Accident Benefit Claims
Statutory Accident Benefits (SABs) or No-Fault Benefits.
The standard auto insurance policy in Ontario provides certain benefits to persons injured in a car accident regardless of who is at fault. These benefits are defined by a regulation issued under Ontario’s Insurance Act. The regulation is commonly known as the Statutory Accident Benefits Schedule or SABs for short. Each automobile insurance policy provides a certain standard level of benefits. Access to statutory accident benefits in Ontario is defined but in practice will depend on the administrative approach taken by individual insurers.
Optional Insurance Coverage
The policy holder has the choice of purchasing increased levels of protection for certain coverages provided in the standard policy. When purchased this increased level of protection becomes available to the policy holder, the policy holder’s spouse and any dependents if they are injured in an accident. This is an underutilized feature of statutory accident benefits in Ontario because consumers usually shop for the cheapest coverage available. It is only once they have been injured that buyer’s remorse sets in on the realization that the standard coverage is not sufficient to cover actual loss of income caused by the accident injuries.
The statutory accident benefits in Ontario available under the SABS are:
Income Replacement Benefits
If you cannot work because of the injuries caused by a motor vehicle collision this benefit will compensate you in a limited way for the loss of your income. The compensation is partial as you can only receive the lesser of a maximum of 80 % of your net income or $400.00 weekly.
If you suffer a complete inability to carry on your normal activities because of the injuries caused by a motor vehicle collision this benefit will compensate you in a limited way. The benefit is not payable during the first 6 months of entitlement. The benefit amount is only $185.00 weekly.
If you cannot continue as a primary caregiver this benefit will reimburse you for expenses you incur in arranging for replacement services. It also is limited in amount.
Medical and Rehabilitation Benefits
This benefit will pay for reasonable and necessary medical and rehabilitation expenses that are not covered by a government health plan or a private health plan that the injured insured may have through work or a family member. There are various limits and controls on access to this benefit. Access to prompt and effective medical and rehabilitation treatment is an important factor in recovery from accident injury.
Attendant Care Benefits
If you are unable to carry out certain personal care activities (such as bathing, toileting, dressing or feeding yourself) as a result of injuries sustained in a motor vehicle collision this benefit will pay reasonable and necessary expenses for an aide, attendant or long-term care facility. The calculation of the benefit is made using rates that are in some cases well below market value.
Other Expenses Benefits
This benefit may pay for expenses such as lost educational expenses, the cost of certain people visiting you during treatment and recovery and reasonable costs related to housekeeping or home maintenance required due to injuries sustained in an accident. You may also be covered for repairing or replacing certain items of your clothing that were lost or damaged in the collision.
Death and Funeral Payments Benefits
There are lump-sum payments available for survivors of a person killed in a car accident and to help pay for a funeral.
If your insurer has denied you entitlement to or cut you off from payment of statutory accident benefits in Ontario then you can get our assistance to obtain payment of your benefits. Simply contact us and we will be happy to discuss with you your claim to payment of statutory accident benefits in Ontario.
The lawyers at McNally Gervan LLP understand the system and are here to help accident victims get the support they need and the benefits they deserve.
The lawyers at McNally Gervan LLP understand the system and are here to help accident victims get the support they need and the benefits they deserve. They are experienced in dealing with insurance companies, and will fight for medical and rehabilitation and other benefits that insurers deny to injured accident victims and their families.
If you have a question or need assistance, our team of personal injury lawyers is here to help. We know every personal injury case is unique and we work hard to make sure our clients are fairly compensated. We know it’s personal.