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六。Finding fault

In Quebec and Ontario, charts or rules are used to determine fault or responsibility for "Direct Compensation -- Property Damage" claims, but not for injury claims. Ontario Insurance Act Regulation 668: Fault Determination Rules contains examples of common types of collisions and describes how fault is assigned for insurance purposes. In some other jurisdictions, insurers use inter-company "settlement" charts; these are not legally binding on the policyholder, however.

Owners of cars with drivers who are at fault (or partially at fault) in a crash often must pay higher insurance premiums if the policy is renewed. However, the insurance company may be unwilling to renew the policy if there are Criminal Code convictions and/or frequent at-fault claims.

The circumstances of a collision may show that more than one driver was negligent. Each driver's insurance company may then become involved in the settlement based on the degree of responsibility attributed to each person. If there is a dispute about responsibility, court action may be required to resolve it.


Insurance which pays for some or all of the insured person's loss, no matter who caused it, is often described as "no-fault" coverage. Despite its name, it really does matter who caused the damage, because if you are at fault, your insurance premiums may increase.


An insurance premium is the money the policyholder pays to the insurer for financial protection against specific risks for a specific timespan. Unlike the premiums for many forms of life insurance, property and casualty insurance premiums are not intended to produce a reward other than financial peace of mind.


An insurance claim is the exercising of the right of an insured person to be reimbursed by his or her insurance company for certain financial losses suffered. It can be any notification of a possible loss under an insurance policy whether or not any payment is likely to follow. For every claim that is reported, the insurance company must set aside reserves equal to its anticipated cost.


The deductible is the portion of the insured loss that you pay; the amount appears on your policy. A common collision deductible is $300. This means that you would pay $300 of any repair bill and your insurance company would pay the balance. Any damage that costs less than $300 would therefore be your own responsibility. Because cars are susceptible to frequent minor damage, it is generally more cost-effective for policyholders to "self-insure" in this way for smaller mishaps; this helps to keep premiums affordable.

There is no deductible in the case of fire or lightning or (except under Quebec policies) for theft of the entire automobile. Deductibles may apply to other types of physical damage coverages.

If a collision was not your fault, your insurer may try to recover the money it has paid, as well as your deductible (which it will refund to you), from the person responsible for the accident (except where insurers are prevented from doing so by law, as is the case in Ontario and Quebec). In these two provinces, under Direct Compensation, you will recover the portion of your deductible, to the extent that the other driver was at fault, from your own insurer.


If someone tries to gain by deliberately lying to an insurance company about even part of a claim, he or she forfeits the right to payment for the whole claim. Fraud increases everyone's insurance costs. To help keep down costs for honest policyholders, insurers prosecute those who make fraudulent claims.

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2001-12-30 -04:00
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