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Insured Persons. Who is Covered?

Generally, all Ontario residents are insured with accident benefits for two reasons:

  1. A scheme of laws ensures all vehicles operated in Ontario are insured with accident benefits1. As will be seen below, if one vehicle in an accident is insured, everyone injured in the accident is likely considered an insured person for accident benefits.
  2. If none of the vehicle involved in the accident is insured, an injured person may apply to a special fund established by the province2, called the Motor Vehicle Accident Claims Fund. One of the major functions of this Fund is to “provide statutory accident benefits directly to persons involved in an automobile accident, who have no recourse to automobile insurance”3.

The Statutory Accident Benefits Schedule (‘SABS’) defines who an insured person is under any car insurance policy in Ontario. The following individuals are considered insured persons whether they are involved in an accident, or suffer impairment as a result of others being involved in an accident4:

  • The person named in the policy;
  • Other persons named in the policy;
  • The spouse of the named insured;
  • The dependents5 of the named insured;
  • The dependents of the named insured’s spouse;

The SABS also makes the following individuals insured persons where they are involved in an accident:

  • A person involved in an accident in Ontario with the insured automobile (such as, occupants, other drivers, and pedestrians);
  • Occupants who were Ontario residents at any time 60 days before the accident, if the accident occurred outside of Ontario.

To learn more or to discuss your motor vehicle accident, contact your team at Kotak today!

Citations:

  1. Compulsory Automobile Insurance Act, R.S.O. 1990, Chapter C.25, (s.2); and Insurance Act, R.S.O. 1990, Chapter I.8 (s.268 (1)).
  2. Insurance Act, R.S.O. 1990, Chapter I.8 (s.268 (2)).
  3. https://www.fsco.gov.on.ca/en/auto/mvacf/Pages/default.aspx
  4. Insurance Act, Ontario Regulation 34/10, (s.3).

Section s.7(b) of the SABS defines ‘dependent’ as being “principally dependent for financial support or care on the individual or the individual’s spouse”. However the court has addressed the issue of dependency through 4 criteria: 1) amount of dependency, 2) duration of dependency, 3) needs of dependent, and 4) ability of dependent to be self-supporting. – State Farm v. Bunyan, 2013 ONSC 6670.

Disclaimer

The contents of this blog are intended to provide general information on the law. It is not intended to form any solicitor-client relationship. Readers are encouraged to seek independent legal advice.

KOTAK PERSONAL INJURY LAW/DISABILITY LAWYERS CAN HELP YOU

We understand that being denied disability benefits can be frustrating and devastating. Your time to fight your disability insurance company is limited. Please do not delay in calling long term disability lawyer. We have successfully sued numerous disability insurance companies including: Manulife, Sunlife, Desjardins, Great West Life, Blue Cross, AIG, SSQ, RBC, Industrial Alliance and more.

Call your trusted long term disability lawyers at 1-888-GOKOTAK (Toll Free for all of Canada), or (416) 816-1500 (Local Number for Ontario Residents), (403) 319-0071, (587) 414-1010 (Local Numbers for Alberta Residents). Our consultation is free and we don’t get paid until you do. We can meet you at our offices, at a coffee shop, your home or a local court house. We represent disabled people throughout Ontario and Alberta, including Toronto, Mississauga, Brampton, Milton, Georgetown, Orangeville, Oakville, Burlington, Hamilton, St.Catharines, Niagara Falls, Stoney Creek, Kitchener/Waterloo, Cambridge, London, Windsor, Markham, Pickering, Oshawa, Peterborough, Keswick, Kingston, Ottawa, Banff, Brooks, Calgary, Edmonton, Fort McMurray, Grande Prairie, Jasper, Lake Louise, Lethbridge, Medicine Hat, Red Deer, Saint Albert and other locations.

Disclaimer: This article is intended to supply general information to the public. We make every effort to ensure the accuracy of this information. However, as laws change quickly, the reader should always ensure the accuracy and applicability of such information with respect to their particular case. The information contained in this article cannot replace a thorough and complete review of the reader’s situation by competent legal counsel who has had an opportunity to review all of the facts.