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What Happens When an Insurance Claim is Made Against You?


Date Posted:

March 26, 2024

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    If you’re caught up in the aftermath of a car accident and facing a personal injury case, it’s crucial to understand the whole picture, especially what happens when an insurance claim is made against you. 

    In this blog, we’ll simplify the process of car insurance claims in Ontario, dive into the specifics of when a claim is made against you, and discuss how it can impact your life. We’ll also highlight the importance of legal support to guide you through. Our aim is to make navigating these waters as straightforward and stress-free as possible. 

    Understanding Insurance Claims

    In Ontario, car insurance policies act as a safety net, safeguarding financial interests of drivers in the event of a car accident. These policies are designed to cover various expenses associated with accidents, including but not limited to vehicle repairs, medical treatments, and potential legal liabilities. The essence of auto insurance lies in its ability to mitigate the financial strain accidents can impose on individuals, so that a moment of misfortune doesn’t lead to a lasting financial burden.

    Understanding how insurance coverage works in Ontario requires familiarity with its modified”no-fault” insurance system. This system ensures that, regardless of who is at fault in an accident, your own insurance company will cover your vehicle damage and certain medical claims.. It simplifies the claims process and provides immediate financial assistance for recovery, without the need to determine fault. However, this does not preclude the possibility of pursuing a claim against the at-fault driver for more serious injuries or damages not covered by the car insurance policy.

    The Process When a Car Insurance Claim is Made Against You

    When an insurance claim is made against you in Ontario, the process typically unfolds as follows: 

    Notification to Your Insurance Company

    The process begins when you’re notified of a claim against you, either directly by the claimant or by an insurance agent. It’s important to inform your insurance provider immediately upon receiving notice of a claim. This early notification allows your insurer to start their process and ensures that you’re compliant with your policy’s requirements.

    Investigation by the Insurance Company

    Once notified, your insurance company undertakes an investigation to gather facts about the accident. This may involve reviewing police reports, interviewing witnesses, and examining the accident scene. The goal is to ascertain the circumstances of the incident and determine liability.

    Assessment of Claims by an Insurance Adjuster

    Insurance adjusters play a central role in evaluating the claims made against you by the other driver. They assess the seriousness of the injuries reported to determine the potential compensation amount. Adjusters consider the evidence collected during the investigation to make an informed decision.

    Role of Your Own Insurance Versus the Other Insurance Company

    In Ontario’s modified “no-fault” system, your insurance company covers your losses, while the claimant’s insurer handles theirs. However, if you’re deemed at fault for causing serious injuries, your insurer may need to compensate the other party. 

    Typically when a claim is made against you, negotiations ensue as both parties try to reach an equitable settlement.

    Potential Outcomes of the Claims Process

    The claims process can culminate in several ways, including a settlement agreed upon by both parties or, if an agreement can’t be reached, legal action. Settlements are the most common outcome because they resolve the claims efficiently and avoid the complexities of court proceedings. However, if disputes over liability or the actual cash value of compensation amounts persist, the matter may escalate to litigation, where a court will determine the outcome. In such cases, the support of a lawyer to protect your rights and interests can be invaluable. In Ontario, your auto insurance company has the right to hire a lawyer to defend you and they will handle the litigation process and any settlement negotiation for you.

    The Impact of the Claim on Your Insurance

    When a claim is made against you for negligent driving causing injuries or for driving infractions causing collisions, it often leads your insurance company to evaluate your risk profile. Most insurance companies view a claim as an increased risk, which can result in higher premiums or changes in your coverage terms during renewal. This practice is based on statistical analyses that correlate the likelihood of future claims with past incidents.

    Legal Assistance in Insurance Claims

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    Dealing with the fallout from a car accident becomes even more challenging when a claim is filed against you. In such situations, it is wise to notify your insurance company immediately of a potential claim or notice letter from the other driver.  

    Whether it’s disputing unfounded claims, arguing for a fair assessment of damages, navigating the intricate legal and insurance protocols, or defending you in court, an experienced lawyer levels the playing field. 

    McNally Gervan – Protecting Your Interests, No Matter What Comes Your Way

    Whether you’re dealing with a car insurance claim, a life insurance claim, a claim for a fatal injury, or any other personal injury matter, McNally Gervan can help. Through years of experience in the field, we have developed strategies that put you in position to achieve a favourable outcome in your case. Contact us today to set up a free consultation.