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General Insurance Claims FAQs

What is No-Fault Insurance?

Each party involved in an accident reports to their own insurance company, regardless of who is at fault. "No Fault" refers to the fact that regardless of fault each person reports to their own company and companies do not sue each other to recover on certain types of losses. "No-Fault" does not literally mean that no one is "at fault". The insurance company is compelled to assess fault using the Fault Determination Rules that are part of the Insurance Act. CAA Insurance operates in Ontario, Nova Scotia, New Brunswick and PEI. The No-Fault principle exists in Ontario and in New Brunswick.

What is a reportable claim?

As part of the Ontario policy, you agree to inform us of any incident involving the automobile that must be reported to the police under the Highway Traffic Act or for which you intend to make a claim under the policy. The Highway Traffic Act of Ontario indicates that you must report any accident that involves an injury, and must report any accident in which the total damages to all vehicles and property is greater than $1000. You must notify us within 7 days after the accident, or if unable, as soon as possible after that.

In Nova Scotia, New Brunswick and Prince Edward Island, you must promptly notify us of any accident that involves injuries of damages to someone else's property or vehicle. If your own automobile is damaged and if the damage is covered by the contract, you must also notify us promptly.

If I make an Accident Benefits claim will it affect my insurance rates?

Assessment of rates for the most part is based on who is liable for the accident. Whether or not you claim for Accident Benefits once you have submitted a claim is not a factor when calculating rates.

Why do I pay my deductible?

The deductible is the amount you agree to pay toward the cost of any claim you make and the deductible, if any, is shown on the Certificate of Automobile Insurance. The deductible applies each time a claim is made and separately to each automobile that is insured. Some sections of coverage do not have a deductible. For example, if you are involved in a motor vehicle accident in Ontario involving another vehicle and the other vehicle is "at-fault" for the accident, and if the other vehicle has valid insurance you will typically not be required to pay a deductible.

What details do I get at the scene of an accident?

After an accident, it is important for you to obtain complete information on the other party or parties involved. For example,

• all vehicle information
• License plate numbers
• All names, addresses, and phone numbers
• drivers license numbers for the other involved drivers
• the location of the accident, e.g. major intersections
• police information (if they attended the scene)

If the police have attended the scene, it is reasonable to assume that they will secure much of the above information. It is important that you get the officer's name, badge number and report number so that we can get the police report.

Vehicle-Related FAQs

What is a CRC?

This is a Collision Reporting Centre.

The Collision Reporting Centre is an independently owned, police-sanctioned facility created to help motorists in reporting minor motor vehicle collisions. Drivers involved in collisions resulting in minor damage and no injuries must report within twenty-four hours to a Collision Reporting Center. The Collision Reporting Centre will inspect your vehicle and take photographs of the vehicle damage. The driver must also complete a collision report form, which is reviewed by a police officer. This service is currently available in the Greater Toronto Area, Halton and Peel regions, Barrie, and Peterborough, and is likely to expand to other jurisdictions.

What is a total loss?

If repairs to a vehicle would cost more than the Actual Cash Value of a vehicle at the time of the loss, it is considered to be a total loss.

What is Actual Cash Value or ACV?

It is our option to repair, replace or rebuild a damaged vehicle or we can simply pay for the damage. If the damage makes the vehicle a "total loss" as detailed above we will seek to pay you for your vehicle. Our obligation is to pay you Actual Cash Value which the value of your vehicle considering all aspects of the condition of your vehicle such as mileage and wear and tear as well as optional, non-standard items that might increase the value of your vehicle. Please review your policy; you may have an endorsement that extends your coverage to provide replacement cost coverage subject to certain limitations.

What are my repair options?

You have the right to repair your vehicle at the shop of your choice, since it is your vehicle. We have the right to inspect the vehicle before repairs are started. You should only choose a shop that you feel comfortable with and we can help you with that choice. We have carefully selected a number of repair shops that we will recommend to you by reason that we have a standing relationship with these shops based on years of service, quality of work, and their customer service orientation. We stand by the work done by these shops and guarantee that the repairs will be completed to an excellent standard of quality.

What is Like Kind and Quality?

Should parts of a vehicle require replacement, they would be replaced with parts that are the same quality or better than the original parts, to bring your vehicle back to its pre-loss condition. If these parts are not available and are replaced with parts of a superior quality, then a betterment charge is applied and paid by you, the policyholder. For further clarification we refer you to Statutory Condition 6(6) of the Ontario Automobile Policy or Statutory Condition 4(6) found in the S.P.F. #1 policies of Nova Scotia, New Brunswick and Prince Edward Island.

What coverage do I have for a rental vehicle?

If you have loss of use coverage, (Endorsement 20) on your policy, you are entitled to have a replacement vehicle similar to your vehicle, in the event of an accident. You will have the replacement vehicle, for the duration of the repairs or up to the limit of this coverage, which is $900.

If you are "at fault" and do not have this endorsement, you would not have coverage for a rental vehicle.

If you are "not at fault" for an accident, and you do not carry this endorsement, you will have coverage for a rental vehicle, but this coverage can only be confirmed once the investigation is complete and fault has been determined in accordance with the Fault Determination Rules.

If your vehicle is considered safely drivable, a rental vehicle will be authorized only for the time period while the vehicle is out of service, meaning during the time that repairs are actually being conducted.

What is a Collision Damage Waiver, or CDW?

This is collision damage coverage for a rental vehicle. This is required if you do not carry any optional collision coverage on your own automobile policy.

For a daily charge, this coverage is available from the rental company. You will not be reimbursed for this expense since it is coverage in excess of what your own policy provides. It is important to point out again that you do not need to purchase this additional insurance if your own policy has collision coverage and you are in a rental vehicle as a result of a claim.

Accident Benefits FAQs

What do I do if I am injured in an accident?

Notify your insurance company immediately. A trained Accident Benefits Adjuster will take you through all the steps required to process your claim.

Do I need a lawyer?

No, you do not need a lawyer. You may wish to choose representation any point throughout the claim. Your Accident Benefits adjuster is available to answers any of your questions.

Why do my medical expenses have to be submitted through my private plan first?

The law in Ontario stipulates that your automobile policy is secondary to any other health coverage available to you. However, any services not covered under such a plan that your insurance company has approved will be paid.

Is pain and suffering covered under the Accident Benefits policy?

No. Your Accident Benefits Adjuster will be able to provide you with more information.

The accident was not my fault. Why does my own insurance pay for my Accident Benefits claim?

No fault insurance is in place to ensure that you have coverage readily available to you regardless of who is at fault. Processing your Accident Benefits coverage through your own insurer allows for efficient and friendly service.

If my benefits are discontinued or reduced and I do not agree, what process do I have to go through to challenge my insurance company's decision?

You are encouraged to discuss your questions with your Accident Benefits Adjuster. If you are not able to come to a consensus you can contact the company's Ombudsman. Monica Cain 905-771-3393. For more information on the dispute resolution process please visit the automobile insurance website at www.autoinsurance.gov.on.ca, or write to The Dispute Resolution Services Branch at Financial Services Commission of Ontario Box 85 15th Floor, Toronto, On M2N 6L9 or call the mediation hotline at (416) 590-7210.