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Understanding the Difference Between a Tort Claim and an Accident Benefits Claim
If you've been injured in a motor vehicle accident in Ontario, you're not alone — and it's normal to feel unsure about what to do next. Between medical appointments, missed work, and insurance paperwork, it can feel overwhelming.
In Ontario, there are two main parts to most car accident cases:
- Accident Benefits (through your own insurance company), and
- A Tort Claim (a lawsuit against the at-fault driver).
Both are important and often work together to make sure you're properly compensated. Here's a simple breakdown to help you understand how each one works.
- Accident Benefits Claim — Support Through Your Own Insurance
Accident Benefits are available to anyone injured in a car accident, regardless of who was at fault. These benefits are meant to help you recover physically, emotionally, and financially.
They can include coverage for:
- Medical and rehabilitation expenses (like physiotherapy, chiropractic care, and counselling)
- Income replacement if you can't work due to your injuries
- Attendant care if you need help with personal care
- Non-earner benefits if you weren't working but can't carry on your normal activities
- Housekeeping and caregiver benefits, in certain cases
- Death and funeral expenses, in the case of a fatal accident
It's important to act quickly. You must notify your insurance company within 7 days of the accident and submit your forms within 30 days of receiving them.
- Tort Claim — Holding the At-Fault Driver Responsible
A Tort Claim is a lawsuit against the driver (and their insurer) who caused the accident. This claim helps you recover losses that aren't fully covered by Accident Benefits.
You may be able to claim compensation for:
- Pain and suffering (for serious and permanent injuries)
- Loss of income and future earning capacity
- Future medical and care costs
- Out-of-pocket expenses
- Loss of care, guidance, and companionship for close family members
There are special rules for pain and suffering claims — your injuries must meet a "threshold" (meaning they are serious and permanent), and a deductible may apply.
You generally have two years from the date of the accident to start a lawsuit, but it's best to speak with a lawyer as soon as possible to protect your rights and preserve evidence.
How These Two Claims Work Together
Your Accident Benefits help you right away after an accident — even if you were at fault.
Your Tort Claim is about long-term compensation and accountability — ensuring you're not left paying for someone else's mistake.
Your lawyer will coordinate both claims to make sure nothing is missed and that you receive the maximum support available.
Why Legal Advice Matters
Car accident claims can be complex and time-sensitive. A personal injury lawyer can help by:
- Explaining your rights in plain language
- Making sure you meet all deadlines and submit proper forms
- Negotiating with insurance companies on your behalf
- Assessing your tort claim and potential compensation
- Reducing stress so you can focus on recovery
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.
