Frequently Asked Questions about Automobile Accident Benefits
You are entitled to receive accident benefits from an insurance company, no matter who is at fault.
Who is required to pay for these expenses?
What types of benefits are available?
What are accident benefits?
Every automobile insurance policy contains statutory (mandatory) accident benefits coverage. These accident benefits will cover a wide range of medical and rehabilitation expenses over and above what is paid by OHIP. Regardless of who is at fault for the accident or the seriousness of your injuries, the accident benefits insurer is required to pay for these expenses.
Who is required to pay for these expenses?
You are entitled to certain benefits from your own car insurance company or from the car insurance company of another vehicle involved in the accident, no matter who is at fault.
If you are injured in an automobile accident, it is important for you to understand that there is always an accident benefit insurer, and which is one of the following:
- Your own insurance company;
- The insurer of the vehicle in which you were a passenger;
- The insurer of any other vehicle involved in the accident;
- The Motor Vehicle Accident Claims Fund set up by the Government of Ontario.
The insurance process is quite complicated and includes very specific time limits that must be met to avoid delay or denial of your benefits. During your initial consultation, we will help you fill out the accident benefits application.
What types of benefits are available?
You may be entitled to receive the following benefits:
[Note: Your insurance plan may vary in coverage.]
1. Supplementary Medical Benefits & Rehabilitation Benefits
The insurer may be required to pay all of the reasonable expenses incurred as a result of your accident, including:
- medical, hospital and nursing care,
- chiropractic, psychological and occupational therapy,
- medication, prescription eyewear, dental devices and medical aids,
- transportation to and from treatment sessions,
- social and vocational rehabilitation,
- home renovations and vehicle modifications.
You are entitled to receive up to $100,000.00 of medical and rehabilitation benefits for expenses incurred for up to 10 years after the accident.
If your injury is determined to be catastrophic, you are entitled to receive up to $1,000,000.00 for expenses incurred over your entire lifetime.
2. Income Replacement Benefit
A maximum of $400 per week if you are off work as a result of your injuries.
3. Non-Earner Benefit
Six months after the accident, receive $185 per week, if you were not employed at the time of the accident but were enrolled in school or had completed your education during the year prior to the accident and were not employed in a job that reflected your education.
4. Caregiver Benefit
Maximum of $250 per week and an additional $50 per week for each person, such as a child or a person who suffers from mental or physical incapacity, in need of care if you were the primary caregiver.
5. Catastrophic Impairment Benefit
Includes paraplegia or quadriplegia, permanent loss of use of both arms or both legs, loss of vision in both eyes, and severe brain injuries.
6. Attendant Care Benefits
Following the accident, you can receive up to $3,000.00 per month in attendant care for two years. If your injury is catastrophic, you can receive up to $6,000.00 per month or $1,000,000.00 lifetime limit.
7. Student Benefit
Maximum of $15,000 for lost educational expense if you were a student at the time of the accident.
8. Family Member Expenses Benefit
Following an accident, there are expenses incurred by family members and those living with the injured person who visit during your treatment or recovery. They may be able to recover expenses such as mileage, meals, travel expenses, parking, fares and hotel. Please remember record and keep your receipts.
9. Housekeeping and Maintenance Benefit
Maximum of $100 per week for a period of up to two years following the accident if you require housekeeping or home maintenance assistance by reason of your injuries in the accident.
10. Death & Funeral Expenses Benefit
If a family member has died as a result of injuries sustained in the accident, the spouse and dependants are entitled to certain death benefits as well as reimbursement for funeral expenses.
