Tort Claims
What damages can I claim?
- Pain and suffering, referred to as “general damages”.
- Loss of income and loss of ability to earn income.
- Housekeeping and home maintenance expenses.
- Health care expenses not covered by OHIP or your Accident Benefits carrier (See Accident Benefits Claims).
- The effect of the accident on your family relationships.
To claim for your pain and suffering, you must suffer a permanent serious impairment of an important physical, mental or psychological function or psychological function or permanent serious disfigurement, such as scarring. This is referred to as the "verbal threshold."
In order to "pass the threshold" your impairment must:
- substantially interfere with your ability to continue your regular or usual employment, despite reasonable efforts to accommodate you;
- substantially interfere with your ability to continue training for the career you have chosen;
- substantially interfere with most of the usual activities of daily living;
- have been continuous since the accident and not expected to substantially improve with treatment.
For all accidents after October 1, 2003 all claims for pain and suffering
are subject to a $30,000 deductible. This is referred to as the "monetary
threshold". Simply put, if your damages for pain and suffering
are assessed at $50,000, after the application of the deductible you recover
$20,000.
The deductible does not apply to more serious cases were pain and suffering
damages are assessed at $100,000 or more.
- From the first week after the accident until the time your case settles or reaches a trial, you can claim 80% of your after-tax income loss. If you continue to be disabled from work, future income loss can be claimed, based on 100% of your gross income loss.
- In most cases, you must first seek compensation for income loss from:
- Employment disability insurance; or
- Any private disability insurance; or
- Your accident benefits insurer.
- If the sources of income replacement are insufficient to pay for your actual income loss, a claim for the difference can be made against the party who caused the accident.
- No income loss is payable for the first week following the accident.
c. Housekeeping and Home Maintenance
- If you are unable to maintain your home as you did before the accident, you can claim reimbursement for expenses you incur.
- You must first seek reimbursement for housekeeping and home maintenance expenses from your accident benefits insurer and claim the difference.
- If your injury meets the verbal threshold (see above) you may be able to claim for past, present and future health care expenses not covered by OHIP or by your accident benefits insurer.
If a person is injured or killed in a motor vehicle accident caused by another party, the spouse, same-sex partner, children, grandchildren, parents, grandparents, brothers and sisters of the person are entitled to recover the following:
- actual expenses reasonably incurred for the benefit of the person injured or killed;
- actual funeral expenses reasonably incurred;
- a reasonable allowance for travel expenses actually incurred in visiting the person during his or her treatment or recovery;
- a reasonable allowance for loss of income or the value of nursing, housekeeping or other services for the person; and,
- an amount to compensate for the “loss of guidance, care and companionship” that the claimant might reasonably have expected to receive from the person if the injury or death had not occurred.
- Claims for “loss of care guidance and companionship” arising out of accidents occurring after October 31, 2003 are subject to a $15,000 deductible.
- If the claim is assessed at more than $50,000, the $15,000 deductible
does not apply.