Ontarians Involved in Car Accidents in Quebec
Every day more than 150,000 motor vehicles and an additional 9,000 cyclists and pedestrians cross one of five interprovincial bridges connecting Ottawa and Gatineau.
The workforce and social life in these communities is so integrated that once the novelty of crossing between provinces wears off, people living and working in the National Capital Region probably don’t spend much time thinking about the very real differences in the laws of each province. In a matter of moments, however, all of that can change.
If you are an Ontarian involved in a motor vehicle accident in Quebec, the path to accessing medical benefits and/or compensation can be significantly different from the one you would take in your home province. And choosing the wrong path could be a costly mistake.
In this blog I explore how no-fault accident benefits policies in Ontario and Quebec differ, your options when deciding how to make a claim, and how an experienced personal injury lawyer can assist you if the accident caused you to suffer a catastrophic injury.
Both Ontario and Quebec use no-fault accident benefits systems to pay out claims for medical and attendant care. With no-fault benefits, even if you are partially or fully responsible for the accident, you are still able to claim benefits that will assist in your recovery. Ontario’s Statutory Accident Benefits Schedule (“SABS”) outlines an accident victim’s entitlements. Quebec’s Société de l'assurance automobile du Québec (“SAAQ”) provides a similar explanation of an accident victim’s compensation and indemnities.
A major difference between the two provinces is how their respective no-fault benefits systems are funded. In Ontario, all motor vehicle drivers must hold a standard insurance policy from a private vendor. Claims in Ontario are made either through your own insurer or the insurance provider of another person involved in the accident if you do not have your own. If no one involved in the accident holds insurance (for example, in a hit and run), a victim can make a claim to a special fund established by the provincial government.
In Quebec, a public system covers all provincial residents. For the purposes of the Quebec system, anyone who is a driver or passenger of a motor vehicle registered in the province is deemed to be a resident. And, in accordance with Section 59 of Ontario’s SABS regulations, Ontario residents who are injured in an accident in Quebec may elect to receive the same benefits as if they were a resident of Quebec.
…But No Tort?
With Section 59 available to Ontario residents involved in an accident in Quebec, determining which benefits to claim will likely be top of mind following an accident. In almost all cases, Quebec’s benefits are superior to what Ontario offers.
Several years ago, Ontario’s SABS benefits were reduced in an effort to lower auto insurance premiums. Drivers had, and still have, the option to purchase enhanced benefits to increase the limits of some of these amounts or to alter the qualifying language for certain benefits. Ontario claimants relying on the standard benefits package are generally much worse off than their Quebec counterparts.
For example, Ontario provides up to $400 weekly (or 70% of weekly lost wages, whichever is lower) as an income replacement benefit for a period of up to 104 weeks after the accident. This works out to a maximum of $20,800 per year. The income replacement benefit then ceases unless the claimant is suffering from a complete inability to engage in any employment or self-employment for which he or she is reasonably suited by education, training or experience.
In Quebec, the income replacement indemnity is based on 90 per cent of a person’s net annual income (based on a gross annual income of up to $88,000) for the employment the person held at the time of the accident. The maximum amount of this indemnity is indexed every year and it is paid for however long the SAAQ determines a claimant is unable to work.
Similarly, while applicants in Ontario can receive a maximum of $3,000 per month for attendant care, Quebec’s benefit system offers double this amount.
Why the difference? Although the public versus private nature of each program plays a role in how benefits are calculated, a major distinction between the two provinces is a claimant’s ability to file a tort claim for damages.
Ontario residents involved in motor vehicle accidents in the province can sue an at-fault driver for compensation and damages beyond what SABS provides, including non-pecuniary losses such as pain and suffering. If an accident occurs in Quebec, suing an at-fault person for such damages is not possible as provincial law ensures the SAAQ handles all matters dealing with compensation. As such, the 2022 SAAQ Compensation Table offers a maximum indemnity of $265,939 for the pain and suffering involved with permanent impairment.
In addition to a generally richer benefits scheme, Quebec’s system also does not rely on the three categories of injuries used in Ontario to determine an applicant’s benefit limits.
When Ontario residents are injured in motor vehicle accidents in their home province, they qualify for benefits based on guidelines or assessments by medical providers. The minor injury guidelines provide quick access to benefits for common injuries such as strains and sprains. At the opposite end of the spectrum, a catastrophic injury designation opens up access to the maximum benefits available. The intermediary category, generally known as non-catastrophic injuries, provides the maximum amounts of benefits for all other cases.
The criteria for catastrophic injury designations are strict. As a personal injury lawyer working in Ontario, I am very familiar with heart-breaking “threshold cases” where insurers have decided that severely injured people have not met the criteria required for the level of benefits that would come closest to meeting their actual needs. In the absence of these categories, the SAAQ evaluates the extent of a person’s injuries to determine their individual needs.
A Second Set of Eyes
While the Quebec system may be superior in many ways, it is not perfect. The SAAQ, like private insurers, can err when assessing benefits; for a person who has suffered a catastrophic injury, receiving less than what they deserve can dramatically affect their quality of life.
If you or a loved one is an Ontario resident who has been seriously injured in a motor vehicle accident in Quebec and you are unsure of how to proceed, I would be happy to discuss the matter with you. You have the right to retain an Ontario lawyer to assist with the claims process in both provinces.
Whether it’s having a second set of eyes to review the details of your accident and injuries when making a major SAAQ claim or dealing with your own insurer if you have purchased optional benefits that could enhance your coverage through the Ontario system, at Nicholson Gluckstein Personal Injury Lawyers, we are here to help in any way we can. To learn more about our services and commitment to full-circle care, please contact us.
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