Managing your recovery: A self-advocacy guide |Ontario

A sudden injury or illness of a family member or a close friend can be overwhelming. Added to the stress is the uncertainty related to health care options. Whether injured in a motor vehicle accident, a work place incident or by the negligence of someone else’s action, the health care decisions that you make may have a long-term effect.

With accident benefits claims following a motor vehicle accident or disability insurance claims, some decisions will involve your immediate needs and others will involve your continuing and future care needs.

It is important to understand who is responsible for paying for health care so that you can make the appropriate applications and ask questions of health professions, insurance adjusters, and lawyers. With the correct information, an understanding of the funding system and with appropriate supports you will be able to achieve optimal recovery

Basic health care is funded by provincial and federal taxes by way of:

• Ontario Health Insurance Plan (OHIP); and
• Ministry Programs.

The funding that is available will depend on:

• how and when the injury occurred;
• whether additional health care coverage has been purchased; and
• socio-economic status.

Insurance companies provide additional health care programs that are privately funded.

These services can include:

• Workplace Safety and Insurance Board (WSIB);
• Private Supplementary Health Plans;
• Motor Vehicle Accident Insurance; and/or
• other private funded insurance packages.

The goal of this self-advocacy guide is to educate the reader, foster an understanding of one’s legal rights and identify the obligations of public, private and workplace insurance programs. By being knowledgeable, the reader will be able to make informed decisions about health care options and funding, be able to advocate for the best outcome and/or be compensated accordingly.