ACCIDENT BENEFIT CLAIMS
This area of law is complex and always changing. It is vital that you select an experienced legal team when navigating Ontario Accident Benefit claims. At Singer Kwinter, we work for you, achieving the compensation that is rightfully deserved after a life altering injury. We have the knowledge, resources and experience to ensure you obtain the financial security and clinical support that will be necessary over your lifetime.
Effective June 1, 2016, Ontario’s no fault accident benefits, commonly known as the SABS (Full Name: Insurance Act Ontario Regulation 34/10 Statutory Accident Benefits Schedule – Effective June 1, 2016), underwent its most recent significant changes.
If you are injured in an accident involving a motor vehicle, you are entitled to apply for medical, economic, and other benefits. It does not matter who is at fault for the accident. If you are injured because of a car accident, you are entitled to apply, even if you do not have insurance.
The amount and type of benefits available depend on the type of injury. There are three main categories for injuries: minor injuries, catastrophic, and non-catastrophic.
Download the Singer Kwinter Guide to accident benefits: A Guide to Ontario’s Statutory Accident Benefits Schedule (SABS) for Motor Vehicle Accidents (Occuring on or after June 1, 2016).
A common dispute with the insurance company and the insurance adjuster is a difference of opinion with respect to the category of the injury. This makes a significant difference in your rights.
The following are the type of benefits that are potentially available to a person injured in Ontario in a motor vehicle accident, or someone who has an Ontario motor vehicle insurance policy but is injured outside of Ontario.
Financial (you may be entitled to one of the three types of income):
- Income replacement benefits – Up to a maximum of $400.00 a week. Eligible if you were earning income before the accident and are unable to return to work. Calculated by taking 70% of your gross income, commencing one week following the loss, for the first two years if you are unable to do your own job; thereafter if you are unable to do any job, until age 65 which decreases until death. Optional benefits may also increase the amount.
- Non-earner benefits – Payable after 4 weeks at $185/week if you are completely unable to carry on a normal life. Payable after age 18 and for a maximum of 104 weeks.
- Caregiver benefits – if you were responsible for providing care to someone before the accident, but can no longer provide that care, then you may be eligible. Available without a waiting period if your injury makes you substantially unable to continue care-giving activities. Maximum of $250/week for first dependent, plus $50 for each additional dependent. At 104 weeks, must meet more stringent “complete inability” test. Terminates once dependents reach age 16, or are no longer a person in need of care. No adjustment at age 65. This benefit is only available if you have optional benefits or sustain a catastrophic impairment
- Recovery and Assistance:
- Medical, rehabilitation, and attendant care benefits – Covers medical and therapeutic expenses not covered under OHIP. Common items include physiotherapy, chiropractic, massage, acupuncture, medications, assistive devices, and home and vehicle modifications. There is a maximum amount available depending upon the severity of the injuries of (minor Injury, non-catastrophic injury or catastrophic injury), unless you have optional benefits. Please reference: A Guide to Ontario’s Statutory Accident Benefits Schedule (SABS) for Motor Vehicle Accidents (Occuring on or after June 1, 2016) for more details on each category.
- Qualified case manager services – A professional paid to co-ordinate medical, rehabilitation and attendant care benefits.
- Transportation – Pays a certain amount per km of travel.
- Housekeeping and Home Maintenance – Maximum of $100 per week for life if you sustain catastrophic injuries.
- Lost education expenses – Up to a maximum of $15,000.
- Visitor’s expenses – Pays for reasonable and necessary expenses incurred in visiting injured person during treatment or recovery. Terminates 104 weeks after the accident when minor injury or non-catastrophic injury. Lifetime coverage for catastrophic injuries.
- Damage to clothing – Pays for all reasonable expenses incurred.this includes clothing, prescription eyewear, dentures, hearing aids, prostheses, and other medical assistive devices damaged in the accident. There is no limit.
- Cost of assessments, examinations, and writing of reports- maximum of $2,000 per report. Medical and rehabilitation expenses and A/C benefits limits include all fees and expenses required to conduct assessments, examinations, and preparing reports in connection with any benefit or payment to or for an insured. Accountant’s reports and Catastrophic Assessment Reports may be excluded from the limits.
- In-home assessments and examinations – available under non catastrophic impairment and catastrophic impairments. Please reference: A Guide to Ontario’s Statutory Accident Benefits Schedule (SABS) for Motor Vehicle Accidents (Occuring on or after June 1, 2016)
In the event of a death arising from a motor vehicle accident:
- Death benefits include –
- $25,000 lump sump to an eligible spouse
- $10,000 lump sum to each dependent including a supported former spouse
- $25,000 divided equally among dependents, if there is no spouse.
- Funeral benefits – Maximum of $6,000 for funeral expenses.
You are eligible to apply for these benefits if you qualify under the law. You may qualify and receive some, all or none of the benefits based on your personal circumstances. Prior to an accident, you are entitled to purchase optional benefits which can modify and increase the amount and type of benefits available. The above summary provides a general overview, however, because of the complexities in this area of law, your entitlement may differ.
If you or someone you know has injuries involving a motor vehicle, contact Singer Kwinter and schedule your FREE INITIAL PHONE CONSULTATION. You pay no fees until your case is won or settled. With over 40 years practicing in personal injury law, we have the expertise to get you the compensation you deserve.
Call Toll Free 1.866.285.6927
Disclaimer: Content on this page is strictly for information purposes only and should not be construed as legal advice.
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