You may be entitled to accident benefits under Ontario’s Statutory Accident Benefits Schedule (SABS) if you've been injured in a car accident. These benefits can help cover medical expenses, lost income, and other costs related to your recovery. Understanding what benefits are available to you is crucial to ensuring you receive the support you need.
Accident benefits provide financial support for individuals injured in motor vehicle accidents, regardless of who was at fault. These benefits include coverage for medical treatment, rehabilitation, income replacement, and other necessary expenses.
Many injuries from car accidents fall under the Minor Injury Guideline (MIG). A minor injury includes:
- Sprains and strains
- Whiplash-associated disorders
- Contusions and abrasions
- Lacerations and subluxations
If your injuries fall within the MIG, you are eligible for up to $3,500 in medical and rehabilitation benefits. Your treatment provider must submit a Treatment Confirmation Form (OCF-23) for approval.
If your injuries are more severe and do not fall under the Minor Injury Guideline, you may be entitled to greater benefits. In such cases:
- Your healthcare provider must submit a Treatment and Assessment Plan (OCF-18) before treatment begins.
- Coverage for medical and rehabilitation expenses can go up to $65,000 for non-catastrophic injuries and $1,000,000 for catastrophic injuries.
- Income Replacement Benefit: Covers 70% of your gross pre-accident income, up to a maximum of $400 per week.
- You must be employed or self-employed at the time of the accident or have worked at least 26 weeks in the past 52 weeks.
- Payments continue for up to 104 weeks unless you cannot work in any occupation.
- Medical and Rehabilitation Benefits: Covers necessary treatment, including physiotherapy, chiropractic care, and prescription medication.
- Requires prior approval through an OCF-18 form unless it falls under the MIG.
- Mileage reimbursement of $0.40 per km for travel to treatment (with a 50 km deductible per trip, unless injuries are catastrophic).
- Non-Earner Benefit: Provides $185 per week for up to 104 weeks if you are not employed and suffer a complete inability to carry on a normal life due to the accident.
- Attendant Care Benefit: Covers the cost of a caregiver or personal attendant to help with daily living activities.
- Provides up to $3,000 per month for non-catastrophic injuries and $6,000 per month for catastrophic injuries.
- Lost Education Expenses: Covers up to $15,000 in educational expenses if you are unable to continue your studies due to your injuries.
- Housekeeping and Home Maintenance Benefit: If you are substantially unable to perform housekeeping tasks, you may be eligible for up to $100 per week (available only if optional coverage was purchased or for catastrophic injuries).
- Death and Funeral Benefits: If a person dies due to a motor vehicle accident, their eligible survivors may receive a death benefit.
- Funeral expenses may be reimbursed under the policy.
To access accident benefits, you must complete and submit the necessary forms, including:
- OCF-1: Application for Accident Benefits.
- OCF-3: Disability Certificate (for income replacement or non-earner benefits).
- OCF-6: Application for Expenses (for reimbursement of costs related to the accident).
To avoid delays in processing your benefits, you must submit these forms within 30 days of receiving them.
- Accident benefits are secondary to other insurance coverage. If you have an extended health insurance plan, you must claim expenses from that plan first before submitting them under your accident benefits.
- Delays in submitting forms may impact your benefits. Always complete and send them as soon as possible.
Navigating accident benefits can be complex, but you don’t have to do it alone. At HURT911 Injury Law, we specialize in helping accident victims secure the benefits they deserve.
📞 Call us at 1-855-HURT911 for a FREE consultation.
This blog entry is for informational purposes only and does not constitute legal advice. Reading this article does not create a lawyer-client relationship. For a free consultation, please contact HURT911 Injury Law at 1-855-HURT911.