Glossary

Insurance terms explained

Ontario motorists must have the following standard coverages: Liability, Accident Benefits, Uninsured Automobile, and Direct Compensation – Property Damage. You may also purchase additional insurance for loss or damage to the automobile and Optional Increased Accident Benefits. This is a brief explanation of the insurance coverage available to you. For complete details, please consult your policy. Your Insurer will supply you with a copy of the policy if requested.

Liability

Provides coverage for you or other insured persons if someone else is killed or injured or their property is damaged in an automobile incident. It will pay for legitimate claims against you or other insured persons up to the limit of your coverage as well as the cost of settling claims.

Accident Benefits

Provides benefits that you and other insured persons may be entitled to if injured or killed in an automobile accident. These benefits include: income replacement for persons who have lost income; payments to non-earners who suffer complete inability to carry on a normal life; payment of care expenses to persons who cannot continue to act as a primary caregiver for a member of their household; payment of medical, rehabilitation, and attendant care expenses; payment of certain other expenses; payment of funeral expenses; and payments to survivors of a person who is killed. You may also purchase optional benefits to increase the standard level of benefits provided in your policy.

Your insurance company is obligated to explain your Accident Benefits coverage to you in detail.

The optional benefits your insurance company must offer are:

Increased Income Replacement

The standard level of income replacement provided in the policy ($400 per week maximum) may be increased by purchasing optional coverage so that the weekly limit is up to $600, $800 or $1,000. All income replacement benefits are based on 70% of your gross weekly income.

Increased Medical, Rehabilitation, and Attendant Care

The standard benefit pays up to $65,000 for medical, rehabilitation, and attendant care expenses with a 5 year limit in most cases. If catastrophically impaired, the standard benefit pays up to $1,000,000 for medical, rehabilitation, and attendant care expenses. You may purchase an optional medical, rehabilitation, and attendant care benefit of $130,000 or $1,000,000.

Additional Catastrophic Impairment

You may purchase an optional catastrophic impairment benefit of an additional $1,000,000 added to the standard medical, rehabilitation, and attendant care benefit OR the optional increased medical, rehabilitation, and attendant care benefit.

Caregiver Benefit, Housekeeping, and Home Maintenance Expenses

The standard benefit for caregiver benefit, housekeeping, and home maintenance expenses is available only for a person who is catastrophically impaired. You may purchase an optional benefit to provide these coverages for other impairments.

Death and Funeral

The standard level of death benefits paid to the surviving spouse and dependant of a person who is killed ($25,000 to a surviving spouse and $10,000 to each surviving dependant) may be doubled by purchasing this optional coverage. This coverage also increases the standard funeral expense benefit from $6,000 to $8,000.

Dependant Care

There is no standard dependant care benefit. You may purchase an optional benefit to receive weekly dependant care expenses of $75 for the first dependant, and $25 for each additional dependant, up to $150 per week, for employed persons not receiving a weekly caregiver benefit.

Indexation Benefit

This optional coverage will ensure that certain weekly benefit payments and monetary limits will be adjusted on an annual basis to reflect changes in the cost of living.

Uninsured Automobile

Provides coverage if you or other insured persons are injured or killed by an uninsured motorist or by an unidentified (e.g. hit-and-run) driver. It also covers damage to your automobile and its contents caused by an identified, uninsured motorist, subject to a $300 deductible.

Direct Compensation – Property Damage

Provides coverage in Ontario, under certain conditions, for damage to your automobile and to property it is carrying, when another motorist is responsible. It is called Direct Compensation because you will collect from us, your insurance company, even though you are not at fault for the accident. There may be a deductible amount and this amount is either paid by you toward the cost of repairs or is deducted from the loss settlement. Higher deductibles may reduce your premium.

Loss or Damage

Provides a selection of optional coverages for your own automobile. Payments cover direct and accidental loss of, or damage to, a described automobile and its equipment. There is usually a deductible amount indicated for each coverage and this amount is either paid by you toward the cost of repairs or is deducted from the loss settlement. Higher deductibles may reduce your premium. There are four types of coverages as seen below (Specified Perils, Comprehensive, Collision or Upset, All Perils):

Specified Perils

Covers the described automobile against loss or damage caused by certain specific perils. They are: fire; theft or attempted theft; lightning, windstorm, hail or rising water; earthquake; explosion; riot or civil disturbance; falling or forced landing of aircraft or parts of aircraft; or the stranding, sinking, burning, derailment or collision of any kind of transport in, or upon which, the described automobile is being transported.

Collision or Upset

Covers damage when a described automobile is involved in a collision with another object or tips over.

Comprehensive

Covers a described automobile against loss or damage other than those covered by Collision or Upset, including perils listed under Specified Perils, falling or flying objects, missiles and vandalism.

All Perils

Combines the Collision or Upset and Comprehensive coverages.

Additional definitions:

Building

‘Buildings’ include all fixed structures on the premises, any additions and extensions, permanent fittings/fixtures, materials, maintenance equipment, repairs, minor alterations or building services, and decorative trees, shrubs, and plants inside of the building. Limited coverage (by way of extension) is provided for growing plants, trees, shrubs, and flowers out in the open. Debris removal, as well as the removal of debris blown in due to windstorm, are covered (as extensions) subject to certain limitations. Certain building attachments may be limited to Named Perils.

Stock

‘Stock’ includes merchandise, packing, wrapping, advertising materials, and similar property of others if the insured is obligated to insure or is legally liable. Extensions can provide limited coverage for building damage due to theft, for the temporary removal of property in order to prevent loss (or further loss), and debris removal. Certain classes of property may be subject to a sub-limit and/or Named Perils. If stock is insured separately, a premium adjustment is available upon the filing of an application within six months of the anniversary date of the insurance policy.

Equipment

‘Equipment’ includes all contents specific to the insured business, with the exception of stock; ie. (1) furniture, furnishings, fittings, fixtures, machinery, tools, utensils, and appliances; (2) similar property of others if the insured is obligated to insure or is legally liable; and (3) tenant improvements made at the expense of the insured, provided the insured is not the owner of the building. Extensions can be provided on a limited basis for (1) personal property of officers and employees; (2) building damage due to theft; and (3) growing plants, trees, shrubs, or flowers out in the open. Subject to certain limitations, extensions also provide coverage for the temporary removal of property in order to prevent loss (or further loss), debris removal, and the removal of debris blown in due to windstorm.

*For purposes of the Insurance Companies Act (Canada), this document was issued in the course of the insurance company’s insurance business in Canada.

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