What do accident benefits in Ontario cover?

Car accidents are more common than most of us would like to think. In Ontario alone, there were more than 26,000 fatal and personal injury collisions in 2023, according to provincial data. And while auto insurance is something we hope to never use, knowing what kind of support you’re entitled to if something happens can offer precious peace of mind – especially when it comes to accident benefits.

Whether you're dealing with medical bills or lost wages, or require caregiving support, accident benefits are designed to help. 

But with changes on the horizon in Ontario’s insurance landscape, it’s more important than ever to understand what these benefits are, how they work, and whether you'll want to opt in or out once new rules take effect.

What are accident benefits?

Accident benefits are a mandatory part of every auto insurance policy in Ontario. They provide financial support to you and your passengers if you're injured in a collision, regardless of who was at fault.

These benefits help cover expenses related to your recovery, lost income, caregiving needs, and, in the worst cases, death and funeral costs. You don’t need to sue or wait for another driver’s insurance to step in, accident benefits are there for you, first and foremost.

What’s covered under accident benefits?

Accident benefits include several types of coverage. Here’s a breakdown of the most common ones:

1. Medical and rehabilitation benefits

These cover medical expenses and treatments not paid for by OHIP or your private health plan — think physiotherapy, chiropractic care, occupational therapy, and more.

For example, if you injure your back in a crash and need several months of physiotherapy to recover, accident benefits can help cover the cost.

2. Income replacement benefits

If you're unable to work due to accident-related injuries, this benefit provides up to 70% of your gross income (to a maximum of $400 per week, though higher limits are available if you’ve purchased additional coverage).

If you break your leg in a car accident and can’t return to work for six weeks, income replacement helps bridge the gap.

3. Caregiver benefits

If you’re a primary caregiver and an accident leaves you unable to care for dependents, this benefit helps cover the cost of hiring someone else to step in.

For example, if a stay-at-home parent with young children is injured in a car accident, they’ll likely need to hire outside help during their recovery. The caregiver benefit helps offset those additional costs while ensuring that daily care continues without placing additional financial strain on the household.

4. Non-earner benefits

This benefit is for people who aren’t employed at the time of an accident, like students, retirees, or stay-at-home parents, but who suffer serious impairments that prevent them from carrying on with normal life activities.

An example of this would be a full-time college student who suffers a brain injury in a crash and can’t return to school or participate in daily routines. This benefit provides financial support during their recovery.

5. Other benefits

• Attendant care benefits: Helps pay for a personal support worker or nurse if you require daily assistance.
• Death and funeral benefits: Provides a lump sum to a deceased person’s spouse and dependents and helps with funeral expenses.
• Optional coverage add-ons: Some policies allow you to increase the limits of certain benefits for an additional premium.

Read more: Should you increase your accident benefits coverage?

Common Challenges When Making a Claim

While accident benefits are designed to support recovery, the claims process isn’t always a smooth experience.

Delays and processing issues

Paperwork errors, lack of documentation, or delays in getting medical assessments can slow down your claim. Keep detailed records and respond promptly to any requests from your insurer.

Claim denials

Claims can be denied if the insurer believes the treatment isn’t necessary, the injury isn’t accident-related, or paperwork was incomplete. If this happens, you have the right to dispute it, usually through the Licence Appeal Tribunal (LAT).

Coverage confusion

Another common issue is misunderstanding what’s covered, especially if you have other types of health or disability coverage. Your private benefits usually pay first, with accident benefits covering the rest. To avoid future confusion during a critical time, talk to a broker or claims adjuster to coordinate between different plans.

Changes coming to accident benefits in Ontario

In 2024, the Ontario government proposed new legislation that would give drivers the option to decline certain accident benefits starting July 1, 2026, as part of a broader effort to give consumers more control over their auto insurance premiums.

This shift comes on the heels of changes to Direct Compensation Property Damage (DCPD) coverage, which became optional in 2024. The rationale? Let drivers decide what coverage they truly need and potentially save them money in the process.

So, what might become optional under the new rules?

• Medical and rehabilitation benefits above the standard amount
• Income replacement benefits beyond the base level
• Attendant care and caregiver benefits

In other words, you’ll still be required to carry a basic level of protection, but some of the more robust or enhanced coverage options may be opt-in rather than standard.

Should you remove any of these coverages?

It might be tempting to drop some of the optional benefits to lower your premium, but you should do so with caution.

Estimates on how much you could actually save on your premium vary, and some experts aren’t entirely convinced that the changes will result in lower premiums in the mid- to long-term. And remember, what you save upfront could cost you thousands later if you’re seriously injured. 

Read more: What is the mandatory minimum car insurance you need to have in Canada?

Know what you’re covered for, now and in the future

Accident benefits are a critical part of your auto insurance policy, designed to support your health, your income, and your recovery in the event of a collision.

And while upcoming changes may offer some flexibility, they also put more responsibility on policyholders to make informed choices. Before making any adjustments to your coverage, speak with an insurance professional and think through your personal circumstances.

Do you have private health coverage? Are you financially prepared for a gap in income if you're injured? As with so many things in insurance, the best time to understand your policy is well before you need it.

Read next: How a car accident affects your insurance premium