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Your Right to Recover Under An Accident Benefit Policy

A car accident can leave you with serious injuries—and serious financial troubles. You may be unable to work due to your injuries. On top of that, you may need costly treatments and expensive medication to help you recover. The good news? After an accident, you can get the financial support and healthcare you need because you have the right to recover under an accident benefit policy.

Photo of a person waiting on their hospital bed holding a disposable hair net

What Is An Accident Benefit Policy?

An accident benefits policy, also known as Statutory Accident Benefits or “SABS” in Ontario, provides compensation if you are injured or killed in a collision. SABS coverage includes income replacement benefits, medical, rehabilitation and attendant care benefits, and several other expenses (discussed in more detail below).

Who Is Entitled To Accident Benefits?

Anyone injured or killed in a vehicle accident is entitled to accident benefits in Ontario, regardless of who was at fault. For that reason, SABS are also commonly referred to as “no-fault” accident benefits. So, even if you caused the collision, you are still entitled to accident benefits coverage for your injuries. You make your claim for accident benefits to your insurer under your own automobile insurance policy.

Accident benefits also cover injured pedestrians, cyclists, and passengers. If you are a pedestrian or cyclist, you are entitled to claim accident benefits from the insurer of the vehicle that caused your injuries. If you were a passenger in a vehicle, you are entitled to claim accident benefits from the insurer of the driver who caused your injuries.

What Is Covered In An Accident Benefits Claim?

The types and amounts of coverage you have will depend on any optional coverage you purchased when you insured your vehicle. That being said, all basic automobile policies in Ontario include the following standard accident benefits:

  • Medical and rehabilitation benefits to cover health care and rehabilitation costs not covered by OHIP or your own extended health insurance plan (if you have one). Eligible benefits include physiotherapy, prescriptions, chiropractic care, counselling, surgery, medication, and medical equipment (hearing aid, wheelchair, prosthetics, etc.). There are coverage limits you should be aware of, which depend on the severity of your injuries and impairments:

    • If you suffered minor injuries such as sprains, strains, whiplash, abrasions, contusions, or other small injuries, you are entitled to up to $3,500 coverage for medical and rehabilitation benefits.

    • If you suffered “non-catastrophic” injuries, you are entitled to up to $65,000 for medical, rehabilitation and attendant care benefits (discussed below).

    • If you suffered catastrophic injuries that leave you with long-term or permanently disabling injuries (e.g., traumatic brain injury, spinal cord injury, paraplegia or tetraplegia), you are entitled to up to $1 million for medical, rehabilitation and attendant care benefits.

  • Income replacement benefits to cover part of your lost income. If you are unable to work, income replacement benefits cover up to 70% of your gross income, capped at $400 per week (unless you purchased greater coverage).

  • Non-earner benefits if you don’t qualify for income replacement (e.g., student or self-employed), and cannot continue with your daily life as you did prior to the accident, you may qualify for benefits of up to $185 per week.

  • Caregiver benefits if you can no longer provide care to a dependent due to the severity of your injuries. You are eligible for compensation to hire someone to help you care for them.

  • Attendant care to cover long-term help you require if you suffer non-catastrophic or catastrophic injuries. You’re not entitled to attendant care benefits if your injuries are classified as minor.

  • Death benefits payable to your spouse ($25,000) and/or dependants ($10,000 each) and funeral expenses (up to $6,000) if you die as a result of the accident.

Depending on your circumstances, you may also be eligible for additional benefit coverage, including housekeeping and home maintenance while you recover from your injuries, compensation for personal items damaged during the accident (e.g., clothing, glasses, medical devices), lost educational expenses (e.g., lost tuition, textbooks), and reasonable expenses for family and friends who visit you while you are recovering.

Do You Need A Personal Injury Lawyer To Make a SABS Claim?

Claiming accident benefits from your auto insurance provider can require legal assistance. Your insurance company may try to downplay your injuries to reduce the amount paid out to you in your accident benefits claim. The insurer may deny your claim, pressure you to settle too early or for less than your claim is worth, or fail to give your claim the attention it deserves. Negotiations may stall, leaving you in limbo.

It’s strongly recommended that you work with a skilled personal injury lawyer to ensure you get the full amount of accident benefits you're entitled to. To that end, an experienced lawyer from Kelly Greenway Bruce can help you receive fair compensation and ensure your rights are protected. We are a full-service law firm with extensive experience in personal injury matters with offices in Oshawa and Lindsay.

Personal injury lawyers at our firm can assist by communicating with the insurance company on your behalf, helping you gather evidence to support your claim, and negotiating strategically to get what your claim is worth. If your accident benefits case goes to trial, we can fight on your side in the courtroom.

Our lawyers are insightful, innovative, and dedicated to securing the compensation that you deserve.

Contact our office today. We offer a free initial consultation for all personal injury matters.


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