Statutory Accident Benefit Claims Lawyers

If you have been injured in a motor vehicle accident, understanding your rights to benefits can feel overwhelming. At Gluckstein Lawyers, our dedicated personal injury lawyers are here to help you navigate the complexities of Accident Benefits in Ontario. We are committed to ensuring you receive the full compensation and support you need to focus on your recovery.

Your Guide to Accident Benefits in Ontario.

In Ontario, anyone injured in a car accident is entitled to receive Statutory Accident Benefits (SABS), regardless of who was at fault. These benefits, provided by your own auto insurance company, are designed to help cover necessary medical expenses and replace lost income so you can focus on your recovery.

Understanding SABS Benefits and Eligibility.

SABS offers a comprehensive set of benefits based on the nature and extent of your injuries. Importantly, Statutory Accident Benefits (SABS) apply to a wide range of accident scenarios-not just traditional car crashes. In Ontario, you are generally eligible for SABS if you are injured in any of the following circumstances:

• Motor Vehicle Accidents: Injuries resulting from a collision involving cars, trucks, vans, motorcycles, or other motor vehicles.
• Pedestrian Accidents: If you are struck by a motor vehicle as a pedestrian, you have the right to claim accident benefits.
• Cycling Accidents: Cyclists injured in accidents involving a motor vehicle can also seek SABS coverage.
• Public Transit Incidents: Passengers injured while boarding, exiting, or occupying a public transit vehicle (such as a bus or streetcar) may qualify for benefits.
• Motorcycle and Off-Road Vehicle Accidents: Riders or passengers who are injured in accidents involving motorcycles, ATVs, or snowmobiles are usually covered by SABS.

The benefits you may be eligible for will depend on whether your injuries are considered minor, non-catastrophic, or catastrophic. Key SABS benefits include:

• Medical and Rehabilitation Benefits: Covers reasonable and necessary medical or rehabilitation services not covered by OHIP or private insurance, such as physiotherapy, chiropractic treatments, massage therapy, medications, mobility aids, and therapy devices.
• Attendant Care Benefits: Provides funding for an aide or attendant to assist with your personal care if you have sustained serious injuries that require help with daily living.
• Income Replacement Benefits (IRB): If your injuries prevent you from working, IRB supplements your lost wages, generally up to 70% of your gross weekly income to a maximum limit set by regulation.
• Non-Earner Benefits: For those who were not employed at the time of the accident but are now unable to continue their normal activities, such as students or caregivers.
• Caregiver Benefits: If you were the primary caregiver for dependents and can no longer fulfill that role due to your injuries, this benefit may cover the cost of substitute care.
• Other Benefits: This can include Housekeeping and Home Maintenance, Expenses of Visitors, Lost Educational Expenses, and Death and Funeral Benefits.

How to Obtain Accident Benefits Under SABS.

The process of applying for accident benefits can be complex and requires attention to detail. Here is a step-by-step overview of what is involved:

1. Notify Your Insurer Promptly: As soon as possible after your accident, notify your auto insurance provider about your injuries. You typically have seven days to inform your insurer of the accident and your intention to apply for benefits.
2. Complete the Application Package: Your insurer will send you an Accident Benefits Application Package. This generally includes forms such as the Application for Accident Benefits (OCF-1), Employer's Confirmation Form (if you are claiming income replacement), Disability Certificate (OCF-3), and other supporting documents.
3. Gather Required Documentation: You will need to submit medical documentation supporting the injuries sustained, proof of income if you are applying for IRB, and any other records relevant to your employment or daily activities. Your healthcare providers may need to complete and sign some forms.
4. Submit Your Application: Complete and return the application forms to the insurer as soon as possible. You are required to return the OCF-1 within 30 days of receiving it, or provide a reasonable explanation for delay.
5. Assessment by Insurer: The insurance company will review your documentation, may ask for additional medical examinations or assessments, and will determine the scale of benefits for which you qualify. For more serious injuries, a determination of "catastrophic impairment" may be necessary, which can unlock additional benefits.
6. Approval and Payment of Benefits: Once your claim is approved, benefits should be paid within specific timelines as set by law. For example, income replacement benefits are often paid every two weeks.

Common Challenges in the SABS Claims Process:

• Incomplete or Incorrect Paperwork: Missing information or errors can delay your claim or result in denials.
• Disputes over Severity of Injuries: Insurers may classify injuries in a way that limits your access to certain benefits.
• Missed Deadlines: Strict timelines must be followed throughout the process. Late applications may be denied.
• Benefit Reductions or Terminations: Insurers may reduce or stop benefits based on independent assessments or changes in your status.

Having an experienced legal team on your side can help ensure that your claim proceeds smoothly, deadlines are met, and your rights are protected every step of the way. At Gluckstein Lawyers, we understand the SABS framework, can anticipate common pitfalls, and advocate for all benefits you are entitled to receive.

How Gluckstein Lawyers Can Help.

Navigating insurance claims alone can put your recovery and financial security at risk. Gluckstein Lawyers has a proven track record of successfully managing Accident Benefits claims for clients across Ontario. Our client-focused approach means we handle every aspect of your claim with compassion and expertise.

We assist you by:

• Managing Communication: We take over all communication with the insurance company, so you can focus on your health.
• Completing and Submitting Forms: Our team ensures all necessary forms are accurately completed and submitted on time to avoid delays or denials.
• Securing Disability Benefits: We fight to ensure your injuries are properly assessed and that you receive the correct level of income replacement and other disability benefits.
• Disputing Denials: If your insurer unfairly denies or terminates your benefits, we are prepared to challenge their decision and advocate for the compensation you deserve.
• Maximizing Your Claim: We work to ensure you receive access to all available benefits, including those for medical care, rehabilitation, and attendant care.

Contact Us for a Free Consultation.

If you have been injured in a motor vehicle accident, contact Gluckstein Lawyers today to speak with one of our experienced personal injury lawyers. We are here to provide the clarity and support you need to move forward.