No-Fault Accident Benefits
Every automobile policy in Ontario contains mandatory accident benefits coverage. A list of available benefits is set out in the Statutory Accident Benefits Schedule (SABS).
To get access to these benefits you must notify your insurance company within 7 days of the accident, or as soon as possible after that. You must file the complete application forms with your insurance company within 30 days after receiving them.
Income Replacement Benefits
You may be entitled to receive weekly income replacement benefits (excluding the first week) if you suffer injuries in an accident. You will not receive income replacement benefits for the first 7 days after a collision. Then, as long as you qualify, you can receive 70% of your gross weekly income less any benefits you may be entitled to from other insurance policies or employment plans.
You can receive a maximum of $400 per week unless you purchased optional coverage.
If you qualify for these benefits they are available to you up to age 65 and then they start to reduce on a gradual basis.
Medical and Rehabilitation Benefits
The insurance company may be required to pay all of the reasonable expenses incurred as a result of your accident, including:
- (i) medical, hospital and nursing care not covered by OHIP;
- (ii) chiropractic, psychological and occupation therapy;
- (iii) medication, prescription eyewear, dental devices and medical aids;
- (iv) transportation over and above 50 kilometers to and from treatment sessions;
- (v) social and vocational rehabilitation;
- (vi) home renovations and modifications.
Attendant Care Benefits
If you have been injured in an accident, your insurance company may be required to pay the cost of providing for an aide or attendant.
You may be able to receive up to $3000 per month in attendant care for two years, up to a maximum of $36,000. If you have purchased optional coverage you can receive up to $72,000 or $1,072,000.
In your injury is catastrophic, you can receive up to $1,000,000 for attendant care.
If, at the time of the accident, you were not working but were enrolled in school or had completed your education during the year prior to the accident and were not employed in a job that reflected your education, you may be entitled to a non-earner benefit. You are only entitled to this benefit if you suffer an injury that creates a complete inability to carry on a normal life and are over 16 years of age.
The amount of the non-earner benefit is $185 per week. However, nothing is payable for the first 26 weeks after the accident. If you were enrolled in school or had completed your education in the year prior to the accident, you are entitled to a non-earner benefit in the amount of $320 per week after the first 104-week period has expired.
You may be entitled to a caregiver benefit if your injury is considered to be catastrophic and you were living with and were the primary caregiver for a person in need of care and were not being paid for those activities.
The maximum amount of the caregiver benefit is $250 per week for the first person in need of care plus $50 per week for each additional person.
Expenses of Visitors
If your family members and other individuals who were living with you at the time of the accident visit you, they are entitled to payment of all reasonable and necessary expenses incurred as a result of the accident during your treatment or recovery. There is no payment after 104 weeks unless the injury is catastrophic.
You can receive $100 per week for all reasonable expenses for housekeeping and home maintenance, if your injury is considered to be catastrophic. If you purchased optional coverage, you can receive $100 per week for all reasonable expenses for housekeeping and home maintenance, regardless of the injury you have sustained.