If you are a resident of Ontario and you've suffered a
personal injury in a car accident, most – if not all –
of your medical expenses are covered. However, they are not all
covered by the same sources – instead, there is a number of
services, from public to private insurance, providing your health
coverage, and it can be very important to know in advance who
The initial provider of your health coverage is public health
insurance, known as the Ontario Health Insurance Plan (OHIP). OHIP
covers your medical care in the hospital, from surgical procedures
to drugs to meals, with a couple of exceptions – a private
room, or additional services such as cable television, are
Once you have left the hospital, OHIP still covers a number of
your expenses. Follow-up appointments with hospital clinics, family
doctors, and specialists are covered by OHIP. However, OHIP does
not cover everything.
One of the key expenses not covered by OHIP is medication
outside of the hospital. This is usually covered by private
insurance, sometimes offered through a union, employer, or school,
and sometimes acquired by the individual. If you don't have
access to such a plan, there is a provincial government insurance
provider covering prescription medication, the Trillium Drug Program . Trillium uses a
deductible based on your income tax filing. The more you make, the
greater your deductible. While Trillium covers most prescription
medications, it does not cover all of them, and you may need to
verify that your prescription is covered.
Many of your out-of-hospital extra expenses, however, may be
covered by your auto insurance under statutory accidents benefit
coverage. While OHIP will provide some coverage for physiotherapy,
this is limited to those below the age of 19, above the age of 65,
recipients of social services, and those who have been an
in-patient overnight at a hospital for their injuries – and
even here it is for a limited term (although with a doctor's
referral, it can be extended). If you do not fall under these
categories, or your referral has run out, your additional therapy
and recovery costs may be covered by the statutory accident
benefits in your auto insurance.
Your auto insurance may also provide coverage for additional
expenses outside of physiotherapy. In the case of a serious injury,
you may need attendant care – this may be reimbursed by the
statutory accident benefits, along with coverage for loss of
income. If you are a caregiver, the statutory benefits may provide
for the costs to bring in a replacement until such time as you are
able to resume your former duties.
What if you were struck while on foot by an uninsured driver or
became the victim of a hit-and-run? There may be coverage available
from Ontario's insurance payer of last resort, the Motor
Vehicle Accident Claims Fund (MVACF).
When you have suffered an injury in an auto accident, it is just
as important to know who covers what part of your treatment and
rehabilitation, as it is to know that they are covered. While
coverage through OHIP is more or less automatic, coverage through
the statutory accident benefits or the MVACF requires you to apply
for them. Failure to do this quickly enough can result in being
denied the coverage you need. Knowing what is covered and by whom
is one less worry allowing you to move on with therapy and
It's not often that our little blog intersects with such titanic struggles as the U.S. presidential race – and by using the term "titanic" I certainly don't mean to suggest that anything disastrous is in the future.
J.J. v. C.C., is an interesting case in which the court held that an automotive garage owes a duty to minor children to secure the vehicles on the premises by locking the cars and safely storing the car keys...
In Irwin v. Alberta Veterinary Medical Association, 2015 ABCA 396, the Alberta Court of Appeal found that the "ABVMA" failed to afford procedural fairness to a veterinarian undergoing an incapacity assessment.
Register for Access and our Free Biweekly Alert for
This service is completely free. Access 250,000 archived articles from 100+ countries and get a personalised email twice a week covering developments (and yes, our lawyers like to think you’ve read our Disclaimer).