Personal Injury Blog

Representing Yourself in a No-Fault Insurance Claim? You Need to Know This.

If you or a loved one is injured in an automobile accident, life can get turned upside down in a heartbeat. All you want is to receive the treatment and support you need to return to normal life and put the incident behind you. It can be tempting to try to simplify the process of recovery by dealing with everything yourself instead of hiring legal professionals to handle your case. This option can be the quickest and can seem like the most efficient approach.

However, if you decide to represent yourself or a loved one in a “no-fault” accident benefits claim, you will have to navigate a long list of forms, procedures, and legislation to gain access to treatment, home care and income replacement. For your reference, we have compiled a list of essential links and sources below. A solid understanding of each of these elements is necessary to properly represent someone in an automobile accident benefits claim involving the Statutory Accident Benefits Schedule (SABS).

Our lawyers, paralegals, and support staff have a wealth of experience managing accident benefits claims for our clients, enabling thousands of accident victims to maximize their recovery. This experience allows us to achieve outstanding results efficiently, while taking the stress and uncertainty off their shoulders. For a free, no-obligation consultation, contact us. Campisi LLP - Champions with Heart!

ESSENTIAL RESOURCES REGARDING ACCIDENT BENEFITS:

SABS Benefits Claims Forms

https://tinyurl.com/3eu4fu9p

AABS – Main Page – Forms and FAQ

https://tinyurl.com/4wuu5k89

LAT Decisions – Current and Up to Date

https://www.canlii.org/en/on/onlat/

Licence Appeal Tribunal Rules

https://tinyurl.com/5n7k52ef

Governing Body over Auto Insurance, Complaints Issues New Guidance for Auto Insurers / Stakeholders -

Financial Services Regulatory Authority

https://www.fsrao.ca/

Guidelines and Bulletins – FSRA still links back to FSCO until they are all moved to FSRA.

Many are now called “Guidance”

FSCO Link: https://tinyurl.com/4ejkacss

 

 

FSRAO “Guidance” Link: https://tinyurl.com/3x7wdyyz

 

GOVERNING LEGISLATION:

Insurance Act, R.S.O. 1990, c. I8

https://www.ontario.ca/laws/statute/90i08

Compulsory Automobile Insurance Act, R.S.O. 1990, c. C.25

https://www.ontario.ca/laws/statute/90c25

Highway Traffic Act, R.S.O. 1990, c. H.8

https://www.ontario.ca/laws/statute/90h08

Off-Road Vehicles Act, R.S.O. 1990, c. O.4

https://www.ontario.ca/laws/statute/90o04

Licence Appeal Tribunal Act, 1999, S.O. 1999, c. 12, Sched. G

https://www.ontario.ca/laws/statute/99l12

Statutory Powers Procedure Act, R.S.O. 1990, c. S.22

https://www.ontario.ca/laws/statute/90s22

Statutory Accident Benefits Schedule – Effective September 1, 2010

https://www.ontario.ca/laws/regulation/100034

O. Reg. 160/16

ASSESSMENT OF EXPENSES AND EXPENDITURES - STATUTORY ACCIDENT BENEFITS

O. Reg. 90/14

SERVICE PROVIDERS - STANDARDS FOR BUSINESS SYSTEMS AND PRACTICES AND OTHER PRESCRIBED CONDITIONS

O. Reg. 89/14

SERVICE PROVIDERS - LISTED EXPENSES

O. Reg. 350/13

SERVICE PROVIDERS - PUBLIC REGISTRY

O. Reg. 349/13

SERVICE PROVIDERS - PRINCIPAL REPRESENTATIVES

O. Reg. 348/13

SERVICE PROVIDERS - LICENSING

O. Reg. 408/12

ADMINISTRATIVE PENALTIES

O. Reg. 534/06

PRESCRIBED INFORMATION FOR THE PURPOSES OF SECTION 101.1 OF THE ACT

O. Reg. 7/00

UNFAIR OR DECEPTIVE ACTS OR PRACTICES

O. Reg. 461/96

COURT PROCEEDINGS FOR AUTOMOBILE ACCIDENTS THAT OCCUR ON OR AFTER NOVEMBER 1, 1996

O. Reg. 401/96

ASSESSMENT OF HEALTH SYSTEM COSTS

O. Reg. 283/95

DISPUTES BETWEEN INSURERS

O. Reg. 777/93

STATUTORY CONDITIONS - AUTOMOBILE INSURANCE

R.R.O. 1990, Reg. 676

UNINSURED AUTOMOBILE COVERAGE

R.R.O. 1990, Reg. 668

FAULT DETERMINATION RULES

R.R.O. 1990, Reg. 664

AUTOMOBILE INSURANCE

 

REGULAR STANDARDS:

In compiling authorities for a hearing you should include the appropriate standards.

Physicians Pre-2021

https://web.archive.org/web/20190221122423/https://www.cpso.on.ca/CPSO/media/documents/Policies/Policy-Items/Third-Party-Reports.pdf?ext=.pdf

https://web.archive.org/web/20170203191049/http://www.cpso.on.ca/CPSO/media/uploadedfiles/policies/policies/policyitems/Medical-Records.pdf?ext=.pdf

https://web.archive.org/web/20190221125008/https://www.cpso.on.ca/CPSO/media/documents/CPSO%20Members/Assessors/Assessing-Standards.pdf

Physicians Post June 2021

https://www.cpso.on.ca/Physicians/Policies-Guidance/Policies/Third-Party-Medical-Reports

https://www.cpso.on.ca/Physicians/Policies-Guidance/Policies/Third-Party-Medical-Reports/Advice-to-the-Profession-Third-Party-Medical-Repor

https://www.cpso.on.ca/Physicians/Policies-Guidance/Policies/Consent-to-Treatment

Occupational Therapists

https://www.coto.org/docs/default-source/default-document-library/standards-for-assessments-2020.pdf?sfvrsn=ed21435d_0

https://www.coto.org/docs/default-source/pdfs/code-of-ethics-2020.pdf?sfvrsn=ec605359_24

https://www.coto.org/docs/default-source/pdfs/guidelines_for_working_with_third_party_payers_2017.pdf?sfvrsn=35a85d59_10

https://www.coto.org/docs/default-source/default-document-library/standards-for-consent-2017.pdf?sfvrsn=311a0ab3_2

Psychologists

https://www.psych.on.ca/getmedia/27f2404e-8fda-4711-bdaa-91ea1c6a140b/2010-opa-auto-guideline.pdf

https://cpo.on.ca/wp-content/uploads/Standards-of-Professional-Conduct-2017-Practical-Applications-Current-to-March-19-2021.pdf

https://cpa.ca/docs/File/Ethics/CPA_Code_2017_4thEd.pdf

FSRA Covid Guidance

https://cpa.ca/docs/File/Ethics/CPA_Code_2017_4thEd.pdf

Professional Conduct and Practice Regulations

https://www.canlii.org/en/on/laws/regu/o-reg-856-93/latest/o-reg-856-93.html

https://www.canlii.org/en/on/laws/regu/o-reg-95-07/latest/o-reg-95-07.html

https://www.canlii.org/en/on/laws/regu/o-reg-801-93/latest/o-reg-801-93.html

https://www.canlii.org/en/on/laws/regu/o-reg-7-00/latest/o-reg-7-00.html

 

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