Société de l'assurance automobile du Québec - Claim following an accident: incomplete study of the case

A citizen who says she had a motorcycle accident filed a claim that was refused by the Société de l’assurance automobile du Québec (SAAQ).

After her accident, she did not contact the police and was taken to a hospital centre by an acquaintance. There were no witnesses to the accident. Afterwards, the citizen filed a claim for compensation, which SAAQ refused due to lack of proof.

The citizen’s complaint concerned:

• SAAQ’s refusal to recognize that she had been in a motorcycle accident and to provide her with the services in connection with this accident.

The Québec Ombudsman’s investigation revealed that:

• according to SAAQ, the citizen was unable to prove that the accident had occurred;
• she went to a hospital centre the day of the accident and was treated for scrapes and bruises sustained in a motorcycle accident;
• SAAQ had not requested a copy of the user’s record held by the hospital centre where she had been treated;
• SAAQ did not have all the information required to make a decision when it refused the citizen’s claim.

The Québec Ombudsman asked SAAQ to:

• refer to the citizen’s user’s record and review her eligibility.

SAAQ accepted and acted on the Québec Ombudsman’s recommendation. The citizen’s claim was finally accepted.