Auto Claims

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 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 to review these helpful tips from the Financial Services Commission of Ontario, 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. This will help them determine the full scope of damage, work out how much your insurance policy covers, and further guide you through the process.

A determination of injuries is an important first step. If there are none, then the claim will focus on vehicle repairs including, the common practice, of assigning an Estimator who will visit the vehicle to begin assessing the extent of the damage. Here is some useful information about the claims process:

1. Role of the Broker
  • If possible, make your first call to your insurance broker. We will review coverage, deductibles, impact on future pricing and give an overview of what you should expect during the claim process.
  • If you wish to file a claim, your broker will do so immediately with your Insurance Company.
  • Questions? Conflict with your Insurance Company? Confusion? Overwhelmed with the situation? Your insurance broker is here to help. We will act as your advocate during the claim process
  • We work for you. We are here to support you. During the whole claims process, feel free to contact us for help and advice.

2. Role of the Adjuster
  • After submitting your claim, an Adjuster assigned by your insurance company will contact you. They will outline what you can expect, timelines, repair facilities and in the case of injuries, your medical options.
  • The Adjuster takes the lead in the claim process from the insurance company perspective. They are your main point of contact throughout the claim (but your broker is always available to help)
  • The Adjuster (or Estimator, if assigned) will evaluate the extent of the damage and begin determining repair costs.
  • You will be provided with options where to have your vehicle repaired. Every insurance company will have a network of designated repair facilities where they will guarantee the work done on your car. But remember, the choice is always yours.
  • Once the repairs are complete, you will be required to complete a Proof of Loss form to wrap up the claim.

3. Understanding fault

  • In some instances, more than one party involved in the accident may share fault. Someone could be considered 100% at fault, 15% at fault, 0% at fault, or anywhere in-between. No matter the condition of the road, weather, visibility, point of impact on the vehicles, actions of pedestrians, or other explanation, these rules still apply.
  • Police charges or offense do not explicitly impact your at-fault level from insurance perspective.
  • Many people believe you are only ‘at-fault’ if you are charged or get a ticket – this is not true. Fault is assigned on every accident and many accidents happen without the driver(s) being ticketed.
  • Depending on who is at fault in the claim, your premium may increase at the next policy renewal including if you are only partially at-fault. Discuss with your insurance broker for more detail.
  • Even if someone else was driving your vehicle, the accident may impact your record and affect your premium. Think of it this way: If you’re trusting someone to borrow your vehicle, you’re also trusting them to borrow your insurance policy.
  • For more information on how your Insurance provider determines fault please visit the Insurance Act and Fault Determination Rules on the Government of Ontario website.

4. What compensation can I expect?

  • The exact amount will be dependent on various factors including if you are at-fault and the exact coverage you have purchased.
  • The information provided here is general in nature. For your specific circumstance or if you are not sure, speak with your insurance broker for guidance. Below are some of the factors that will impact the amount of your compensation
  • OPCF 43 – Waiver of Depreciation
    • If you purchased your damaged vehicle new, you may have purchased the extra endorsement (opcf 43) called the waiver of depreciation. The coverage removes the insurer’s right to deduct depreciation from the value of your vehicle when settling a claim for loss or damage caused by a peril for which you are insured
    • Basically it means that if your newer car is a write-off and you have purchased this coverage, then your settlement will be based on the cost of your vehicle when it was new, essentially ‘waiving any depreciation’. Speak with your broker for specifics and details unique to your situation.
  • Write-Offs
    • If your car has significant damages then the cost of repair may be higher than the value of the vehicle itself. If this is the case, then it is commonly referred to as a Total Loss or a Write-Off.
    • If your car has been determined to be “written-off”, then your insurance company will offer you a cash settlement and not repair the vehicle.
    • Your settlement is based on many factors but commonly it will reflect the cost to replace with a vehicle of similar age, make, model, condition, vehicle mileage, used car listings in your area for similar vehicles etc.
  • Rental Car Coverage:
    • You may be eligible to receive a temporary rental vehicle while your car is being repaired. If you have purchased the extra endorsement (OPCF 20 – Car Rental), it provides a rental if you have been found at-fault for the cause of the claim. If you are 0% at-fault (not at-fault) you will also automatically be entitled to a rental during this time.
    • Car rental coverage on a policy is for “a similar substitute automobile” and typically has a limitation on how much is covered. Pay close attention to this limit so that you do not go over it. If the repairs on your vehicle are lengthy your limit may be used up leaving you on the hook for costs beyond that.
    • In situations where your car has been deemed a total loss (commonly referred to a ‘written-off’) its important to know that once an insurance company gives you a formal offer on your settlement you have only a day or two more on your car rental.
  • Paying the Deductible:
    • The amount of your deductible will be deducted from the amount you are compensated except in certain circumstances.
    • If you were deemed to be Not –at-fault, you may not need to pay the full deductible.
    • If your vehicle is damaged in a hit-and-run where the other party is not identifiable, you are responsible for the deductible if you have the coverage. This is one of the rare examples of an accident where you are not responsible but need to pay a deductible.

5. 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 

6. 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.
  • Other information which may be of interest: