The Process Of Submitting An Injury Insurance Claim In Ontario
If you have been injured in a car accident, slip and fall accident or are making a claim against an insurance company for disability benefits, there are several key steps that must be taken.
It is important to retain an Ontario personal injury lawyer soon after your accident or disability denial so that your claim can get properly started as soon as possible.
Depending on the seriousness of your injury and how reasonable the insurance company or defendant is in negotiations, your claim could settle early on or go all the way through to trial. Outlined below are the key steps involved in personal injury and long term disability claims:
Notice letter
This is the first step in making a claim. The notice letter is sent by your personal injury lawyer to the person or company that caused your injury.
The notice letter informs the at-fault party that they were responsible for your injury and that you will be making a claim. The responsible party is notified that they should inform their liability insurance company, so the insurer can respond to the claim.
Gathering Evidence
To support and prove your case, medical records are ordered from your treating health care providers. This can include your family physician, medical specialists, psychologists, physiotherapists, chiropractors and others who have treated you.
Other documents may also be required. For example, if you are making an income loss claim, your income tax returns or employment records will likely be collected.
Your Ontario personal injury lawyer may also contact witnesses to build your case. For example, in a car accident case, this could involve a statement from an independent witness who saw the crash.
Court Documents
If an early settlement is not reached with the liability insurance company, your lawsuit must be commenced within two years. This is done by filing a Statement of Claim at the courthouse, which is then served on the defendant.
The insurance company for the person responsible for your injuries will then hire a lawyer. The insurance company’s lawyer will respond with a Statement of Defence, outlining the defendant’s position.
Examinations for Discovery
The Examination for Discovery is when the parties testify under oath about the case. The Examination for Discovery is a very important step. It permits both sides to better understand the case and the evidence that each side will rely on.
At the Examination for Discovery, you will be questioned by a lawyer on behalf of the insurance company. Your own injury lawyer will examine the person who was at fault for the accident or a representative of the insurance company that denied your benefits.
When you are examined, your personal injury lawyer is present with you and if there is an improper question your lawyer will object.
The Examination for Discovery is not held in a courtroom in the presence of a judge and jury. Instead, it is usually held in a room similar to a board room in the presence of a court reporter who records all questions and answers. After the examination is complete, all questions and answers are transcribed in an official transcript.
Attendance at Medical Examinations
Our Ontario injury lawyers may refer you to our own expert medical doctors or other specialists to provide an opinion about your injury, impairments and the effect of the accident has had on your life.
The defence lawyer is also entitled to have you attend for an assessment with his or her chosen expert. When you attend an examination with the defence lawyer’s expert it is important to keep track of certain information such as the length of the assessment, the names of the people who saw you and how you felt later that day or the following day.
Although the defence experts are supposed to be objective, you may very well find that the report prepared by the defence expert is heavily slanted to favour the position being taken by the insurance company.
Mediation
A Mediation is an out-of-court settlement meeting that the parties and their lawyers attend with a Mediator. The Mediator is selected by agreement between the parties and is neutral. The Mediator does not make a decision about which side is right or wrong. His or her job is to try and bridge the gap between the parties so that the claim settles.
At a Mediation, both sides present their position in the same room. After the positions have been presented usually the parties then go into separate rooms. The Mediator will then go from room to room; bringing offers to settle provided from one side to the other. The Mediation continues until the case settles or it becomes clear that a settlement cannot be reached.
A Mediation is private, confidential and without prejudice. Nothing that any party says at the Mediation can be used against them at a later date such as the trial. This is to encourage an open dialogue and frank settlement discussions.
Pre-Trial Conference
If a case is not settled at the Mediation, the next stage is a Pre-Trial Conference. This is where the parties and their lawyers meet privately with a judge at the courthouse. After reviewing the case the judge may provide an opinion about what the case is worth and who is at fault. The parties may exchange settlement offers.
If a settlement is not reached the parties may discuss trial issues such as the trial date, expected trial duration and witnesses who will testify at the trial.
The judge at the trial will not be the same judge who presided over the Pre-Trial Conference.
Trial
The trial is the final stage of the lawsuit. This is where the parties go to court, give evidence and call witnesses. Most Ontario personal injury trials are held before a jury but sometimes there is only a judge. After all of the evidence has been called and submissions made, the judge or jury will make the decision who was at fault and how much the case is worth.
For more information about making a personal injury or long term disability claim, or to arrange a free no-obligation consultation, please contact SG Injury Law’s Ontario personal injury lawyers: