man looking at his X-ray after an accident

How Are My Medical Bills Paid After an Accident?

Date Posted:

March 8, 2023

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    In the aftermath of an accident, medical bills can pile up quickly, adding stress and uncertainty to an already difficult situation. If you have been involved in an accident, you may be wondering how these bills will be paid.  OHIP (Ontario Health Insurance Plan) doesn’t cover many medical, personal care and rehabilitation services that accident victims require. 

    In this blog, we will explore the options available to you, including insurance coverage and government programs, to help you navigate the process and ensure that your medical expenses are covered. Whether you have suffered a minor injury or a more serious one, it’s important to understand your options so that you can get the compensation you are entitled to.

    No-Fault Car Accident Benefits in Ontario

    Ontario is a modified  “no-fault” jurisdiction where individuals who are involved in a car accident are eligible for benefits through their auto insurance policy, regardless of who was at fault for the accident. This type of insurance provides individuals who have been involved in a car accident with an efficient way to receive compensation for medical expenses, lost income, and other damages without having to go through a lengthy process to determine fault for the accident.

    In Ontario, individuals who have been involved in a car accident are eligible for benefits through their own car insurance company. According to the Financial Services Commission of Ontario (FSCO), the following are the official guidelines for attendant care, as well as medical and rehabilitation expenses under Ontario’s no-fault insurance coverage rules:

    • Minor injuries: $3,500
    • Non-catastrophic injuries: $65,000
    • Catastrophic injuries: $1,000,000

    That said, there exists a grey area as to what injuries are considered to be minor, non-catastrophic, or catastrophic. This is why it is important to remember insurance companies are for-profit businesses that have a monetary incentive to downgrade your injuries to a less severe class. “Minor injuries” receive very little coverage, only $3,500, for medical and rehabilitation expenses.  To ensure your injuries are categorized appropriately after an accident, it is recommended you consult a personal injury lawyer.

    Who Pays Your Medical Bills?

    After you are injured in a car accident in Ontario, there are three entities that mightwill pay your medical bills:

    • OHIP 
      • The Ontario Health Insurance Plan (OHIP) pays for your hospital expenses. This can include inpatient and outpatient services. It may also include certain medical surgical, and diagnostic services like X-rays and MRI scans, and other medical procedures.
    • Group Health Insurance Company
      • Some people are fortunate and have group health insurance benefits and long-term disability benefits through their employer.  These plans vary widely in the coverage that they provide.
    • Car Insurance Company
      • The insurance companies will cover medical expenses that are not covered through the Ontario Health Insurance plan up to the amounts we detailed above.
    • Government of Ontario – Ministry of Health and Long-Term Care
      • Some Medical treatment, rehabilitation services, and other associated medical costs are covered by the Ontario Ministry of Health and Long-Term Care.

    If you have medical expenses beyond those covered by the Ontario Health Insurance Plan, your group insurance, car insurance and the Ontario Ministry of Health and Long-Term Care, you will have to cover those expenses yourself. However, if you can prove that another person was at fault for the accident, you may be able to submit a successful claim or lawsuit and receive compensation to cover your additional medical expenses. In this case, you would need to hire a personal injury lawyer and take legal action against the responsible party.


    Filing a Claim to Have Your Bills Paid by the Person or Party At Fault

    lawyer sitting at desk doing research for an accident claim

    Car accidents can have severe and long-lasting effects on your health, which is why accident victims often incur medical expenses that are not covered by no-fault car insurance. As a result, it is important to take the necessary steps to put yourself in a position to file a lawsuit ( tort claim), should you need to.

    Gather Your Evidence

    In the event of a car accident, gathering evidence is a crucial aspect of the process of the claim process. It is important to capture the scene through photographs, gather the personal details of any witnesses, and secure a copy of the police report, if possible. You should also write down your recollection of events while the details are still fresh in your mind.

    Getting the compensation you deserve largely rests on your ability to prove the other person was at fault and that they caused the injuries and damages you sustained. Gathering as much information as possible from the scene will give you more material to potentially use to prove your case.

    Beyond the scene of the accident, it is advisable to keep track of any medical expenses, time off work, and other consequences you suffered as a result of the accident. This information will not only help you understand the full financial impact of the accident but also be helpful when making a claim for compensation.

    Hire a Lawyer

    If you have not already done so, it is recommended you hire a lawyer to help you pursue your claim. Personal injury lawyers are familiar with the processes involved in these sorts of cases and can help guide you as you seek the compensation you deserve. Reputable law firms generally offer free consultations. Take advantage of these sessions to get a better sense of your options and verify that the lawyer is a good fit for you.

    File Your Lawsuit

    When the time comes to initiate legal proceedings, you will submit your lawsuit to the Ontario Superior Court of Justice. We recommend that you have a lawyer involved in your case early int he process so that when the time comes to file your lawsuit your lawyer is familiar with your injuries and your family and work situations.

    McNally Gervan Can Help You Through This Difficult Time

    The aftermath of an accident is a whirlwind that often overwhelms victims and causes them to miss out on opportunities to secure compensation for the medical treatment they receive. While this is understandable given how severe accidents can be, it does not have to be the case.

    At McNally Gervan, our lawyers are dedicated to assisting innocent accident victims in getting the compensation and insurance benefits they are entitled to. With experience in personal injury, life insurance and long-term disability cases, our lawyers have the expertise to help you through this difficult time. Contact us now for a free consultation