Car accidents may be traumatic and capable of causing devastating damage to our lives. They’re among the leading causes of serious injuries in Ontario. Accident victims can require significant financial assistance to cover treatment, rehabilitation and other expenses resulting from the injuries sustained.

Thankfully, the Statutory Accident Benefits Schedule entitles you to receive no-fault accident benefits if you were injured in a car accident.

This article will explore what’s included in statutory accident benefits and how Bergel Magence can help you with your claim.

What Are Statutory Accident Benefits?

We take car insurance as a way to cushion ourselves when accidents happen. Every insurance provider is required to have a no-fault Statutory Accident Benefits (“accident benefits”) included in every automobile insurance policy.

A no-fault policy ensures that every car accident victim receives needed financial support, regardless of who caused the accident. One thing some people don’t realize is that if you have auto insurance, the benefits also apply if you were injured in a motor vehicle accident as a cyclist or a pedestrian. If you don’t have insurance, you can still claim accident benefits from the insurance company of a driver who was involved in the accident.

Although you may be entitled to compensation, the benefits are not automatically paid after an accident. There’s a claim process involved and strict deadlines that you must meet. An experienced accident benefits lawyer can help you with the claim process and ensure that you obtain what you deserve.

What Statutory Accident Benefits Can You Claim?

As stated above, accident benefits are mandatory in Ontario. You are entitled to these benefits whether you were injured in a motor vehicle accident as a passenger, driver, cyclist or pedestrian. But what do they include? How much are accident benefits? Let’s explore some of the minimum benefits you can claim.

1. Medical and Rehabilitation Benefits

Injuries, particularly catastrophic injuries, are costly to treat and recover from. To ensure that you receive proper treatment, rehabilitation and care, you can receive compensation as follows:

  • Non-catastrophic injuries

Non-catastrophic injuries are classified into minor and non-minor injuries. Minor injuries include abrasion, lacerations, sprain, strain and whiplash, and the maximum claim is $3,500 toward medical rehabilitation.

A non-minor injury is any injury that is not minor but does not qualify as a catastrophic injury, such as fractures. The medical and rehabilitation benefits and attendant care for non-minor injuries are limited to $65,000 payable for a period of up to five years after the accident.

For non-catastrophic injuries, you have the option to increase the benefits when you take out the insurance policy. This involves paying increased premiums.

  • Catastrophic injuries

Catastrophic injuries are severe injuries, such as loss of vision, traumatic brain injury, loss of a limb, serious psychological impairment and very serious impairment. Medical and rehabilitation benefits and attendant care top out at a maximum of $1 million for catastrophic injuries and are payable for life.

One can opt to increase the payout by paying higher premiums when the policy is taken out.

2. Non-earner benefits

If you are unemployed during a car accident, you may not qualify for income replacement benefits if you sustain an injury. However, you may qualify for non-earner benefits if you meet the following criteria:

  • you are a student
  • completed your studies within the last year but are still seeking employment

To be eligible for non-earner benefits, you must have suffered an injury leading to the complete inability to carry on a normal life. You may be entitled to $185 per week for a maximum of 2 years.

3. Income replacement benefits

An auto accident can result in injuries that hinder your ability to work and earn an income. If you are employed or were employed for at least 26 weeks within the last 52 weeks prior to your accident, or if you were receiving employment insurance at the time of the accident, you may qualify for income replacement benefits. In order to qualify, one must suffer a substantial inability to perform the essential tasks of their employment. This criteria applies for the 2 year period after the injury is sustained, after which the threshold changes to whether or not the injured victim can perform any job with their skills, education and/or training.

If you qualify for income replacement benefits, you can potentially get compensation of up to 70% of your gross income, capped at $400 per week. One can increase this benefit when you take out the insurance policy. This involves paying an increased premium.

4. Caregiver benefits

If you were a caregiver at the time of the accident and can no longer carry out these duties, you might qualify for caregiver benefits if you purchase optional benefits on your premium, or if your injuries are deemed catastrophic. These benefits help you hire a professional to care for you and your dependents.

Caregiver benefits are set at $250 per week, plus $50 per week for every child/ dependent under your care.

5. Death and funeral benefits

If a person dies in a car accident, their surviving family may receive death and funeral benefits as follows:

  • Spouse – $25,000
  • Dependents – $10,000 each
  • Funeral expenses – maximum of $6,000
  • Former spouses if the deceased had contractual obligations to them – $10,000.

Exclusions From Accident Benefits

There are certain exclusions when it comes to receiving accident benefits. The exclusions may restrict your access to some or all accident benefits.

Some of the exclusions for accident benefit claims include:

  • Driving without insurance
  • Driving a car without the owner’s consent
  • Driving while committing a crime
  • Driving while excluded from driving under your auto insurance policy
  • Operating a vehicle without a valid driving license

If you believe your insurance company denied, reduced or unfairly excluded you from receiving your accident benefits, get in touch with a Toronto personal injury lawyer for a case assessment. Bergel Magence Personal Injury Lawyers offers a free consultation and relies on their vast expertise to analyze your case.

Legal Advocacy to Secure Car Accident Benefits in Toronto, Ontario

Although statutory accident benefits are mandatory, insurance companies can make it complicated for persons to obtain the benefits they deserve. In some cases, they deny your claim leaving you without medical treatment and in financial distress. This may call for an application to the License Appeal Tribunal to dispute the denial of benefits.

Additionally, some of the financial limits under the Statutory Accident Benefits Schedule (SABS) might not be enough to fully cover the care needed for some injuries and other needs. This calls for a claim for compensation from the at-fault driver through a civil lawsuit.

For over five decades, Bergel Magence Personal Injury Lawyers has represented injured parties across Ontario recovering hundreds of millions of dollars for those who need it most. We have the experience, knowledge and determination to fight for damages as you recover from your injuries.

Call our office today at 416-665-2000 to schedule a free consultation with zero risk or obligation.

You don’t pay until we win!

FAQs

Are statutory accident benefits mandatory in Ontario?

Yes. Statutory accident benefits are part of the mandatory automobile coverage in all insurance policies in Ontario.

Can I claim statutory accident benefits even if I am at fault?

Yes. Ontario has a no-fault statutory accident benefits policy. This means if you are injured in an auto accident, you can receive benefits regardless of who caucused it.

What If an insurance company denies my claim?

If an insurance company denies your accident benefits, you can dispute the decision through the Automobile Accident Benefits Service (AABS) or file an application with the License Appeal Tribunal (LAT).

It’s advisable to retain an accident benefits lawyer to help you with your application. This increases the chances of your claim being approved and getting the most benefits possible.