Insurance Issues – Optional Benefits

by | Jun 13, 2016 | Insurance Issues

Insurance Issues – Optional Benefits

The foremost question in a customer’s mind when buying car insurance is “how much will it cost?” Of course, that is an important question, but it is not the only important question.

Ontario courts have made it very clear that insurance brokers must provide sufficient information about optional benefits to ensure that the customer is given all possible options to allow him or her to assess the need for more coverage against risk and cost.

The duty of the agent or broker to properly explain available insurance benefits will vary from case to case, but must include a clear explanation of the benefits and a consideration of the client’s particular circumstances. The explanation must be meaningful and more than a trivial attempt.

For instance, your insurance broker must take the time to properly explain Statutory Accident Benefits and Optional Benefits to you and your family members when you renew your car insurance policy. There are Optional Benefits that increase the amounts available for medical treatment and attendant care, and that provide for housekeeping and home maintenance as well as care giving.

When it comes to automobile insurance, the Ontario government introduced dramatic changes to the Statutory Accident Benefits Schedule in a historic legislative change in September 2010. It severely reduces no-fault accident benefits available to the vast majority of motor vehicle accident victims in Ontario. There are many other changes made to the basic automobile insurance policy since that date that have significantly reduced the benefits available to accident victims.

Consumers must consider more than just the price of automobile insurance.It is perfectly Ok to tell the broker your situation and ask questions to ensure that the auto policy you are buying is right for you and your family.

Insurance agents and brokers need to be aware that merely mentioning optional benefits without explaining them may leave them liable if the customer is without sufficient coverage following an accident. Thus the onus is on the broker to be sure that the client understands the coverage that they are accepting and its relevance to their life circumstances.

If you feel you have suffered as a result of your broker not fully explaining the optimal benefits coverage, you are within your rights to file a lawsuit. In order to pursue a claim against an insurance agent or broker for withholding sufficient insurance details, you need to prove two things: that the broker failed to properly offer optional benefits and that you would have purchased the optional benefits had they been properly offered.

To learn more about filing a lawsuit for insufficient optional benefits coverage against an insurance agent, contact Mackesy Smye, Hamilton’s trusted legal firm.


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