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Ontario Automobile Policy 1

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Ontario Automobile Policy
Parliament of Ontario
  • (OAP 1) Owner’s Policy
CitationVisit Regulation
Territorial extentOntario
Enacted byParliament of Ontario
EffectiveDecember 31, 1990
Administered byFinancial Services Commission of Ontario
Amends
June 1, 2016
Related legislation
Ontario Insurance Act
Summary
Standardized auto insurance policy for all private vehicles registered in Ontario
Keywords
Ontario car insurance policy
Status: In force

The Ontario Automobile Policy (OAP 1, also called the Owner's Policy) is a regulation under the Ontario Insurance Act enacted by the Parliament of Ontario to cover financial damages to persons and property after a car crash. All private companies registered to sell auto insurance in Ontario, are required to use the OAP for their private car insurance policy. The OAP is the legal contract that connects an Ontario driver with every Ontario based insurance company.

Insurance coverage is divided up between several different portions of the policy. The circumstances of the accident determine which section is used. An often misunderstood one is the Direct Compensation Property Damage (DCPD). The OAP is a "No Fault" insurance rules for accidents within the province. DCPD is mandatory to purchase, and it says insured drivers claim through their own insurance companies for repairs, rental, and tow charges, even when they are not at fault for an accident. If the at fault driver in Ontario doesn't have DCPD, then a driver is covered by Uninsured Motorist Property Damage instead (UMPD). UMPD is also mandatory to buy.

Other sections of the policy are Specified Perils and Comprehensive, which insure events like hail, theft, and vandalism. Collision covers damages from at-fault accidents and hit and runs. All Perils combines Comprehensive and Collision but adds some coverage. Each is optional to buy, however lease and car loan companies usually require Collision and Comprehensive.

The Ontario Automobile Policy does have several extra insurance pages called Endorsements. These are optional to buy. The most common are rental insurance (Loss of Use) used for Collision and Comprehensive claims, and new parts/new vehicle replacement (43 Endorsement).

In Ontario accident fault is judged according to the Ontario Fault Determination Rules. Which means whether an auto claim is covered by DPCD, or Collision, or a mixture of both, depends on how the insurance adjuster evaluates a driver's fault rating after an accident.

Needed For Insurance Coverage

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Every insurance section of the OAP has requirements that need to be met before a claim can be made under that section.

Coverage Required Section
DCPD Accident happened inside Ontario. 6.1[1]
The driver has to be at least partially not at fault. 6.4.1[2]
At least one other vehicle involved has insurance from a company licensed in Ontario, or if outside of Ontario agree to join the Ontario DCPD club. 6.1[3]
Collision/Comprehensive/All Perils The vehicle damage is not eligible under DCPD insurance coverage. 7.1.1[4]
Uninsured Motorist Neither the owner or driver of the responsible automobile have liability insurance. 5.1.2[5]
The Uninsured Automobile cannot be owned/registered to the named insured or spouse. 5.1.2[6]
Other Automobile in the accident is identified. 5.2.3[7]
Other Automobile is legally liable. 5.2.3[7]

What is covered

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Each section of the OAP coverage certain events like car crashes, vandalism, and hit and runs. Below is a summary.

Event DCPD Collision Comprehensive All Perils Specified Perils Uninsured Motorist
Car accident (at fault) no yes[8] no yes[9] no no
Car accident in Ontario (50% at fault). partial[10] (50%)[11] yes[8] no yes[9] no no
Car accident in Ontario (0% at fault). yes[10] (100%)[11] yes[8] no yes[9] no no
Car accident (not at fault) outside Ontario. no yes[8] no yes[9] no no
Car accident (not at fault) at fault driver has no insurance. no yes[8] no yes[9] no yes[12]
Hit and Run (Identified driver) yes[10] yes[8] no yes[9] no no
Hit and Run (Unknown driver) no yes[8] no yes[9] no no
Hitting the ground no yes[13] no yes[9] no no
Hitting an object on the ground no yes[13] no yes[9] no no
Turnover no yes[13] no yes[9] no no
Theft or attempted theft no no yes[14] yes[9] yes[15] no
Theft by a cohabitant no no excluded[16] yes[17] excluded[16] no
Theft by an employee no no excluded[18] yes[17] excluded[18] no
Fire no no yes[14] yes[9] yes[19] no
Lightning, windstorm, hail, or rising water; earthquake no no yes[14] yes[9] yes[20] no
Explosion no no yes[14] yes[9] yes[21] no
Riot or civil disturbance no no yes[14] yes[9] yes[22] no
Falling or forced landing of aircraft or parts of aircraft no no yes[14] yes[9] yes[23] no
Damage while in transport no no yes[14] yes[9] yes[24] no
Falling or flying objects no no yes[25] yes[9] no no
Missiles (ex. kicked up rocks) no no yes[26] yes[9] no no
Vandalism no no yes[27] yes[9] no no
Anything else not a collision - and not specially excluded. (see list below) no no yes[28] yes[9] no no

What is not covered

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Each section of the OAP coverage does not cover certain events like car crashes, vandalism, and hit and runs. Below is a summary.

Event DCPD Collision Comprehensive All Perils Specified Perils Uninsured Motorist
Damage to tires. no if caused by a collision[29] if caused by an insured peril such as fire, theft, or vandalism[30] if caused by an insured peril such as fire, theft, or vandalism[30] if caused by an insured peril such as fire, or theft[30] no
Mechanical breakdown. no if caused by a collision[31] if caused by an insured peril such as fire, theft, or vandalism[32] if caused by an insured peril such as fire, theft, or vandalism[32] if caused by an insured peril such as fire, theft[32] no
Rusting, corrosion, wear and tear, freezing, or explosion within the engine. no if caused by a collision[33] if caused by an insured peril such as fire, theft, or vandalism[34] if caused by an insured peril such as fire, theft, or vandalism[34] if caused by an insured peril such as fire, or theft[34] no
Lying about a theft, or owning an automobile. no no[35] no[35] no[35] no[35] no
Illegal disposal of the automobile. no no[36] no[36] no[36] no[36] no
A lien holder or lessor reclaiming the vehicle. no no[37] no[37] no[37] no[37] no
Selling your car, even if it was trickery or fraud. no no[38] no[38] no[38] no[38] no
Radiation damage. no no[39] no[39] no[39] no[39] no

Deductibles

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Insurance claims often come with deductibles. Either it is a percentage of the deductible purchased (100% of a $1,000.00 collision deductible) or a standard dollar deductible. Below is a summary.

Event DCPD Collision Comprehensive All Perils Specified Perils Uninsured Motorist
Car accident (at fault) no 100%[40] no 100%[40] no no
Car accident in Ontario (50% at fault*). 50%*[41] 50%[40] no 50%[40] no no
Car accident in Ontario (0% at fault*). 100%*[41] 100%[40] no 100%[40] no no
Car accident (not at fault) outside Ontario. no 100%[40] no 100%[40] no no
Car accident (not at fault) at fault driver has no insurance. no 100%[40] no 100%[40] no $300[42]
Hit and Run (Identified driver) 100%*[41] 100%[40] no 100%[40] no no
Hit and Run (Unknown driver) no 100%[40] no 100%[40] no no
Hitting the ground no 100%[40] no 100%[40] no no
Hitting an object on the ground no 100%[40] no 100%[40] no no
Turnover no 100%[40] no 100%[40] no no
Theft or attempted theft no no 100%[40] 100%[40] 100%[40] no
Theft by a cohabitant no no excluded 100%[40] excluded no
Theft by an employee no no excluded 100%[40] excluded no
Fire, lightning no no $0.00[43] $0.00[43] $0.00[43] no
Windstorm, hail, or rising water; earthquake no no 100%[40] 100%[40] 100%[40] no
Explosion no no 100%[40] 100%[40] 100%[40] no
Riot or civil disturbance no no 100%[40] 100%[40] 100%[40] no
Falling or forced landing of aircraft or parts of aircraft no no 100%[40] 100%[40] 100%[40] no
Damage while in transport no no 100%[40] 100%[40] 100%[40] no
Falling or flying objects no no 100%[40] 100%[40] no no
Missiles (ex. kicked up rocks) no no 100%[40] 100%[40] no no
Vandalism no no 100%[40] 100%[40] no no
Anything else not a collision - and not specially excluded. (see list below) no no 100%[40] 100%[40] no no

* DCPD deductibles are rarely purchased, but if done, the DCPD deductible applies for not at fault accidents.

Disputes

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Insurance company adjusters are responsible for getting accident details and interpreting the OAP. Insurance adjusters determine what accidents will be covered under what section. However, policyholders may dispute an adjusters determination by a process of appeal. Each insurance company has a difference process. The insurance representative (adjuster, broker, or agent) is responsible for advising policyholders of the procedures.[44]

Also, each insurance company has a Complaint Officer. Alternatively, the complaint can be sent to the Chief Executive Officer directly.[45] If a policyholder and insurance company do not come to an agreement, the insurance company is obligated to send a "final position letter" outlining their reasons as well as providing a policyholder with the name and details of an independent Ombudsman organization who reviews all complaints.[46] Upon receipt of an unresolved complaint with applicable paperwork and final position letter, a Complaint Officer at the independent Ombudsman organization will review and respond to all complaints.[47]

References

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  1. ^ OAP 1.S. 6.1 "The coverage under this Section applies only if the accident takes place in Ontario and at least one other automobile involved is insured under a motor vehicle liability policy.".
  2. ^ OAP 1.S. 6.4.1 "The amount we (the insurance company) pay under this Section of your policy will be determined by the degree to which you or the driver were not at fault in the accident. Responsibility for an accident is determined by the Insurance Act (Ontario) and the Fault Determination Rules. These may find you or the driver wholly or partially responsible. The degree of responsibility is expressed as a percentage".
  3. ^ OAP 1.S. 6.1 "The coverage under this Section applies only if the accident takes place in Ontario and at least one other automobile involved is insured under a motor vehicle liability policy. The policy covering the other automobile must be issued by an insurance company licensed in Ontario, or one that has filed with the Financial Services Commission of Ontario to provide this coverage.".
  4. ^ OAP 1.S. 7.1.1 "This Section applies only to the extent that a claim for damage to an automobile and its equipment would not be covered by Section 6, Direct Compensation - Property Damage Coverage of a motor vehicle liability policy.".
  5. ^ OAP 1.S. 5.1.2 "An uninsured automobile is one for which neither the owner nor driver has liability insurance to cover bodily injury or property damage arising out of its ownership, use or operation, or the insurance is not collectible.".
  6. ^ OAP 1.S. 5.1.2 "An uninsured automobile is one for which neither the owner nor driver has liability insurance to cover bodily injury or property damage arising out of its ownership, use or operation, or the insurance is not collectible. However, this does not include an automobile owned by or registered in the name of the insured person or their spouse.".
  7. ^ a b OAP 1.S. 5.2.3 "We (the insurance company) will pay for damage to and for loss of use of the automobile or its contents, or to both, that you or other insured persons have a legal right to recover from the identified owner or driver of an uninsured automobile in an accident involving an automobile.".
  8. ^ a b c d e f g OAP 1.S. 7.1.2.c "Collision or Upset - we (the insurance company) will pay for losses caused when a described automobile is involved in a collision with another object or tips over. Object includes: another automobile that is attached to the automobile,".
  9. ^ a b c d e f g h i j k l m n o p q r s t u OAP 1.S. 7.1.2.d "All Perils -this option combines the coverages of Collision or Upset and Comprehensive.".
  10. ^ a b c OAP 1.S. 6.2 "We will pay the cost of damage to the automobile, its equipment, contents and for loss of use of the automobile or contents arising from an accident for which another person would have been legally responsible in the absence of section 263 of the Insurance Act (Ontario). Section 263 takes away your right to sue the other person for these losses.".
  11. ^ a b OAP 1.S. 6.4.1 "The amount we pay under this Section of your policy will be determined by the degree to which you or the driver were not at fault in the accident. Responsibility for an accident is determined by the Insurance Act (Ontario) and the Fault Determination Rules. These may find you or the driver wholly or partially responsible. The degree of responsibility is expressed as a percentage.".
  12. ^ OAP 1.S. 5.2.3 "Claims for Certain Property Damage We will pay for damage to and for loss of use of the automobile or its contents, or to both, that you or other insured persons have a legal right to recover from the identified owner or driver of an uninsured automobile in an accident involving an automobile. Subject to the $300 deductible, we will pay up to $25,000.".
  13. ^ a b c OAP 1.S. 7.1.2.c "Collision or Upset - we (the insurance company) will pay for losses caused when a described automobile is involved in a collision with another object or tips over. Object includes: the surface of the ground, and any object in or on the ground.".
  14. ^ a b c d e f g OAP 1.S. 7.1.2.b "Comprehensive - we (the insurance company) will pay for losses, other than those covered by Collision or Upset, including: perils listed under Specified Perils,".
  15. ^ OAP 1.S. 7.1.2.a "Specified Perils - we (the insurance company) will only pay for losses caused by ... theft or attempted thef ...".
  16. ^ a b OAP 1.S. 7.2.3 "Certain Thefts Not Covered We (the insurance company) won't pay under either the Comprehensive or Specified Perils coverages for loss or damage caused when a person who lives in your household steals the automobile.".
  17. ^ a b OAP 1.S. 7.1.2.d "All Perils - this option combines the coverages of Collision or Upset and Comprehensive. This coverage includes loss or damage caused if a person who lives in your household steals a described automobile. Coverage also applies if an employee who drives or uses, services or repairs a described automobile, steals it.".
  18. ^ a b OAP 1.S. 7.2.3 "Certain Thefts Not Covered We (the insurance company) won't pay under either the Comprehensive or Specified Perils coverages for loss or damage caused when ... We (the insurance company) also won't pay under these coverages for loss or damage caused when an employee of yours steals the automobile and the employee's duties include driving, maintaining or repairing the automobile. This applies at any time, and not simply during working hours.".
  19. ^ OAP 1.S. 7.1.2.a "Specified Perils - we (the insurance company) will only pay for losses caused by fire...".
  20. ^ OAP 1.S. 7.1.2.a "Specified Perils - we (the insurance company) will only pay for losses caused by ... lightning, windstorm, hail, or rising water; earthquake ...".
  21. ^ OAP 1.S. 7.1.2.a "Specified Perils - we (the insurance company) will only pay for losses caused by ... explosion;".
  22. ^ OAP 1.S. 7.1.2.a "Specified Perils - we (the insurance company) will only pay for losses caused by ... riot or civil disturbance;".
  23. ^ OAP 1.S. 7.1.2.a "Specified Perils - we (the insurance company) will only pay for losses caused by ... falling or forced landing of aircraft or parts of aircraft; ".
  24. ^ OAP 1.S. 7.1.2.a "Specified Perils - we (the insurance company) will only pay for losses caused by ... the stranding, sinking, burning, derailment or collision of any kind of transport in, or upon which a described automobile is being carried on land or water.".
  25. ^ OAP 1.S. 7.1.2.b "Comprehensive - we (the insurance company) will pay for losses, other than those covered by Collision or Upset, including: ... falling or flying objects,".
  26. ^ OAP 1.S. 7.1.2.b "Comprehensive - we (the insurance company) will pay for losses, other than those covered by Collision or Upset, including: ... missiles,".
  27. ^ OAP 1.S. 7.1.2.b "Comprehensive - we (the insurance company) will pay for losses, other than those covered by Collision or Upset, including: ... vandalism.".
  28. ^ OAP 1.S. 7.1.2.b "Comprehensive - we (the insurance company) will pay for losses, other than those covered by Collision or Upset,...".
  29. ^ OAP 1.S. 7.2.1 "We (the insurance company) will not cover the following losses unless they result from a peril for which you are covered ... and your policy covers these perils: to tires;".
  30. ^ a b c OAP 1.S. 7.2.1 "We (the insurance company) will not cover the following losses unless they result from a peril for which you are covered or they are caused by fire, theft or vandalism and your policy covers these perils: to tires;".
  31. ^ OAP 1.S. 5.2 "We (the insurance company) will not cover the following losses unless they result from a peril for which you are covered ... and your policy covers these perils: consisting of, or caused by mechanical fracture or breakdown of any part of the automobile;".
  32. ^ a b c OAP 1.S. 5.2 "We (the insurance company) will not cover the following losses unless they result from a peril for which you are covered or they are caused by fire, theft or vandalism and your policy covers these perils: consisting of, or caused by mechanical fracture or breakdown of any part of the automobile;".
  33. ^ OAP 1.S. 7.2.1 "We (the insurance company) will not cover the following losses unless they result from a peril for which you are covered ... and your policy covers these perils: consisting of, or caused by rusting, corrosion, wear and tear, freezing, or explosion within the engine.".
  34. ^ a b c OAP 1.S. 7.2.1 "We (the insurance company) will not cover the following losses unless they result from a peril for which you are covered or they are caused by fire, theft or vandalism and your policy covers these perils: consisting of, or caused by rusting, corrosion, wear and tear, freezing, or explosion within the engine.".
  35. ^ a b c d OAP 1.S. 7.2.1 "We (the insurance company) won't pay for loss or damage: resulting from a dishonest claim of ownership".
  36. ^ a b c d OAP 1.S. 7.2.1 "We (the insurance company) won't pay for loss or damage: resulting from a ... illegal disposal".
  37. ^ a b c d OAP 1.S. 7.2.1 "We (the insurance company) won't pay for loss or damage: resulting from ... theft of the automobile by anyone who has legal possession of it under a written agreement (a mortgage, conditional sale, lease or other similar agreement);".
  38. ^ a b c d OAP 1.S. 7.2.1 "We (the insurance company) won't pay for loss or damage: resulting from a change in ownership that is agreed to, even if that change was brought about by trickery or fraud;".
  39. ^ a b c d OAP 1.S. 7.2.1 "We (the insurance company) won't pay for loss or damage: caused by radioactive contamination;".
  40. ^ a b c d e f g h i j k l m n o p q r s t u v w x y z aa ab ac ad ae af ag ah ai aj ak al am an ao ap aq ar as at au av OAP 1.S. 7.3 "The deductible is the amount you agree to pay toward the cost of any single claim you make under this Section.".
  41. ^ a b c OAP 1.S. 6.4.2 "The deductible, if any, is the amount shown on the Certificate of Automobile Insurance, multiplied by the percentage to which you or the driver of the automobile were not at fault for the accident. ".
  42. ^ OAP 1.S. 5.2.3 "Subject to the $300 deductible, we will pay up to $25,000.".
  43. ^ a b c OAP 1.S. 7.3 "If you are insured for loss or damage caused by fire or lightning, there is no deductible for these losses.".
  44. ^ FSCO [1] "If you are not satisfied with how your claim is being handled, there are steps you can take. Improved measures have been put in place to help consumers get their insurance complaints resolved more quickly. Among them is the establishment of a Complaint-Handling Protocol by all insurance companies licensed to operate in Ontario. How the complaint process works varies from company to company. Your company representative (agent, broker, claims adjuster, or customer service representative) will be able to provide you with specific information about the procedures to follow should you have a complaint."
  45. ^ FSCO [2] "For your convenience, FSCO has compiled a list of all company Consumer Complaint Officers. This list is available online at: www.fsco.gov.on.ca. If you are unable to find the name of your company's Consumer Complaint Officer on this list, you should direct your complaint directly to the Chief Executive Officer of your insurance company, or contact FSCO at: (416) 250-7250, Toll-free: 1-800-668-0128."
  46. ^ FSCO [3] "If you are unable to resolve your complaint with your insurance company, your company is obligated to provide you with a letter stating its final position on your complaint. The company's Consumer Complaint Officer will ensure that you receive a letter stating the company's final position, as well as providing you with the name and details of an independent Ombudsman organization that can review the complaint if you still do not agree with the company's final position."
  47. ^ FSCO [4] "If you decide to write to the independent Ombudsman organization referred to in your company's final position letter, make sure to describe your complaint and why you disagree with the company's position. Remember to include your company's letter and any documentation that relates to your complaint. Upon receipt of your unresolved complaint, a Complaint Officer at the independent Ombudsman organization will review and respond to your complaint. "
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