ACCIDENT BENEFITS

SABS INSURANCE CLAIMS
Car
Motorcycle
Truck
Pedestrian
Cyclist

What are Accident Benefits?

Accident benefits provide compensation if you are injured in a car accident. Ontario's no fault system mandates insurance companies protect their insured and others injured in a car accident with benefits not covered by private insurance.

The FSRA provides a definition :

"This section of your automobile insurance policy provides you with benefits if you are injured in an automobile accident, regardless of who caused the accident, including supplementary medical, rehabilitation and attendant care, caregiver, non-earner and income replacement benefits. Options exist to increase most of these coverages."

Get in Touch

At Echeverria Legal Services, we specialize in helping clients navigate the complexities of accident benefits claims in Ontario. With a thorough understanding of the Statutory Accident Benefits Schedule (SABS), we provide dedicated support in securing the compensation you need for medical treatment, income replacement, and rehabilitation. From filing your application to managing claim documentation and negotiating with insurers, we are committed to maximizing your benefits. If your claim is denied or limited, we advocate on your behalf before the License Appeal Tribunal (LAT) to ensure fair treatment. Let Echeverria Legal Services guide you through every step of your accident benefits claim, so you can focus on recovery.

And remember, we work on contingency, meaning that you don't pay LEGAL fees until your claim is resolved!

WHAT IS COVERED BY ACCIDENT BENEFITS?

The Statutory Accident Benefits Schedule (SABS) is an important document that outlines what is covered under your policy.

It applies to all basic automobile, motorcycle and truck insurance policies. It outlines the mandatory and optional limits for medical care, income replacement, death, funeral expenses and loss of income from disability.

What Are Standard Accident Benefits In Ontario?

Accident benefits are mandatory in Ontario. All policies will include it. There are standard and optional additions that you can add to your plan.

Here is what the benefits will cover across the province :

INCOME REPLACEMENT, NON-EARNER AND CAREGIVER BENEFITS

Income replacement benefits : If you are unable to work, you may qualify for benefits of 70% of your gross income, capped at $400 per week. You have the option to increase of up to $1,000 per week.

Caregiver benefits : If you cannot provide care to a dependent, you could receive compensation to hire someone to help you care for them. This applies to specific injuries. You can add optional endorsements to include all injuries.

Non-earner benefits : If you don’t qualify for income replacement, are a student, and cannot continue on daily life as previous to the incident, you may qualify to receive $185 per week.

MEDICAL, REHABILITATION AND ATTENDANT CARE BENEFITS

This will help with medical and rehab expenses that are not covered by a private health plan or the government (OHIP).

Mandatory coverage includes up to $65,000 for non-catastrophic injuries or up to $1 million for catastrophic injuries. You have the option to increase the amount for non-catastrophic injuries to $130,000 and increase catastrophic injuries to $2 million.

Medical and rehabilitation benefits : This covers the cost of health care and rehabilitation. This includes physiotherapy, prescriptions, chiropractic, counseling, and other services not covered by OHIP or through your group plan (if applicable). Medical care and costs that qualify are listed in the statutory accident benefits schedule

Attendant care benefits : If you are unable to continue as a primary caregiver, you will be provided with assistance at your home or healthcare facility to help you recover from a serious injury. This helps single-parent families, families with one stay at home parent, and households with other dependents. It includes up to $250 per week and an additional $50 per week for each subsequent dependent living in the house.

DEATH AND FUNERAL BENEFITS

In the event if you pass away as a result of an accident, the following will be paid out :

$25,000 to your spouse

$10,000 to each of your dependents

A maximum of $6,000 for funeral expenses

$10,000 to former spouses if the person had financial obligations to them

You have the option to increase limits up to $50,000 for your spouse, $20,000 to dependents, and $8,000 for funeral expenses.

OTHER EXPENSES

Additional expenses can be covered, including :

Lost educational expenses: Compensation for lost tuition, books and other education related expenses up to $15,000.

Expenses of visitors : Reasonable expenses incurred by family and friends to visit you during recovery and treatments. Your spouse, children, grandchildren, parents, grandparents, siblings, certain other dependents, and guardians qualify.

Housekeeping and home maintenance : Receive up to $100 per week for reasonable expenses to help with housekeeping and maintaining your home while you recover.

Damage to clothing, glasses, and other belongings : Receive compensation for damaged clothing, glasses and other personal medical devices damaged during the accident.

Cost of examinations: Compensation for the cost of examinations related to treatments as part of your recovery.

WHAT ARE OPTIONAL ACCIDENT BENEFITS IN ONTARIO?

You have the option to increase limits for income replacement, medical care, caregiver benefits, death and funeral benefits, and more. Here is what you can add :

Dependent care benefits : This will cover up to $75 per week for your first dependent and $25 for each additional dependent. This can only be claimed if you were employed at the time of the accident and have to pay for additional childcare expenses due to injuries sustained.

Indexation : This gives you an annual adjustment for yearly inflation rates. Adjustments are done in accordance with the Consumer Price Index of Canada.

More options include :

Up to $130,000 in additional medical expenses

Additional death and funeral expenses up to $50,000, raises dependents to $20,000

Catastrophic impairment up to $1 million

Extra income replacement

Keep in mind increasing your limits will increase your premiums.

WHAT ARE ACCIDENT BENEFITS FOR A PASSENGER, PEDESTRIAN OR CYCLIST?

All passengers, pedestrians and cyclists involved in an auto accident are eligible for it. Regardless of the type of accident or who was at fault, you will almost always be covered by insurance. You will need to file a car insurance claim against the other driver.

HOW DO YOU SETTLE YOUR ACCIDENT BENEFITS?

There will come a time after an accident where your insurer will approach you to settle your claim. In Ontario, you must wait one year before settling it.

Your insurer will propose a fixed amount to settle and close your claim. Once you agree to a settlement, you cannot request additional compensation from your insurer.

How much you settle for can affect litigation for tort claims against an at-fault driver if you are pursuing legal action. Always assess your situation before settling.