Ottawa Lawyer: Settling Your Ontario Accident Benefits on Your Own?

Settling Your Ontario Accident Benefits on Your Own

If you have had an Ontario motor vehicle accident and more than one year has passed, if you are handling your case without an Ontario personal injury lawyer, your accident benefits insurer may approach you to settle your claim.  If you settle your claim, all future accident benefits will cease, even if you get worse.  As a result, it is important to ensure you get enough money in the settlement to cover your reasonable costs.


When you settle your accident benefits, you will generally be settling all past, present, and future claims to benefits arising from the particular accident. Future claims are pretty easy to understand.  No more treatment plans will be approved and there will be no future benefits funded.

Potential Pitfalls in Settlement: Considerations for Treatment Plans, Expenses, and Income Replacement Benefits

However, there are some pitfalls you can fall into:

Treatment Plans: Once you settle your accident benefits, the insurer does NOT have to pay to complete already-approved treatment plans, unless that is specifically part of the settlement deal.  In other words, if 12 chiro appointments have been approved, and you have only completed 6, you do not automatically get the remaining 6 treatments funded unless that is a negotiated part of the settlement.

The insurer will (or should) pay for treatment up to the date of settlement.  Make sure you make this an express term of the settlement.  If you can’t negotiate that term, find out from the adjuster or treatment provider how much is owed to the treatment providers so you know how much of that you will have to pay out of your settlement moneys.  In some cases,  insurers are months behind in payments to your physiotherapist or massage therapist.  Make sure you are informed before you commit to pay out any amounts owing out of the settlement.

Expenses: If you have already submitted expenses incurred for mileage, prescriptions or other out-of-pocket expenses but have not received payment for them, don’t assume those are on top of the settlement because they were already submitted.  Again, unless they are expressly negotiated, anything already submitted to the insurer will be lumped into the settlement.

Income Replacement Benefits: If, as is often the case, your income replacement benefits are in arrears, it is not a given that payment will be made for those arrears in addition to the settlement.  This is something you need to make an express term of the settlement.

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