Have you suffered an injury in an auto accident? If you’re an Ontario driver, you can count on the coverage your auto insurance policy provides. Ontario’s legislation ensures that all auto insurance policies include Accident Benefits. This can help you to pay for expenses from your injuries, such as rehabilitation services or prescription medication. Let’s take a closer look at some of the coverages available to you on your auto policy under Accident Benefits.
What are Accident Benefits?
The AB section provides compensation if you, your passenger(s) or a pedestrian suffers an injury in a car accident. This is regardless of who was at-fault. With No-Fault insurance in Ontario, your insurance company will take responsibility. How? They will pay for any damages and injuries to you, your car and your passengers. In other words, this system allows insurance companies to focus on what’s most important—getting you and your vehicle back on the road.
What do Accident Benefits cover?
Accident benefits cover you for things like rehabilitation treatment, income replacement, and other services that are necessary for your recovery. The Statutory Accident Benefits Schedule (SABS) is an important document that outlines coverage under your policy. Therefore, it applies to all basic automobile policies. It explains mandatory and optional limits for medical care, income replacement, death, funeral expenses and loss of income from disability. SAB insurance helps you if you are a victim of an accident in a number of ways.We have a list of them for you below to help you understand how it all works:
What is covered by Accident Benefits in Ontario?
Though details may vary from province to province, your Accident Benefits coverage generally includes:
Income replacement benefits
Compensation for loss of income if you can’t work as a result of your injuries.
The benefit pays $185 per week, minus all other income replacement assistance you may receive during that time.
If you can’t act as the main caregiver for your dependents, this will reimburse you for help that you hire. A dependent can be your children or someone elderly you are responsible to care for. The Caregiver benefits include up to $250 per week for looking after the household’s first dependent. However, an additional $50 per week is given for each subsequent dependent in the household.
According to FSRAO.ca, standard accident benefit coverage only provides Caregiver benefit for those suffering from “catastrophic injuries”. But you can purchase additional coverage to get this benefit for non-catastrophic injuries, too.
Medical, rehabilitation and attendant care benefits
These benefits will assist you for the following:
Medical and rehabilitation benefits
Covers expenses that aren’t already given to you by your government or private health plan.
Attendant care benefit
This is coverage that you will receive if you cannot care for yourself as a result of the accident. This personal accident benefit will pay reasonable and necessary expenses for an aide, attendant or long-term care facility.
There are three designations of injuries:
- Minor injuries: Can be generally thought of as a strain, sprain, whiplash or bruise. If you suffer from one of these injuries, you can expect up to $3,500 in medical and rehabilitation benefits.
- Non-catastrophic injuries: These are injuries that you are expected to fully recover from. For instance, this could be a concussion or broken bones. These types of injuries could qualify you for up to $65,000 in accident benefits coverage.
- Catastrophic injuries: Catastrophic injuries mean that your injuries will have an effect on you for the rest of your life; these include brain damage, spinal cord injuries or amputation. If you suffer a catastrophic injury, you are eligible for the mandatory coverage of up to $1 million.
You have the option to increase your non-catastrophic coverage to $130,000 and your catastrophic coverage to $2 million. This, of course, would result in increased premiums.
Death and funeral expenses
If you pass away from an accident, a lump sum death benefit is paid out to your spouse and dependents:
- $25,000 to your spouse
- $10,000 to each of your dependents
- A maximum of $6,000 for funeral expenses within 180 days of the accident
- $10,000 to former spouses if the person has financial obligations to them
You have the option of increasing your limits up to $50,000 for your spouse, $20,000 to dependents, and up to $8,000 for funeral expenses.
Other expense benefits
Additional benefits may be included under your auto policy (should you qualify), such as:
Lost education expenses
For lost tuition, books and other education-related expenses up to $15,000.
Expenses of visitors
Costs to bring family members to visit you in rehabilitation facilities.
Housekeeping & home maintenance
Receive up to $100/week while you recover.
Damage to clothing, glasses and other belongings
Compensation for damages as a result of the accident.
Cost of examinations
Compensation for the cost of examinations in relation to treatments as part of your recovery.
Optional Accident Benefits coverage available
If you feel that the amount of coverage on your auto policy is not enough, you have options. This may include increasing 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. You can only claim this benefit if you were employed at the time of the accident. This only applies if you have to pay for additional childcare expenses due to your injuries.
- 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:
- Additional medical expenses: Covering up to $130,000 (plus sales tax).
- Additional death and funeral expenses: Up to $50,000 to your spouse, and raises the benefit for your dependents to $20,000.
- Catastrophic impairment: For up to $1 million.
- Extra income replacement: If you raise your weekly benefit limit from $400 per week to $600, $800 or $1,000.
- Additional coverage for caregivers, housekeeping, and general home maintenance.
- Optional dependent care benefits.
- Top-tier medical coverage: Up to $1,000,000, even if you did not sustain catastrophic impairment due the accident. Your coverage may increase up to $2,000,000 if you sustain catastrophic impairment from the accident.
IMPORTANT: Keep in mind increasing your limits will increase your premiums!
This is a brief overview of your accident benefits in Ontario. It is important for you to understand your individual limits so you can receive proper coverage during your recuperation. It’s important to do a complete review of your policy at the time of renewal each year. This will ensure that you have the coverage that’s right for you. One of our isure brokers will be happy to help you better understand your limits or discuss making changes.