Insurance Companies Entitled To Conduct Examinations Under Oath

#AskStevenWilder

Whether you are a driver, passenger or pedestrian injured in a car accident in Ontario, you are entitled to Statutory Accident Benefits regardless of who was at fault in causing the accident.

The Car Accident Claim Filing Process

Filing a claim for accident benefits begins by notifying your insurance broker, agent or claims representative and completing an application for benefits. You could be asked by your insurance company to participate in an examination under oath as part of their investigation of your claim.

Statutory Accident Benefits claims and cooperating with the insurer

Statutory Accident Benefits payable to someone injured or killed in an auto accident include compensation for the following:

• Medical expenses
• Rehabilitation expenses
• Lost income
• Cost of hiring an aide or attendant

As a claimant under the Ontario Statutory Benefits Schedule, you must cooperate with the insurance company that is handling the claim. Among the information and documents an insurance company may request the following from you:

• Statutory declaration of the circumstances of the accident and your injuries
• Proof of identity
• Address at which you reside
• Any other information necessary for the processing of your claim for benefits

The insurer may also request your attendance at an examination under oath. A decision by the Ontario Court of Appeal removing a requirement that insurers prove justification for the examination may result in more requests in the future.

What you need to know about an examination under oath

An examination under oath is your insurer’s opportunity to question you about the accident, your injuries and other matters pertaining to your claim for benefits. The questioning begins with you being placed under oath. The questions and your answers to them are recorded and transcribed into a written transcript by a court reporter.

The law requires you to submit to an examination under oath, but there are a few restrictions on the insurance company, including:

• It must make reasonable efforts to select a date, time and location that are convenient to you.
• You must be given reasonable notice of the examination.
• Notice of the examination must include a statement of the reason or reasons for it.
• Notice of your right to be represented by a lawyer at your own expense must be included.
• The questioning must be related to your entitlement to benefits.

As a general rule, an insurer can only ask you to attend one examination under oath. If you fail to cooperate and attend, your benefits could be affected. However, once you comply, the benefits to which you are entitled must be restored.

You are excused from attending an examination under oath if your physical or mental condition makes it impossible to do so. This could occur if the injuries you suffered in the accident have not healed sufficiently to allow you to be out and about. If you are unable to attend an examination under oath, your best course of action is to contact your lawyer for advice and let him or her handle it.

Keep in mind that an examination under oath requested under the provisions of the Statutory Accident Benefits Schedule does not preclude your insurance company from requesting one under Ontario Regulation 283/95: Disputes Between Insurers. This could happen in situations in which more than one insurance company could be responsible for the payment of benefits. If this happens, you should immediately contact your lawyer for advice.

Contact a personal injury lawyer immediately

The personal injury lawyers at Diamond and Diamond have the knowledge, skills and experience to advise and represent you when applying for benefits under the Statutory Accident Benefits Schedule. Call our 24/7 injury hotline at 1-800-567-HURT or visit our website to speak to someone now about your claim. Our consultations are free, and we have offices located throughout Ontario.