Insured's Duty to Provide Notice of a Claim
With summer approaching, motorcyclists will be dusting off their bikes and taking to the roads. If you own or operate a motorcycle, here is what you need to know if you are involved in a collision:
For all first-party claims (accident benefits or property damage), you must provide notice to your insurance company within seven days of the collision, regardless of who is at fault.1 Failing to do so or waiting longer than seven days could put your accident benefits at risk. All that is needed for you to report to your insurer is that you were involved in a collision. You do not need to accept any responsibility for the collision or answer any questions related to fault. Similarly, if you receive notice that an action will be commenced against you, you must provide notice to your insurance company within seven days, or as soon as possible.2 You will only have five days to provide notice to your insurance company if you learn that the action has already been commenced.3
Property Damage Claims
After you submit a notice of property damage claim to your insurance company, your insurer must provide you with documentation to quantify the loss within 60 days, or immediately if requested. Upon submitting this documentation to your insurer, you are required to provide the "fullest information obtainable at the time" with respect to the accident and damage.4 After receiving your Proof of Loss, your insurer must provide notice within seven days if they intend to repair, rebuild, or replace the damage to your motorcycle. Otherwise, they will have 60 days to pay the claim based on the amount in your Proof of Loss. 5 If your insurer denies your claim, they are obliged to provide prompt notice and explain the reason for the denial.6
If there is a disagreement between you and your insurer regarding the value of the damage to your motorcycle, either you or your insurer can request an appraisal pursuant to s. 128 of the Insurance Act.7 In the event you or your insurer requests an appraisal, you will both need to appoint an appraiser to act as your representation. Your insurer will then appoint a third appraiser, also known as the umpire, to allow for a decision to be made on agreement of two of the three appraisers. Your insurer is required to pay your claim based on the appraisal decision within 15 days.
Accident Benefit Claims
After sending your insurer notice of a potential accident benefits claim within the seven days of the incident, your insurer must provide you an application for accident benefits (OCF-1). This application is to be completed by you within 30 days, or as soon as possible thereafter if you have provided a "good reason" for the delay.8 The insurer's timeline for paying you benefits is dependent on the specific accident benefit. As a general rule, all "legitimate" claims should be paid to you within 60 days of your insurance company receiving your Proof of Loss.9
Under Ontario law, you also have the option to claim compensation from the driver at fault by filing a lawsuit, while simultaneously claiming accident benefits from your insurance company within two years from the date of your motorcycle collision to file your lawsuit. Through a tort claim, you are able to claim damages for loss of income, future care cost, loss of amenities, loss of amenities, etc. In the unfortunate event of a rider's death, their family can file a claim for compensation under the Family Law Act. It is advised that you contact an experienced personal injury lawyer who can help you navigate the claims process and determine if it is in your best interest to file a lawsuit.
In the event of a motorcycle collision, riders can take a few simple steps that can make a big difference in their recovery.
1. Insurance Act, R.S.O. 1990, c. I.8, s. 258.1; Ontario Automobile Policy (O.A.P 1), s. 1.4.4.
2. Insurance Act, R.S.O. 1990, c. I.8, s. 258.1.
3. Insurance Act, R.S.O. 1990, c. I.8, s.259.
4. Statutory Conditions - Automobile Insurance, O. Reg. 777/93, s.6.
5. Statutory Conditions - Automobile Insurance, O. Reg. 777/93, s.9.
7. R.S.O. 1990, c. I.8, s.128.
8. Ontario Automobile Policy (O.A.P. 1), s. 4.3.1
9. Ibid, s. 1.6.1
The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.