Things to Know About Statutory Accident Benefits in Canada

When you sustain injuries due to a negligent motor vehicle accident in Ontario, you can sue for compensation through a personal injury lawsuit and claim statutory accident benefits. However, if you file a lawsuit, you have to prove that the defendant was negligent or otherwise at fault. On the other hand, if you claim statutory accident benefits (SAB), you can get benefits through your car accident insurance policy regardless of fault as mandated under the Statutory Accident Benefit Schedule (Schedule). 

Pursuing one course does not preclude you from seeking the other. If an insured person claims SABS from their insurer, they may still file a personal injury lawsuit against a negligent party. Regardless of which option you choose, it would be advisable to consult with experienced Diamond & Diamond personal injury lawyers who can advocate on your behalf and ensure that you receive the compensation you deserve.

How Do Statutory Accident Benefits in Canada Work?

Unlike a personal injury lawsuit, SABS is not damages awarded as compensation for your injuries. Instead, it’s part of the provisions in the mandatory car insurance coverage of all vehicle owners for no-fault benefits.

Under the Schedule, auto insurance policies must include provisions for no-fault recovery assistance to an injured policyholder. Retaining a personal injury lawyer can ensure you get all the benefits you should to help you recover from your injuries.

Below is a brief description of the Accident Benefits that an insured person in Ontario can expect to receive in a motor vehicle accident. The type and coverage of benefits will depend on the extent and nature of the injuries.  

Income Replacement Benefits

An insured person may receive Income Replacement Benefits (IRB) for loss of income if their injuries prevent them from going back to work. They are eligible if they were over the age of 16, employed, self-employed, or not employed, but had been employed for at least 26 weeks within a 52-week period before the accident.

The IRB gives a maximum of $400 a week, or 70% of the gross weekly income, whichever is less. An insured person who availed of optional benefits in their insurance policy will receive whatever the optional amount is, regardless of actual loss of income.

Non-earner Benefit

Unemployed persons cannot claim loss of income, so they do not meet the criteria for IRB. However, they may receive the non-earner benefit of $185 a week. To qualify, the insured person must be totally unable to live an everyday life due to injuries sustained in a motor vehicle accident. 

Caregiver Benefit

Unpaid caregivers who sustain severe injuries in a motor vehicle accident that prevent them from carrying out caregiving tasks may receive the caregiver benefit. The amount for this benefit will cover reasonable and necessary expenses and may not exceed $250 a week (plus $50 for each additional person in their care) for a maximum of 104 weeks. Availing the IRB or non-earner benefits disqualifies an injured person from the caregiver benefit.

Medical and Rehabilitation Benefits

The medical and rehabilitation benefits cover all reasonable and necessary accident-related injuries of the insured person. These include emergency care and hospital expenses, an authorized transportation expense, physical rehabilitation services, medical devices, modifications in the home and workplace, housekeeping and caregiver services, medications and counselling. Limits on each category will depend on the extent of the injury and range from $3,500 for minor injuries to $65,000 for severe injuries.

Attendant Care Benefit

Insured persons who require personal care assistance or long-term care but do not qualify for benefits under other sections in the Schedule may avail of the Attendant Care Benefit. The monthly benefits will depend on the level of injuries, ranging from $3,000 for non-catastrophic injuries (not more than 260 weeks) to $6,000 for catastrophic impairment (no time limit).

Other Expenses Benefit

The insurer may also need to pay for the following necessary expenses:

• Lost educational expenses – up to $15,000
• Reasonable and necessary transportation expenses and other costs of eligible visitors – up to 104 weeks except for catastrophic impairment
• Housekeeping and home maintenance – up to $100 a week
• Damage to clothing, glasses, hearing aids, etc.
• Cost of examinations – disability certificates, medical assessments, etc., not more than $2,000

Death and Funeral Benefits

If the insured person dies because of a motor vehicle accident, the insurance company will provide death and funeral benefits to family members. The death benefits include benefits to the spouse ($25,000), each dependent ($10,000) and former spouses with whom the insured had domestic contractual obligations ($10,000). Funeral benefits will cover necessary expenses not exceeding $6,000.

Who Can Qualify for Canada Statutory Accident Benefits?

Regardless of fault, any person over 16 covered by mandatory car insurance policies can receive financial assistance under one or more sections of the Schedule. Even at-fault drivers may qualify. Family members may also apply for death and funeral benefits for the insured person.

Eligibility for individual benefits will depend on the injuries and circumstances of the insured person at the time of the car accident, such as their employment history. The main hurdle in accessing these benefits is dealing with insurance companies. 

Because many of the Accident Benefits provisions are open to interpretation, an insured person may not fully understand their rights. A Diamond Law personal injury lawyer can be a valuable ally in these cases.

If you have been injured in any vehicular accident, you will need to apply for Statutory Accident Benefits to get adequate compensation. Call Diamondlaw.ca to know more.

Want to Get Statutory Accident Benefits? Call Diamond Law Now!

As described in our article on Statutory Accident Benefits Schedule, Ontario’s Accident Benefits can provide assistance to insured persons who suffer injuries due to motor vehicle accidents. Because it is mandatory and is a no-fault assistance program for insurance companies, insured persons in Ontario can file a claim directly with their insurers.

However, insurers will try to limit their payouts by making the process as tricky as they can. You might also have to file many documents. It would be best to let Diamond Law handle it to ensure you get all the benefits you need.

Additionally, the financial limits under the Schedule might fall short of the needs for some injuries. To get the compensation you need, you can file a personal injury lawsuit against a negligent third party and Diamond & Diamond Law can also help with that!

We have broad experience dealing with big insurance companies and handling personal injury cases. Call us today to receive the compensation and SABS benefits you deserve!