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In the industry · May 18, 2010

Ontario’s Accident Benefits are Stricter than Expected

When the doors of a Toronto Transit Commission (TTC) bus door closed on Jasmin Mangallon, she sustained injuries that she claimed affected her ability to live a normal life. Ms. Mangallon already suffered from depression, heart disease, and diabetes; the incident furthered her depression and added whole-body pain and headaches to her problems. As a result, she attempted to claim non-earner benefits under Ontario’s auto insurance legislation.

Unfortunately for Ms. Mangallon, claiming Ontario’s non-earner benefits is not so easy. Non-earner benefits are specifically for people who are uninsured at the time of the accident and who “suffer a complete inability to carry on a normal life as a result of the accident”. The key is that the pain from the accident directly causes the victim’s inability to carry on a normal life. In Ms. Mangallon’s case, FSCO denied her the non-earner benefit because it concluded that her pains were more likely caused by pre-existing conditions.

Non-earner benefits are only one type of a larger set of benefits known as Ontario’s Motor Vehicle Accident Benefits. Most other accident benefits seem equally stringent on their qualification requirements. These include income replacement benefits, caregiver benefits, and housekeeping benefits, which all require “complete” or “significant” inabilities to perform certain tasks as a direct result of the accident. One outlier is medical and rehabilitative benefits, which are granted to any victims who simply “require treatment as a result of a motor vehicle accident”. Ultimately, it is better that most benefits are difficult to claim to prevent fraudulent claims or minor injuries from using up valuable government resources.

Painful symptoms alone not sufficient to claim non-earner benefits: Ontario court. (2010). Retrieved May 12, 2010 from Canadian Underwriter.

Legal Facts: Accident Benefits. Retrieved May 12, 2010 from SLS Professional Corporation.

Filed Under: In the industry Tagged With: accident benefits, fsco

The Antibex Team

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