What to do if you disagree with an at-fault determination from your insurance provider
Being involved in a car accident can be unsettling and stressful. Even if you’re fortunate enough to escape serious injury, your insurance company may still find you at fault, which can dramatically increase your premium.
But what if you disagree with your insurance company’s assessment that you’re the one to blame for the accident? Can you challenge the decision? In Canada, licensed auto insurance providers and governments have protocols in place that allow drivers to appeal at-fault determinations.
We’ll explain your options for disputing an at-fault assessment and where you can find more information.
Fault Determination
Auto insurance companies rely on fault-determination rules (or charts) to assign fault in an accident. These regulations make the process of establishing fault routine and straightforward. It is an insurers responsibility to determine and assign fault in every accident that occurs.
How to Dispute an At-Fault Assessment
If you disagree with your auto insurance provider’s decision that you are at fault, don’t panic you have the right to challenge their assessment.
Step one: Submit a complaint to your auto insurance company
Contact your auto insurance company directly and ask if they’d be willing to revise the decision. Ask to speak with the claims adjuster for a detailed explanation of your at-fault assessment. They can inform you which fault determination rule they applied in your file.
If you believe your complaint has merit based on the information you receive, inform your insurance provider that you wish to present new evidence and provide your side of the story. Doing so may spur them to conduct a second investigation into the accident. The result may be a revised assessment where you’re found not at fault or at least only partially responsible.
To bolster your case, submit all evidence your insurance provider might have overlooked or misjudged.
You may need the following:
- Contact details of witnesses
- Photos of accident debris
- Vehicle damage
- Tire marks
- Camera footage
- Medical reports
Step two: Contact your auto insurance company’s complaint officer
If the claims adjuster refuses to revise their assessment, the next step is to contact your auto insurance company’s complaint officer. All licensed insurance companies have an internal complaints department who will review and help to settle customer disputes. Communicate your concerns to this office and provide them with all relevant evidence and documentation. This includes records of your interactions with the claims adjuster, insurance agents, and any other individuals you spoke with.
If there’s no resolution following this process, your insurance company will provide you with a letter stating its final position on your complaint.
Step 3: Dispute your claim in court
If you disagree with the fault determination made by your insurance company, you also have the option to dispute the matter in court. This can be a valuable step if you believe the decision was unfair or incorrect. By taking the matter to court, you can present evidence, such as witness statements, expert opinions, or additional documentation, to challenge the ruling. In this case a judge would decide the outcome of the dispute by using the ordinary rule of law.
It’s important to note that Fault Determination disputes are outside of the GIO’s mandate as most provinces already have a legislated dispute resolution available to you as a consumer. If you would like to read more about our mandate and our process you can review our Terms of Reference here.
Conclusion
Being deemed at fault for a car accident can be frustrating, especially if you feel it, was an unfair decision. Thankfully, there are options available to challenge that assessment, from gathering evidence and discussing the issue with your adjuster or appealing the determination with your insurers complaints department to finally disputing the matter in court. If you would like to learn more about the options available to you contact the GIO and our team can assist you with understanding the dispute resolution process available in your province.
Additional information specific to your province or territory:
Territories (Northwest Territories, Nunavut, Yukon): In the territories, fault determination typically follows ordinary rules of common law and insurer practices, since there are no standardized provincial fault charts.
*Yukon: if the consumer feels that the “at fault rules” have not been properly applied, they could consider taking court action and potentially cite Section 90 and 91 of the Yukon Motor Vehicles Act.
British Columbia: B.C. does not use the standardized “fault determination charts” common elsewhere. Instead, Insurance Corporation of British Columbia (ICBC) applies fault rules under provincial law and internal guidelines as part of its no-fault system.
Alberta: Alberta uses its version of fault regulations as part of Direct Compensation for Property Damage-related rules under Alberta’s Insurance Act Court action – 585.1 (5)
Saskatchewan: Saskatchewan operates no-fault public auto insurance where insurers or crown corporations determine fault under general traffic and insurance rules.
Manitoba: Manitoba operates no-fault public auto insurance where insurers or crown corporations determine fault under general traffic and insurance rules.
Ontario: Ontario uses standardized Fault Determination Rules under regulations to the Insurance Act to assign fault percentages based on specific collision scenarios for example rear-end collisions or T-bone crashes. These rules provide clear diagrams and percentages and are not influenced by weather or road conditions.
Quebec: Quebec’s system relies on a Driver’s Fault Chart under the Direct Compensation Agreement (DCA) which assigns fault percentages for various collision types.
New Brunswick: New Brunswick uses Fault Determination Regulations under the Insurance Act to assign fault in car accidents.
PEI: PEI’s Automobile Insurance Fault Determination Regulations lay out specific accident scenarios and assign fault percentages.
Nova Scotia: Nova Scotia uses regulations under the Insurance Act to assign fault as part of its no-fault system.
Newfoundland: The province uses Fault Determination Regulations under the Automobile Insurance Act to assign degrees of fault.
Photo: Velito