No Fault Insurance Ontario

No-fault insurance is a type of auto insurance system where each driver’s own insurance company covers their losses and injuries, regardless of who is at fault in an accident. This approach simplifies the claims process and provides quicker access to benefits for policyholders.

Before the introduction of no-fault auto insurance, claimants who had suffered injuries or loss in an automobile accident sued each other to recover from the other party’s insurer. This was referred to as the tort system. 

Under the old tort system, claimants often faced lengthy wait times to receive settlements. This made it challenging for injured individuals to get timely medical treatment, and the auto claim process of repairing or replacing automobiles was delayed and burdensome. 

The no-fault insurance system was established to replace the adversarial tort system, which relied on court-awarded compensation. The goal of the no-fault system was to make it easier and faster for the consumer or claimant to receive compensation for their damages or loss. 

When did no-fault insurance start in Ontario?

In June 1990 the Ontario government under the NDP regime legislated a partial no-fault insurance system designed to replace the tort system that was in place at the time. The legislation has been modified several times since it was first introduced to balance equitable consumer and insurance industry needs. 

With the introduction of no-fault insurance, a new type of auto insurance coverage was implemented: Direct Compensation Property Damage. 

How does No-Fault Insurance work in Ontario?

The no-fault insurance system was designed to replace the contentious tort system, which depended on court-awarded compensation. Under Ontario’s no-fault auto insurance system, the following takes place:

• Claimants who experience bodily injury or property damage file their claims directly with their own insurance company, regardless of fault. 
• Automobile legislation has implemented a schedule of no-fault accident benefits for bodily injury, with specified limits paid by the injured party’s insurer. These benefits are now referred to as accident benefits. 
• For property damage where the insured is not at fault, their insurer provides compensation under Direct Compensation Property Damage (DCPD) coverage.
• If the insured is at fault, the insurer will provide compensation through optional loss coverage, such as collision or all perils coverage.
• Drivers involved in automobile collisions can expedite the claims process and receive prompt compensation.
• Claims are resolved out of court because benefits are established as rights rather than contested items.
• Insurers incur lower costs, and insured individuals pay lower premiums, due to reduced legal fees and court costs in resolving claims.  

What are the benefits of no-fault insurance in Ontario?

The benefits of no-fault insurance in Ontario include the following:

Faster claims processing

Claims are managed by the claimant’s own insurance company, which streamlines the settlement process, making it more efficient and predictable. This allows claimants to receive prompt compensation, enabling timely medical treatment and vehicle repairs.

Simplified Claims Resolution

The claims process is simplified and non-adversarial, with settlements based on established rights rather than court decisions. Benefits for injuries are outlined in an easy-to-understand schedule of accident benefits, while Direct Compensation Property Damage (DCPD) covers property damages.

Reduced Legal and Court Costs

With fewer disputes taken to court, legal fees and court costs are significantly reduced.

Predictable Benefits  

Benefits for bodily injury have been standardized and scheduled to provide clear, reliable, and consistent coverage, known as accident benefits.

Focus of Rehabilitation

Quick access to benefits ensures injured parties can focus on recovery without the financial stress of delayed compensation. The benefit schedule is comprehensive and designed to support the recovery process.

Financial Stability

Reduced litigation costs and predefined benefits minimize the uncertainty of fair and timely compensation, contributing to overall expense control.

Can you sue with no-fault insurance in Ontario?

Under certain circumstances, the Ontario no-fault system allows for legal action. If the injuries sustained in a motor vehicle accident are severe enough, you can initiate a legal tort action. The injuries must involve serious and permanent impairment of either physical or psychological function.

Can you sue for Pain and Suffering under Ontario’s no-fault auto insurance system?

You can sue for pain and suffering if your injury meets the criteria for a serious and permanent impairment, known as the threshold.

Can you sue for loss of income under Ontario’s no-fault auto insurance system?

To sue for loss of income, your injuries must meet the threshold of being serious and permanent. This includes serious disfigurement or permanent impairment of an important physical, mental, or psychological function.

How are property and vehicle damages dealt with under No-Fault insurance in Ontario?

Under Ontario’s no-fault insurance system, property and vehicle damages are managed through your own insurance policy, regardless of who caused the accident. 

Coverage

The coverage provided for the loss or accident depends on the degree of fault assigned to you by the insurance company, which can range from 0 to 100%.

Direct Compensation Property Damage (DCPD) coverage will be used for the percentage you are not at fault. For the percentage you are at fault, collision or all perils coverage (if purchased) will be applied.

For example, in a 50% at-fault accident, DCPD will cover 50% of the loss, while the remaining 50% will be covered by collision or all perils coverage. Additionally, your deductible for the collision or all perils coverage would be reduced by 50%.

Fault Assessment

No-fault insurance does not absolve you from responsibility in the event of a motor vehicle accident in Ontario.  Insurance companies use the Fault Determination Rules to assess each driver’s responsibility percentage. Fault Determination Rules are a set of regulations used by insurance companies in Ontario to determine and assign fault in motor vehicle accidents. These rules help determine the degree of responsibility each driver holds in an accident and are based on various common accident scenarios.

Is no-fault the same as a liability?

No-fault insurance differs from liability or negligence. It’s a system where drivers claim compensation for injuries and property damage directly from their own insurance company, regardless of who caused the accident. However, it doesn’t exempt drivers from liability or fault assessments. Insurance companies rely on the Ontario Fault Determination Rules to determine and assign fault in accidents.

Is no-fault the same as DCPD?

No-fault insurance is a system of auto insurance compensation based on improving the consumer experience by simplifying the claims process and ensuring quicker compensation. DCPD is a component of no-fault insurance that specifically covers property damage to your vehicle when you’re not at fault for the accident.

Who pays the deductible in no-fault insurance?

In no-fault insurance, drivers typically pay their own deductible for vehicle damages, regardless of who caused the accident. If you’re not at fault, the deductible is usually $0 under Direct Compensation Property Damage (DCPD). If you’re at fault, you pay the deductible amount you selected when purchasing your optional loss coverage. The degree of fault determines which coverage applies and how much deductible you need to pay.

Example 1: If the total damages are $10,000 and you have a $1,000 deductible for All Perils or Collision coverage, being found 50% at fault means your deductible would be $500. This is because $5,000 of the $10,000 total loss is covered by Direct Compensation Property Damage (DCPD), which typically has no deductible. The other $5,000 is covered by your All Perils or Collision coverage, and since you’re 50% at fault, you only pay 50% of your $1,000 deductible, which is $500. 

Example 2: If you are 100% at fault for an incident, your optional loss coverage, such as Collision or All Perils, will cover the loss. The full deductible for this coverage will be applied to the claim settlement amount.

If you have a $1,000 deductible on your Collision or All Perils coverage, you would pay the first $1,000 towards the loss, and the insurer would cover the remaining amount. For damages totalling $10,000, you would pay $1,000, and the insurer would pay $9,000.

Example 3: If you’re 0% at fault for an accident, your Direct Compensation Property Damage (DCPD) coverage would fully cover the damages, and your deductible would be $0. For $10,000 in damages, DCPD would cover the entire amount, and you wouldn’t need to use your All Perils or Collision coverage.

The following table demonstrates how fault in an accident impacts the distribution of coverage and deductible payments under no-fault insurance in Ontario. It assumes total damages of $10,000 and a $1,000 deductible for Collision or All Perils coverage. The table shows the proportion of damages covered by Direct Compensation Property Damage (DCPD) and Collision or All Perils, as well as the deductible amount you would pay based on your percentage of fault.

Total Property Damages of $10,000 and Deductible of $1,000 Chart

This breakdown illustrates how varying degrees of fault influence the distribution of damages and the deductible amount you need to pay.

Drawbacks of no-fault auto insurance in Ontario

No-fault insurance has sparked controversy and skepticism regarding its purported benefits. 

Drawbacks of no-fault auto insurance in Ontario include:

Limited Legal Recourse

Under the no-fault system, drivers have limited ability to sue for pain and suffering unless the injuries meet a certain severity threshold. Claimants are also limited in the amount of compensation they can receive for specific types of damages

Potential for Higher Premiums

Since drivers claim directly from their own insurance company, there may be an increase in the number of claims filed, driving up costs for insurers. The cost of administering auto claims rises and is passed on to the consumer.  

Fraud and abuse can also occur due to inflated repair costs and exaggerated medical and rehabilitation treatments.

Reduced Incentive for Careful Driving

Some argue that no-fault insurance diminishes the incentive to drive safely and cautiously since drivers know their insurance will cover their damages regardless of fault.

How much will my insurance go up with a no-fault accident in Ontario?

Auto insurance premiums in Ontario remain unaffected by claims determined to be not at fault. However, accumulating too many not-at-fault claims may affect your eligibility for coverage with specific insurance companies.