Ontario Accident Benefits Explained

Public or Private?

Ontario has private insurance. This means various private insurance companies are responsible for issuing insurance policies and you likely have your own, chosen insurer.

No fault or Tort-based?

Ontario has a threshold no-fault system and there is an accident benefits system in place to deal with an injured party's claims, as well as the possibility of a tort claim if damages meet a certain threshold.

Accident benefits in Ontario

CAREGIVER BENEFITS -

Caregiver benefits, are provided to a party who has suffered a catastrophic impairment and who is the primary caregiver for someone in need. Typically, the person in need of care must reside with the applicant, and the applicant cannot receive any remuneration for engaging in care. An insured party may also apply for caregiver benefits of up to $250.00 per person in need (and $50.00 for each additional person in need thereafter).

INCOME REPLACEMENT BENEFITS -

Limited to the lesser of the applicant's gross weekly wages or $400.00 per week for the first 104 weeks.

NON-EARNER BENEFITS -

Limited to $185.00 per week.

MEDICAL AND REHABILITATION BENEFITS -

Limited to:

  • $3,500.00, minor injury
  • $65,000.00, non-catastrophic injury
  • $1,000,000.00 a catastrophic injury, respectively.

ATTENDANT CARE BENEFITS -

These are expenses that are incurred by or on behalf of an insured person for services provided by an aide/attendant or by a long-term care facility, and they are limited to either $3,000.00 or $6,000.00 per month, depending on whether the applicant is non-catastrophic versus catastrophic. 

HOMEMAKER BENEFITS -

SABS permits an applicant's family member to be reimbursed for providing care to the applicant; however, this family member must prove either:
(1) that they are a professional health care provider who performed attendant care services in the course of employment that they would have been engaged but for the accident, or
(2) that they suffered economic loss as a result of caring for the applicant.

OPTIONAL DEPENDENT CARE BENEFIT-

For those who become injured while caring for others.

LOST EDUCATIONAL EXPENSES-

up to $15,000.00 for students who are unable to complete their elementary, secondary, post-secondary or continuing education. 

VISITOR EXPENSES-

Available for certain individuals wishing to visit the injured party during their recovery.

HOUSEKEEPING AND HOME MAINTENANCE SERVICES-

 Available for drivers having sustained a catastrophic impairment);

FUNERAL EXPENSES-

up to $6,000.00 additional insurance coverage may be purchased to increase the amount of funeral and death benefits payable.

DEATH BENEFITS

vary between $10,000.00 and $25,000.00 depending on whether the applicant is a surviving spouse, a surviving dependent, or the estate of the deceased driver.

How to claim accident benefits in Ontario:

Remember:

If you have been injured in a crash and have coverage from another provider (for example, extended health care from your employer or individually purchased disability insurance), your other insurance will be the primary payer for most medical expenses and/or income replacement.

Want to Learn More?

Read or download the complete O. Reg. 34/10: STATUTORY ACCIDENT BENEFITS SCHEDULE - EFFECTIVE SEPTEMBER 1, 2010 (ontario.ca)
from the Government of Ontario website. You can also read more about Automobile Insurance in Ontario (gov.on.ca).
If you have further questions about this process, or your benefits, contact your claims adjuster.
If you do not know who your claims adjuster is, contact the insurance company.
You can also contact the Insurance Bureau of Canada at 1-844-227-5422 or the General Insurance Ombud service at 1-877-225-0446.