,000 $800 $60,001 - $75,000 $1,000 over $75,000 separate plan Increased Medical, Rehabilitation and Attendant Care s Medical and Rehabilitation Benefit: Covers the cost of reasonable and necessary medical and rehabilitation expenses (e.g., physiotherapy, prescriptions) that are not covered by OHIP or your disability insurance plan. Attendant Care Benefit: Pays for an aide or attendant to look after you if you have been seriously injured in an accident. The standard benefit pays up to $50,000 for medical and rehabilitation expenses, with a 10 year time limit in most cases, and up to $36,000 for attendant care expenses. If catastrophically impaired, the standard benefit pays up to $1,000,000 for medical and rehabilitation expenses and up to $1,000,000 for attendant care expenses. You can purchase an optional medical and rehabilitation benefit of $100,000; optional attendant care benefit of $72,000; or an optional medical, rehabilitation and attendant care benefit of $1,000,000. You should consider purchasing Increased Medical, Rehabilitation and Attendant Care if: 1. You and all drivers do not have coverage for extended health benefits insurance supplied through your work. 2. You or any other driver on your policy have any underlying health issues that may make a serious injury more difficult to recover. 3. You do not have friends or family members available to look after you or insured persons in your household if you were seriously injured.

3 Caregiver, Housekeeping and Home Maintenance Expenses s Caregiver Benefit: If you are providing full time care to dependants and can no longer provide that care as the result of an auto accident, you may be eligible for caregiver benefits to reimburse you for your expenses to hire someone to care for your dependants. Housekeeping and Home Maintenance expenses: If you are unable to perform your usual duties due to your injuries, this benefit pays for reasonable and necessary additional expenses for someone to complete your usual duties. The standard caregiver, housekeeping and home maintenance expenses benefit is available only for a person who is catastrophically impaired. You can purchase an optional benefit to provide this coverage for all impairments. You should consider purchasing Caregiver, Housekeeping and Home Maintenance Expenses if: 1. You or any drivers on the policy are not working but must look after small children or disabled or aging relatives. And, if they were injured and unable to continue, there is no one else available to look after the people they are attending. 2. If your or other insured drivers were injured and unable to maintain your home, you do not have relatives or others who could take over their duties. Dependent Care Pays for additional expenses incurred to care for your dependants if you are employed and are injured in an auto accident. There is no standard dependant care benefit for persons who are employed and care for dependants. You can purchase an optional benefit to receive additional weekly dependant care expenses of $75 for the first dependant, and $25 for each additional dependant, up to $150 per week. You should consider purchasing Dependant Care if: 1. You have young children in daycare, after-school program or being care for by a nanny. 2. You are a single parent or are married and both you and your spouse work. 3. You couldn t afford the cost of the Dependant Care if you or spouse were unable to work.

4 Increased Death and Funeral If you die as a result of an auto accident, the death benefit provides a lump sum payout to your spouse and your dependant; the funeral benefit provides a lump sum payout to cover the cost of your funeral expenses. The standard level of death benefits paid to the surviving spouse and dependant of a person who is killed ($25,000 to surviving spouse; $10,000 to surviving dependant) can be doubled by purchasing this optional coverage. This coverage also increases the standard funeral expense benefit from $6,000 to $8,000. You should consider purchasing Increased Death and Funeral benefits if: 1. You and all insured drivers do not have sufficient life insurance for final expenses and to look after your dependents. Indexation Benefit The automatic adjustment of the income replacement benefit, non-earner benefit, attendant care benefit or medical and rehabilitation benefit according to the Consumer Price Index for Canada to compensate for inflation. This optional coverage will ensure that certain weekly benefit payments and monetary limits will increase on an annual basis to reflect changes in the cot of living. You should consider purchasing the Indexation benefit if: 1. You do not have investments or other sources of income to offset the effects of inflation on the weekly income replacement benefit you are eligible for. 2. You are significantly younger than 65 and risk having the buying power of your income replacement benefits eroded by inflation. Added coverage to Offset Tort Deductible OPCF 48 If you are not at-fault in an accident and sue the driver who was, a deductible (currently $30,000) will be applied to any settlement you receive and will reduce the actual money you receive by the amount of the deductible.

5 This endorsement will provide a buy down on the deductible currently imposed by the insurance act on any settlements (from the current $30,0000 to $20,000) you should be awarded for pain and suffering following an automobile accident. You should consider purchasing the Tort Deductible Offset if: 1. If you would you like to lower the amount taken off any settlement you receive in a lawsuit if you are involved in a serious accident that is not your fault?