Being injured in a car accident is unfortunate, but you may be eligible to receive Accident Benefits (AB) coverage. Accident benefits cover a variety of services, including medical treatment or rehabilitation, income replacement, death benefits or attendant care. Across Canada, all provinces and territories offer variations of the amount of Accident Benefits available. isure answers some of the most commonly asked questions about AB coverage to help you understand how it works and what you need to know.

Are Accident Benefits mandatory in Ontario?

Yes. Accident Benefits are mandatory and car insurance coverage includes them throughout Canada (except in Newfoundland.)

Who is eligible for Accident Benefits?

Anyone involved in an accident with an insured vehicle is eligible for Accident Benefits. Even if you are the at-fault driver.  Therefore, your spouse, children, grandchildren, parents, grandparents, siblings, certain other dependents and guardians all qualify.

Who is not eligible for AB?

If the accident you are involved in happens as a result of an illegal act on your part, you can lose access to some benefits. Illegal acts include racing or driving without insurance. You can be disqualified from payments of income replacement as a result. However, your insurer may still pay for some Accident Benefits coverage.

Who pays for Accident Benefits coverage?

The at-fault vehicle pays for the accident benefits coverage. Therefore, whether you are the driver, a passenger, a pedestrian, a cyclist struck or even a family member who suffers losses because of an accident, you are eligible for benefits. Each party can file a claim with the insurance company of the at-fault vehicle.

Do I need to file an AB claim?

Yes, if you want to seek treatment for your injuries.  Your claims adjuster can provide you with the forms you need to submit. The Accident Benefits Application Package includes five forms. IIn order to have your medical expenses paid for or receive financial reimbursement as a result of lost wages or damages, you must complete the forms and send them back to your isure broker so they can submit them to your insurer.

How long after a car accident can you make an AB claim?

Your insurer will only pay out on claims that are made within their defined timeframe on your policy. Depending on the insurer, it can be anything from a day to a few weeks. So, it’s best for you to report accidents to your insurer within 24 hours, especially if you want your claim settlement as soon as possible.

How long do Accident Benefits last?

Income replacement benefits are payable to you for up to 104 weeks (or two years) following your accident. To determine your level of injury and your possible recovery time, you will first receive an assessment.

Is it better to go through insurance or pay out-of-pocket?

You should file an insurance claim when you can’t afford to pay cash for damages or medical bills that your insurance policy will cover. You should pay out-if-pocket if the repairs or medical bills from an accident that you cause will cost less than your deductible.

What can I claim under the Medical and Rehabilitation benefit through AB?

The Medical and Rehabilitation benefit will address all medical care requirements that you will need, including the cost of rehabilitative therapy. The benefit applies only for healthcare costs not covered by a government or private healthcare plan.

Some of the items that the benefit may cover include:

  • Assistive devices (such as hearing aids, walkers, prostheses and wheelchairs)
  • Prescription and over-the-counter medications
  • Ambulatory care
  • Chiropractic care, physical or occupational therapy
  • Vocational assessment and life skills training
  • Family or career counselling
  • Other medical expenses, such as replacement of damaged or lost prescription eyewear and dentures

What is a Section B claim?

Accident Benefits are sometimes called “Section B” benefits, depending on where you live. Section B benefits include no-fault accident benefits that are part of your automobile insurance policy. You are entitled to them, regardless of fault. For example, if you are a passenger in a vehicle that’s in an accident and you get hurt, your claim goes through the driver’s insurer.

What if I do not have auto insurance? Who provides benefits?

If you were a passenger in a vehicle or were struck (cyclist/pedestrian), the insurer of the driver would cover you OR an insurer of any other automobile involved in the incident. Otherwise, The Motor Vehicle Accident Claims Fund would most likely provide benefits.

What is the Ontario’s Motor Vehicle Accident Claims Fund (MVACF)?

The MVACF is also known as the “payer of last resort” if you suffer an injury in an auto accident and there are no insurance policies to cover your claim. The MVACF is available to all Ontarians if an accident occurs within the province and you or the other driver don’t have insurance.

Can you settle Accident Benefits?

Yes. You can enter into a full and final settlement of your AB claim typically after a year.

What are LAT Accident Benefits?

The License Appeal Tribunal (LAT) is an independent agency that oversees your dispute with your insurance companies involving your Accident Benefits. If you have a dispute over a settlement with your insurer, it will be resolved by the LAT.

For any further questions related to Accident Benefits coverage, contact your isure broker today!

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