You’ve been in a car accident and sustained injuries. After completing a deluge of forms requested by your car insurer, you are now served with a Notice to Applicant of Dispute Between Insurers and wondering what it’s all about.
Background
In Ontario, insurers will sometimes argue between themselves about who is supposed to respond to your claim for Accident Benefits after you’ve been in a car accident. These are referred to as “Priority Disputes”.
If you have received a Notice to Applicant of Dispute Between Insurers it means that the insurer who you applied for Accident Benefit coverage believes that another insurer (and insurance policy) is in “higher priority” to respond to your claim. In other words, they want to transfer your claim to a different insurer.
The Law
The Insurance Act sets out which insurer is in the highest priority to respond to the claim and provide coverage. For example, you own a car and have your own car insurance. You were involved in an accident while travelling as an occupant in a friend’s car. In this case, your own auto insurer is in the highest priority to respond to your claim – not your friend’s. On the other hand, if you did not have your own car insurance (and were not a dependant on anyone else at the time) then your claim would likely be made through your friend’s car insurance policy.
Dependency
The most common source of Priority Disputes are the result of accidents involving individuals who are arguably “dependant” on a policyholder. This is because dependants of insureds can have access to Accident Benefits through policy of the person they are dependant on. Alternatively, if the individual is not a dependant then another insurer would likely be in higher priority to respond to their Accident Benefit claim.
What this means for you
Importantly, you will continue to receive Accident Benefits that you are entitled to from the insurer that you applied to while the insurers attempt to resolve their dispute in the background.
These disputes can take time to resolve. Often, as the claimant, you can provide the most important evidence to the insurers during the dispute process. For that reason, your cooperation is required. Where a priority dispute concerns the issue of dependency, the claimant and other friends/family members may be asked to write a statement or give sworn oral evidence about their life before the accident as it relates to dependency.
Giving evidence without counsel can be challenging, confusing and isolating especially if you are not well informed.
If you’ve been injured as a result of a car accident and have a question about any notice you’ve received from an insurance company, contact us to help navigate this complex area of the law.
SAMUEL DAVIES
Sam is an associate lawyer at Bergeron Clifford LLP.
His range of experience in civil litigation includes advocating in medical negligence, mental health, motor vehicle and boating accident actions, statutory accident benefits and various other personal injury matters.
