Which Insurer for Accident Benefits? Insurance Priority Disputes in MVA Claims

A common issue for individuals involved in car accidents is deciding which insurance company to apply to for accident benefits. Priority disputes arise when there are multiple policies that might respond to the accident benefits claim.

The following is the priority of which insurer to apply to for accident benefits, pursuant to section 268(2) of the Insurance Act:

1. Recovery from your own automobile insurer, when you are a named insured, his/her spouse or dependent;
2. Recovery from the insurer of the automobile in which you were an occupant;
3. Recovery from the insurer of any automobile involved in the accident;
4. If no other recovery is possible, Motor Vehicle Accident Claims Fund (MVACF) may consider payment as mandated by Section 6 of the Motor Vehicle Accident Claims Act (MVACA).[1]

The general rule is that if a claimant has her/his own insurance policy, has a spouse with a policy or is a dependent of someone with a policy, s/he must apply for benefits to that policy first, as it has priority.

It is only in circumstances where a claimant has no insurance policy to go to, that priority falls to the other vehicle involved in the accident.

In the event that there is no coverage, the MVACF is a claim of last resort.

Pursuant to section 268 of the Insurance Act, the first insurer that receives a completed application for benefits is responsible for paying benefits pending resolution of any priority dispute.[2] The insurer may dispute its obligation to pay benefits by giving a written notice to other insurers within 90 days of receipt of the accident benefits application, or after the limitation period under certain circumstances.[3] Priority dispute amongst insurers should not impact payment of accident benefits.

If you have been injured in a motor vehicle accident, call the team at Jasmine Daya & Co. at 416-967-9100 or contact us online to schedule a free consultation.

 

 

[1] Insurance Act, R.S.O. 1990, c. I.8, s. 268(2).

[2] Insurance Act, ibid, s. 268.

[3] Kingsway General Insurance Co. v. Ontario (Minister of Finance), 2007 ONCA 62, [2007] O.J. No. 290 (Ont. C.A.) at para. 20.