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Understanding the Auto Claims Process

Getting into a car accident is stressful.  Understanding the claims process is the first step to helping get life back to normal. Learn about what to expect and how to navigate through the process with the helping steps below. Remember, we are here for you every step of the way.

Before we dive in, please note that there have been numerous cases of tow truck and storage scams in Ontario, and we strongly advise you go through these helpful tips to avoid being a victim. 

The very first thing to expect once your claim is filed is for a claims adjuster to get in touch with you.  At this stage they may need you to complete a Proof of Loss form or in some cases they may even do a site visit. This will help them determine the full scope of damage, work out how much your insurer’s policy covers and further guide you through the process.

Here is some useful information about the claims process:

 1. Role of the Broker

• Files the claim immediately with your insurance carrier.

• First point of contact for any conflict resolution.

• Will act as your advocate during the claim process

• Can help with sending documents to the adjuster if needed.

 2. Role of the Adjuster

• Evaluates the damage and helps you recover your losses.

• After submitting your claim, a claims adjuster assigned by your insurance company will contact you. They will require you to complete a Proof of Loss form and may do a site visit to assess the full scope of damage, to help settle the loss.

3. Understanding fault

• In some instances, more than one party involved in the accident may share fault.  No matter the condition of the road, weather, visibility, point of impact on the vehicles, or the actions of pedestrians, these rules still apply.

• Police charges of offence do not explicitly impact your at-fault levels for insurance purposes.

• If you, as the driver and owner of the car, are at fault, it will go on your insurance record. Your premium may also increase at the next policy renewal, if you are found to be at-fault by 50% or higher.

• Even if someone else was driving your vehicle and were found to be at fault by 50% or higher, their accident will go on your records.

In a situation where you believe there might have been an error in your claim settlement by your insurance provider, contact your claims adjuster as they will be able to advise you on which fault rule was applied in your case.

 

For more information of how your Insurance provider determines fault please visit Insurance Act and Fault Determination Rules.

4. What damage compensation can I expect?

• Depends on your at-fault percentage and your policy coverage.

• Ask your claims adjuster for full details like the information on the fault rules applied and your at-fault percentage. You will be covered for damages depending on those factors and the insurance coverage that you purchased.

5. You may be eligible to receive costs for a temporary rental vehicle.

• If you file a claim with mandatory coverage you will be eligible to receive temporary rental vehicle and damaged personal contents inside the vehicle.

• Depending on your at-fault percentage, in Ontario, your mandatory coverage includes Direct Compensation-Property Damage (DC-PD).

• If you were found 50 per cent not-at-fault, your insurance company will pay 50 per cent of any loss, minus the deductible.

7. Paying the deductible.

• If the accident was not your fault or only partially your fault, you may not need to pay the full deductible.

• A deductible is the amount of the claim that you will have to compensate for, depending on the at-fault percentage and your policy.

8. What you are entitled to if you or anyone involved in the accident has been injured or dies.

The Statutory Accident Benefits Coverage provided by law under every auto insurance policy provides compensation should you or your passengers become injured or perish in an automobile accident. Learn more 

Next Steps:

Through all of this, remember we work for you, so please don’t hesitate to contact your assigned broker from our Rhodes & Williams team.

After, your insurance company and the claims adjuster review all the documents provided, they will be able to issue a final claims settlement. You will be required to sign the proof of loss claims settlement document, which then allows the final claims payment to be made, at a time advised by your insurance company.

We can also review your policy and help you get more protection or make any necessary changes to keep you safer from any future adversities.