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Government vs Insurance Companies: Who Pays If You’re Injured In A Car Accident?

client doctor and lawyer meeting

Treatment and rehabilitation for injuries sustained in a car crash, ATV, motorcycle, or snowmobile accident can take months and cost hundreds of thousands of dollars. Who pays for it all?

The government and your insurance provider each has responsibility regarding compensation and payments for health care services for injury victims. Here’s an explanation.

GOVERNMENT RESPONSIBILITY


Payment responsibilities are laid out in Ontario’s Statutory Accident Benefit Schedule. It stipulates the Ministry of Health pays for front-line professional medical services, which are services provided by doctors and nurses in hospitals covered under the Ontario Health Insurance Plan (OHIP). It also includes licensed health professionals such as physiotherapists and social workers. The services paid by the government include:

  • Medical costs and physician services

  • Hospital services

  • Mental health facilities

  • Air ambulance

  • In-home health services such as nursing, occupational therapy, physiotherapy, speech-language pathology, social work and nutritional services

INSURANCE COMPANY RESPONSIBILITY


On the other hand, your automobile insurer is responsible for paying for all non-professional health care services, including:

  • Personal support such as hygiene assistance and meal preparation

  • Homemaking services such as house cleaning and laundry

  • Attendant care services

  • Community support services such as meals and transportation

  • Caregiver support

  • Home maintenance and repair

  • Social or recreational services

Under Ontario law, insurance companies must arrange non-professional health services for their clients and pay the service provider directly.

WHEN TO CONTACT A PERSONAL INJURY LAWYER

It’s best to contact a personal injury lawyer as soon as possible after being injured in a motor vehicle crash. A lawyer can navigate the complex web of payment structures to ensure you get what you’re owed. Typically, if you pay out of pocket for any health service necessary for your treatment or recovery, a lawyer can help you get reimbursed. If your injuries are substantial, they may exceed available coverage through OHIP or your auto insurance provider. Moreover, an insurance company may deny benefits based on its own investigation. In these cases, hiring a personal injury lawyer to appeal these denials is vitally important. A personal injury lawyer can seek compensation for losses, including:

  • Pain and suffering

  • Loss of income

  • Loss of housekeeping & home maintenance

  • Future health care costs

The sooner you contact a personal injury lawyer, the better your chance of winning your case or reaching a fair out-of-court settlement.

PERSONAL INJURY LAWYER SERVICES IN SAULT STE. MARIE


At Feifel Gualazzi Personal Injury Law Firm, our lawyers dedicate themselves to fighting for your legal rights so that you’re paid what you’re owed. We build strong cases and get our Ontario clients fast and fair compensation and have done for decades. Call us today to schedule a free, confidential consultation.

 

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