Optional and Standard Car Insurance in Ontario – Statutory Accident Benefits Schedule (SABS) – Coverage that Matters!
Motor vehicle accidents often cause significant and catastrophic injuries. It is only when you have a car accident in Ontario that you think about insurance coverage. Like most people in Ontario, you likely purchased standard insurance coverage and have basic accident benefits available to you.
No fault benefits are called accident benefits in Ontario. In Ontario, insureds have the right to buy additional accident benefits insurance (called optional coverages) and that matters when you have been seriously injured in a car accident and need rehabilitation and medical care. Every car insurance policy issued in Ontario must have accident benefits. That is the law and it is mandatory to have car insurance in Ontario. Those accident benefits cover things like income replacement, medical treatment, rehabilitation and other expenses. Expenses quickly add up and not having sufficient insurance can be devastating to a family who is left with having to pay for needed medical care and insufficient income replacement to pay usual living expenses.
Like most people, you hope you never have to claim insurance coverage. However, car accidents happen regularly and if you or someone you care about has been injured in a car accident, you will benefit greatly from accident benefits and will be thankful if additional optional coverages were purchased. If injured in a tragic car accident, you are entitled to claim accident benefits coverage from your own insurer. The injuries sustained in car accidents can be catastrophic and require tens of thousands, sometimes hundreds of thousands of dollars in medical and rehabilitation costs. In many cases, car accident victims are left with life-long debilitating disabilities, needing medical care for life.
If you sustained a serious injury, your benefits may not be adequate to pay for all of your needed medical and rehabilitation expenses. Buying optional benefits at a relatively low cost could provide much more security to you and your family.
Mandatory Coverage in Ontario
To legally drive a vehicle in Ontario, your auto insurance policy must include: Third Party Liability; Accident Benefits coverage; Uninsured Automobile coverage; and Direct Compensation-Property Damage coverage.
Where to claim Accident Benefits?
If injured in a car accident as a driver, passenger or even as a pedestrian or cyclist, you should first claim accident benefits through your own motor vehicle insurance and if you don’t have motor vehicle insurance, you may claim accident benefits from the insurance company of the driver of the other motor vehicle involved in the accident. If that other driver does not have insurance as well, you could apply for benefits through the Ontario government’s Motor Vehicle Accident Claims Fund -MVACF (where no person involved in the accident has car insurance).
So, what is covered in standard accident benefits, where no optional coverage has been purchased?
The SABS sets out the maximum amount of coverage available as a result of a motor vehicle accident. The SABS separate injuries into categories as being minor, non-catastrophic and catastrophic. Coverage depends on where your injuries fall within each definition of category of injury. Benefits available are typically as follows: Medical & Rehabilitation, Non-Earner Benefits, Income Replacement, Housekeeping & Home Maintenance, Attendant Care, Caregiver and cost of Medical Examinations.
Why is it important to purchase optional accident benefits coverage?
In case of serious injuries, the basic coverage can quickly be used up, leaving you with huge medical bills. Not all medical treatments in Ontario are covered by OHIP and buying the minimum income replacement benefits and insufficient medical coverage may leave you unable to pay your usual bills and living expenses. Life can become difficult and spin out of control.
What are the optional coverages?
In Ontario, insurers must offer you optional coverages.
There are other optional coverages that you could buy, but these are the major ones:
Third Party Liability:
Coverage may be increased to $500,000, $1 Million or $2 Million.
Income Replacement Benefits:
Weekly benefits maybe be increased to $600, $800 or $1,000
Medical, Rehabilitation and Attendant Care benefits:
Non-catastrophic Injuries (examples: sprains, broken bones, whiplash) and Catastrophic Injuries (examples:, loss of limb, quadriplegia or paraplegia, traumatic brain injury):
Non-catastrophic Injuries: May be increased to $130,000 or increase $1,000,000 for all injuries, for a total of $2,000,000 for Catastrophic Injuries and increase combined all injury benefit to $1,000,000 and increase Catastrophic Injuries to $2,000,000.
Benefits may be extended to include all injuries.
Housekeeping and Home Maintenance Expenses:
Benefits may be extended to include all injuries.
Death and Funeral Expenses:
Benefits may be increased to $50,000 to your spouse, $20,000 to each of your dependants, and $8,000 for funeral expenses.
Dependant Care Benefits:
Covers care for your dependants if you’re employed and injured in an auto accident up to $75 per week for the first dependant, and $25 per week for each additional dependant.
This optional coverage provides for an annual adjustment of your benefits to account for inflation. Adjusted annually according to the Consumer Price Index of Canada (CPI).
In our law practice, we regularly come across cases where our clients have sustained serious injuries and the SABS coverages are insufficient to pay for all of the needed expenses associated with the injuries sustained. Buying optional coverage is always recommended.
As added security, buying disability insurance through a private insurance company is also recommended.
In many cases, motor vehicle accidents allow the injured to pursue the driver responsible for the car accident. This is called a tort claim. In tort claims, injured parties can claim additional compensation which is not available in accident benefits claims, such as compensation for pain and suffering also called general damages. Other claims such as income loss and medical costs can also be claimed in tort law suits.
To read the SABS, go to our government link on sabs: https://www.ontario.ca/laws/
The content of this article is intended to provide information only and is not legal advice. SABS change frequently and so you really need to consult a lawyer to know what your rights are in respect of car accidents and coverages that may apply to you.
Ottawa Injury Lawyer
Marc N. Quinn