Motor vehicle accidents, car accidents, bicycle accidents, motorcycle accidents, pedestrian / car accidents and any other type of motor vehicle accidents – Statutory Accident BenefitsMotor vehicle accidents, car accidents, bicycle accidents, motorcycle accidents, pedestrian – car accidents and any other type of motor vehicle accidents can have long lasting and devastating financial, social, emotional and psychological consequences for the injured person and their family. If you have been injured in a motor vehicle accident, you should obtain legal advice from a personal injury lawyer and get to know your legal rights and interests. Your personal injury lawyer should be knowledgeable in motor vehicle law.
What is the difference between statutory accident benefits and a tort claim?
If you are injured in a motor vehicle accident, you are entitled to apply for Statutory Accident Benefits (SABS) regardless of fault. You are also entitled to claim tort damages, meaning compensation (damages) from the person at fault for the accident. A tort claim is a law suit in which you claim monetary damages as compensation against the persons responsible for your accident and injuries. In order to claim compensation from the negligent person who caused you injuries in a motor vehicle accident, you must meet a legal test. Under the current “no-fault” insurance system in Ontario, in order to successfully sue someone for damages / compensation, you must meet two criteria, known as the “threshold” which means that: You must have sustained a serious and permanent impairment of an important physical, mental or psychological function or have sustained a serious and permanent disfigurement and your injuries must exceed the statutorily prescribed deductible which is currently $30,000.00.
We can help you obtain compensation for pain and suffering, lost income, medical expenses, expert expenses and other expenses incurred as a result of the accident.
What does no fault mean?
No-fault insurance means that if you are injured or your car is damaged in an accident, then you deal with your own insurance company for coverage and indemnification (compensation), regardless of who is at fault in the accident.
What are Statutory Accident Benefits (SABS)?
Statutory accident benefits (which is also referred to as “no fault-benefits”), are statutory benefits provided to persons in Ontario injured by the use or operation of a motor vehicle. They are governed by the Statutory Accident Benefits Schedule, which is a regulation made under the Insurance Act of Ontario.
Statutory Accident Benefits (SABS) are the no fault component of the Insurance Act when it comes to motor vehicle accidents. These are accident benefits which provide compensation for expenses incurred to treat you, to provide care for you and also to replace your income while recovering from an accident. You are entitled to all of the benefits from your own insurance company. The types of benefits include: income replacement, non earner benefits, disability benefits, caregiver benefits, housekeeping benefits, attendant care benefits, home maintenance benefits, medical benefits, rehabilitation benefits and other expenses related to the injuries you sustained in a car accident.
The accident benefits in Ontario are set by the provincial government by amendments to regulations made under the Insurance Act of Ontario. While you can purchase additional optional accident benefits, for most people, the benefits are what is governed by the standard motor vehicle insurance policy. It is definitely worth reviewing the optional accident benefits because in many cases, the cost is minimal compared to the benefit. The additional optional insurance must be purchased before an accident occurs. The types of increased coverages you can buy include, more caregiver benefits, more income replacement benefits, more medical, rehabilitation and attendant care benefits and more death and funeral benefits.
Who can claim Statutory Accident Benefits?
Every person who is injured in a motor vehicle accident in Ontario is entitled to claim accident benefits. Accident benefits / “no-fault” benefits are claimed from your own motor vehicle insurance company.
What if I do not have motor vehicle insurance?
If you do not have motor vehicle insurance (not insured), you are entitled to claim accident benefits from the motor vehicle insurer of the other person involved in the motor vehicle accident.
If there is no available insurance at all, you may advance a claim for accident benefits to the government’s Motor Vehicle Accident Claims Fund which provides accident benefit coverages for uninsured situations.
What are the different types of Statutory Accident Benefits?
Currently, the accident benefits available include:
Income Replacement Benefit: 80% of net weekly income up to maximum of $400.00 per week to a maximum period of 104 weeks. A 7 day deductible applies.
Non-Earner Benefit: The entitlement is $185.00 per week to a maximum period of 104 weeks. A 6 month deductible applies.
Caregiver Benefit: $250.00 per week for 1st child and $50.00 per week for each subsequent child to a maximum period of 104 weeks. Th benefit only applies for children under the age of 16.
Housekeeping and Home Maintenance Benefit: $100.00 per week to a maximum period of 104 weeks.
Attendant Care Benefits: $3,000.00 per month maximum to a maximum period of 24 months. The monthly amount payable is determined in accordance with a Form 1, as prescribed under the Insurance Act of Ontario.
Medical and Rehabilitation Benefits: $100,000.00 maximum. There is a 10 year maximum period.
Other Benefits: Depending on your circumstances, you may also be entitled to other benefits. For example, benefits to pay for visitors’ expenses, repair or replacement of eyeglasses or clothing damaged in the accident, or case manager services.
If I am injured in an accident, do I automatically qualify for all accident benefits?
You do not automatically qualify for accident benefits. Each benefit has its own qualifying criteria. Examples of needed qualifications needed are as follows:
Income Replacement Benefit: This benefit is for insured persons who were employed for at least 26 out of the last 52 weeks prior to the motor vehicle accident and who, as a result of the accident, suffer a substantial inability to perform the essential tasks of their employment.
Non-Earner Benefit: This benefit is for insured persons who were not employed at the time of the motor vehicle accident and who suffer a complete inability to carry on a normal life as a result of the motor vehicle accident.
Caregiver Benefit: This benefit is for insured persons who are the primary caregiver of a child or children under 16 years of age and who, as a result of the motor vehicle accident, suffer a substantial inability to engage in the care giving activities in which they were engaged in at the time of the accident.
Housekeeping and Home Maintenance Benefit: This benefit is for insured persons who incur expenses as a result of an accident for housekeeping and home maintenance services and are payable if the insured person suffers a substantial inability to perform the housekeeping and home maintenance services that they normally performed before the accident.
Attendant Care Benefit: This benefit is for insured persons who incur expenses as a result of an accident for services provided by an aide or attendant.
Medical and Rehabilitation Benefit: This benefit is for insured persons who require treatment as a result of a motor vehicle accident such as physiotherapy, chiropractic services, etc.
Motor vehicle law experts
At Quinn Thiele Mineault Grodzki LLP, we can handle your accident benefits claims and deal directly with your insurance company, help complete the many forms required and guide you through the maze of procedures, forms and details needed to obtain the benefits you are entitled to receive.
As soon as possible following an accident, you should consult a lawyer who will fight for your rights. Do not rely on the insurance company or adjusters to assist you. Their job is to benefit the insurance company, not you. Only your personal injury lawyer will look out solely for your rights and interests.