Statutory Accident Benefits In Ontario

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Statutory Accident Benefits In Ontario

Injured In A Car Accident? You Are Entitled To Accident Benefits.

In Ontario, all victims of auto accidents are eligible to receive accident benefits.

However, determining the benefits you are eligible for and successfully filing a claim to your insurer can be confusing and overwhelming. That’s why De Rose Lawyers has a dedicated Accident Benefits team with over 40 years of combined statutory accident benefits experience.

What Are Statutory Accident Benefits?

If you are seriously injured in an auto accident, Statutory Accident Benefits help pay for medical and rehabilitative expenses, over and above OHIP and will provide some monies to augment any income that has been lost.

The Statutory Accident Benefits (SABS for short) is included with all basic automobile insurance policies issued in Ontario.

Accident benefits are paid through your own auto insurance provider, or the provider of the vehicle you were a passenger in. If you were a pedestrian, and uninsured, you would receive accident benefits from the insurance company of the vehicle that struck you. If you are a pedestrian and struck by an automobile that is uninsured, you would claim benefits from the Motor Vehicle Accident Claims Fund administered by the province of Ontario.

Types of Statutory Accident Benefits

Income Replacement, Non-Earner and Caregiver Benefits

Income Replacement Benefits

  • If you can’t work as the result of an auto accident, you may be eligible for weekly income replacement benefits of 70% of your gross income up to $400/week.
  • Optional increases of up to $1000/week.

Caregiver Benefits

  • If you can no longer provide full-time care to a dependant (child or other) as a result of a catastrophic injury, you may be eligible for caregiver benefits to reimburse you for expenses to hire someone to take over for you.
  • Optional coverage is available to extend to all injuries.

Non-Earner Benefits

  • If your injuries prevent you from carrying on a normal life, and you don’t qualify for income replacement benefits or were a full-time student at the time of the accident, you may be eligible for non-earner benefits of $185/week.

Medical, Rehabilitation, and Attendant Care Benefits

Medical and Rehabilitation Benefits

  • Covers costs such as physiotherapy, prescriptions, chiropractic care, counseling, and transportation to medical appointments not covered by OHIP or your group insurance plan, but which are listed in the Statutory Accident Benefits Schedule.

Attendant Care Benefits

  • If you’ve been seriously injured in an auto accident, this helps cover costs should you require an attendant to care for you, either at home or in a healthcare facility.
  • The combined mandatory minimum coverage for Medical, Rehabilitation and Attendant Care Benefits is $65,000 for non-catastrophic injuries (fractures, sprains, etc.), and $1M for catastrophic injuries (loss of limb(s), quadriplegia/paraplegia, etc.).

Optional Coverage

  • You can increase benefits to $130,000 for non-catastrophic Injuries, or
  • Increase $1,000,000 for all injuries, for a total of $2,000,000 for Catastrophic Injuries, and
  • Increase combined all injury benefit to $1,000,000 and Increase Catastrophic Injuries to $2,000,000

Death and Funeral Benefits

If you die as a result of an auto accident, benefits include payments of:

  • $25,000 to your spouse
  • $10,000 to each of your dependants
  • A maximum of $6,000 for funeral expenses

Optional Coverage

Benefits may be increased to:

  • $50,000 to your spouse
  • $20,000 to each of your dependants
  • $8,000 for funeral expenses

Other Expenses

Lost Educational Expenses

  • For those who can’t continue studies in an elementary, secondary, post-secondary or continuing education program as a result of injuries from an auto accident.
  • Covers expenses incurred before the accident, such as for tuition, books, equipment, and lodging, for a maximum benefit of $15,000.

Expenses of Visitors

  • Reasonable and necessary expenses incurred by some of those closest to you when they visit you during your treatment or recovery. This includes your spouse, children, grandchildren, parents, grandparents, siblings, certain other dependants and guardians, and those living with you at the time of the accident.
  • Expenses can be claimed for a maximum of 104 weeks after the accident, unless injuries are catastrophic.

Housekeeping and Home Maintenance Expenses

  • If you experience catastrophic injuries in an auto accident and need to hire someone to carry out your housekeeping or home maintenance responsibilities, you are eligible for up to $100/week.

Optional Coverage

  • Benefits may be extended to include all injuries.

How Do I Make An Accident Benefit Claim?

  • To file a claim, you must notify your insurance company immediately of the accident.
  • If you do not have an insurance company, you should notify the insurance company of the other vehicle(s) involved in the accident.
  • If you were self-employed at the time of the accident, you must be able to prove your income in order to receive benefits.
  • Additionally, certain accident benefits claims processes may require you to provide a sworn statement to a representative of the insurance company about the circumstances of the car accident and the injuries you suffered as a result.

Need Help With Your Accident Benefits Claims?

Navigating the legal process to obtain accident benefits can be confusing and overwhelming. Between recovering from your injuries, dealing with insurance companies, and struggling with medical expenses, we understand this is a stressful time. We are here to help.

We Fight For The Compensation, Care And Support You Deserve.

With over 40 years of combined experience, De Rose Lawyers has a specialized Accident Benefits team. Our SABS lawyers and accident benefits lawyers are dedicated to helping our clients receive the maximum benefits they deserve, with a minimal amount of stress.

We will also provide helpful rehabilitation and recovery resources, allowing you and your loved ones to focus on the healing process.

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