Accident benefits paid by the first party insurer under policy insuring the following classes automobile Class of automobile insured by second party insurer When does second party insurer reimburse the first party insurer? How much does the second party insurer pay? When are payments made by the second party insurer? What issues may be disputed? Reimbursements to be assigned to what part of policy? Can claim be transferred to second party insurer?
Situation 1
  • motorcycle, or
  • motorized snow vehicle
Any automobile other than a:
  • motorcycle,
  • off-road vehicle, or
  • motorized snow vehicle
When the driver of the automobile insured by it is partially or entirely at fault in the incident, according to the Fault Determination Rules (Regulation 668, R.R.O. 1990) The total amount of no-fault benefits paid by the first party insurer to its insured is calculated based on the percentage that the driver of the vehicle covered by the second party insurer was at fault in the accident, according to the Fault Determination Rules. (Note: Reimbursement is not available for the first $2,000 in no-fault benefits paid by the first party insurer.) The first party insurer should promptly notify the second party insurer using the "Notification of Loss Transfer" form.

The first party insurer may request reimbursement on a periodic basis using the "Loss Transfer-Request for Indemnification" form. Insurers may agree upon frequency of requests for indemnification.
Disputes about the responsibility of the second party insurer to provide reimbursement to the first party insurer may be referred to Arbitration under the Arbitration Act Accident Benefits No
Situation 2 Any automobile other than a heavy commercial vehicle (over 4,500 kg) A heavy commercial vehicle1 Same as above Same as above Same as above Same as above Same as above No

[1]"commercial vehicle" means, an automobile used primarily to transport materials, goods, tools or equipment in connection with the insured's occupation, and includes a police department vehicle, a fire department vehicle, a driver training vehicle, a vehicle designed specifically for construction or maintenance purposes, a vehicle rented for thirty days or less, or a trailer intended for use with a commercial vehicle. A "heavy commercial vehicle" means a commercial vehicle with a gross vehicle weight greater than 4,500 kilograms.