Payment of Other Expenses

If the injured person was a student enrolled in an elementary, secondary, post-secondary or continuing education program, and as a result of injuries from the accident cannot continue with the program, the injured person can recover expenses related to the program up to a maximum of $15,000.

Lost educational expenses can include expenses incurred before the accident for tuition, books, equipment, or room and board in respect of the program term or program year in which the insured person was enrolled at the time of the accident.

The insurance company is required to pay reasonable and necessary expenses for having certain relatives visit the injured person during their treatment or recovery. The individuals whose expenses would be paid include, but are not limited to, the injured person’s spouse, children, grandchildren, parents, grandparents, brothers and sisters.

The insurance company is not required to pay for visitor expenses incurred more than two years after the accident unless the injured person is catastrophically impaired.

Although not specifically described in the accident benefit legislation, visitor’s expenses may often include expenses relating to mileage, meals, accommodations, air fare, clothing and toiletries. The key to accessing the visitor’s expense benefit is to demonstrate that the expenses are reasonable and necessary and receipts should be provided to the insurer in all possible cases. If a visitor is expected to have expenses over a prolonged period of time, it is suggested that the expenses be communicated with the insurer at the earliest opportunity to ensure the incurred expense claim will be fully accepted and paid.

Many family members are concerned that the payment of their visitor’s expenses will eat into their loved one’s medical-rehabilitation benefit fund. This is not the case. Visitor expenses are paid separately from the injured person’s benefits.

A person involved in an accident may expect to be reimbursed for reasonable expenses incurred in repairing or replacing clothing that was worn at the time of the accident, if it was lost or damaged as a result of the accident.

Similarly, a person involved in an accident may also expect to be reimbursed for reasonable expenses in repairing or replacing prescription eyewear, dentures, hearing aids, prostheses and other medical or dental devices, if lost or damaged as a result of the accident.

Damaged items should be retained whenever possible as should any receipts for the purchase or repair of the damaged items.

In pursuing a claim for accident benefits, an injured person will often need to have assessments and examinations completed on their behalf in order to make a claim for various benefits. The insurer is often obliged to pay for such assessments and examinations which may include, but not be limited to, fees charged for the preparation of Disability Certificates, Treatment and Assessment Plans, Assessments of Attendant Care Needs, and Applications for Determination of Catastrophic Impairment.

The injured person may also, at times, undergo assessments and examinations with various medical and rehabilitation professionals as part of their claim for benefits. Where such an appointment requires third party payment, the accident benefits claim may be accessed; the insurer will not pay more than $2,000 for any one assessment or examination.

The cost of assessments will often but not always have to be paid from the coverage limits. Careful oversight of costs relating to assessments is necessary to ensure that the coverage limits are only accessed when appropriate.

In the most unfortunate event that a person is killed in a motor vehicle accident, a claim for death benefits may be pursued by their surviving family and others.

Assuming that there are no optional benefits purchased on the policy of automobile insurance, the death benefit may be paid out in a variety of ways and may include payments as follows:

• A payment to the deceased person’s spouse of $25,000;
• A payment to each of the deceased person’s dependants, and to each person to whom they had an obligation at the time of the accident to provide support under a domestic contract or a court order, of $10,000;
• If the deceased person did not have a spouse at the time of their death, then an additional payment to the dependants and the persons (other than a former spouse of the deceased person), to whom the deceased person had an obligation at the time of the accident to provide support under a domestic contract or court order, to be divided equally among the persons entitled, of $25,000;
• A payment of $10,000 to each former spouse of the deceased person to whom the insured person was obligated at the time of the accident to provide support under a domestic contract or court order; and
• A payment of $10,000 to a person in respect of whom the deceased person was a dependant at the time of the accident.

As may be expected in our current society, issues involving who can access a death benefit can be highly complex and, at times, contentious. For instance, questions such as who is a spouse, who qualifies as a dependant of the deceased, what constitutes a domestic contract or a court order, and in what instances can a deceased person have been considered a dependant of another can be challenging to answer. Not only are those considering a claim for benefits challenged by such questions, but often the insurance company itself will stumble in navigating how to appropriately apply the coverage and pay the benefits.

Where there is a large or complex family, or a history involved, determining who should have appropriate access to death benefits, particularly when benefits are to be divided amongst multiple individuals, needs expert attention. In a time of much grief and despair over the loss of a loved one, having the support and guidance of a highly experienced personal injury law firm to navigate the claim can be of much assistance.

If a person involved in an accident dies as a result of injuries suffered, a funeral benefit may be paid by the automobile insurer.

The funeral benefit pays for expenses incurred as related to the funeral and is limited to the maximum amount of $6,000. This benefit amount may be increased if there are optional benefits available on the policy.