Ontario Accident Benefits | Guide + FAQs | Square One (2024)

Medical, rehabilitation, and attendant care benefits

This set of benefits helps cover additional costs associated with the actual process of recovering from an injury. While some medical and rehab costs are covered by public (or private) health care, this benefit will help with costs that aren’t already covered.

Medical and rehabilitation benefits will cover a wide range of expenses if they aren’t covered by the insured’s other insurance options (including public health coverage). That includes things like medical and dental procedures, physiotherapy, prescriptions, and even transportation to and from medical treatment sessions — as long as these things relate to the injuries sustained in the accident.

Attendant care benefits cover reasonable expenses if an injured person needs to hire a caregiver to help them while they’re injured, or if they need to move into a long-term care facility.

Medical, rehabilitation, and attendant care benefits are grouped together under one coverage limit. That limit, by default, is $65,000 for non-catastrophic injuries and $1 million for catastrophic injuries. There are several options available for increasing these limits:

1. Increasing coverage for non-catastrophic injuries to $130,000.
2. Increasing coverage for non-catastrophic injuries to $1 million and coverage for catastrophic injuries to $2 million.
3. Increasing coverage for catastrophic injuries by another $1 million.

By choosing options 2 and 3 together, it would result in $1 million in coverage for non-catastrophic injuries and $3 million for catastrophic injuries.

The full list of covered expenses and limitations is also available in the SABS.

Death and funeral expenses

If the absolute worst should happen and someone dies as a result of a vehicle accident, the death and funeral expenses benefit will provide several forms of compensation:

• $25,000 to the deceased person’s spouse
• $10,000 to each of the deceased person’s dependants
• Up to $6,000 for funeral expenses
• $10,000 to the deceased person’s former spouses, if the deceased was obligated to financially support them

As with other accident benefits, there is an option to expand the coverage available under the death and funeral expenses benefit. With this option, the benefit would pay $50,000 to the deceased’s spouse, $20,000 to each dependant, and provide up to $8,000 in funeral expenses.

Other accident benefits

Accident benefits don’t stop there — there are several other standard and optional benefits available.

Payment for other expenses

There are a number of expenses that accident benefits will cover for an injured person. These coverages are included by default.

• Lost educational expenses will provide up to $15,000 to cover expenses for tuition, textbooks, equipment, or room and board that the insured already paid for an educational program that they can’t continue due to their injury.
• Expenses of visitors covers reasonable expenses for family members or certain other people to visit the insured person while they receive treatment for their injuries. This benefit is available for up to 2 years following the accident if the injury was non-catastrophic, or indefinitely if the injury was catastrophic.
• Housekeeping and home maintenance is a benefit that will cover (predictably) housekeeping and home maintenance costs if the insured person suffers a catastrophic injury. This benefit is limited to $100 per week.
• Damage to clothing, glasses, hearing aids, etc. covers reasonable expenses to replace the insured’s medical or dental equipment (prescription glasses, hearing aids, prostheses, etc.) that was damaged in the accident. It also covers expenses to replace clothing damaged in the accident.
• Cost of examinations covers reasonable expenses for assessments or examinations that the insured needs for things like securing a disability certificate, reviewing a treatment plan, or an assessment of attendant care needs.

Dependant care benefit

This is an optional benefit that isn’t available unless it’s been specifically added to the policy.

The dependant care benefit will pay some additional costs necessary to care for the insured person’s dependants following an accident. To qualify, the insured must have been employed at the time of the accident and must have sustained an impairment as a result of the accident. They also must not be receiving the aforementioned caregiver benefit.

This benefit is limited to $75 per week for one dependant plus $25 for each additional dependant.

Indexation benefit

This is another optional benefit that drivers in Ontario can choose to add to their car insurance policy. The indexation benefit makes it so that several accident benefit limits are annually adjusted based on inflation. The adjustment is based on the Consumer Price Index, so the amount that each limit will change is different each year.

The benefits whose limits can be indexed are:

• Weekly income replacement benefit
• Weekly non-earner benefit
• Attendant care benefit
• Medical and rehabilitation benefits

The adjustment to these limits happens on January 1 each year.

Commonly asked questions

How long are accident benefits paid in Ontario?

Each type of benefit has its own time limitations. Income replacement, non-earner, and caregiver benefits are typically available for up to 104 weeks (2 years) after the accident so long as the insured person continues to suffer impairment from their injuries. Medical, rehabilitation, and caregiver benefits are available for up to 260 weeks (5 years) after the accident so long as they’re needed, though this limit doesn’t apply for catastrophic injuries.

Who can apply for accident benefits in Ontario?

Accident benefits are available to anyone injured in a vehicle accident in Ontario: drivers, passengers, pedestrians, and bystanders.

What are the optional accident benefits in Ontario?

The main optional accident benefits are payment for other expenses, dependant care benefit, and the indexation benefit. There are also several options available for increasing the limits of the standard benefits.

What’s the difference between a catastrophic and non-catastrophic injury?

A catastrophic injury or catastrophic impairment is one that results in paraplegia or tetraplegia, amputation of a limb, loss of vision in both eyes, traumatic brain injuries, or similar impairments that seriously compromise a person’s ability to continue their normal life. The Schedule of Accident Benefits describes the precise definitions and limitations of catastrophic injuries.

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