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What Do Accident Benefits in Ontario Cover?

Feb. 2, 2021
4 mins
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Accident benefits is one portion of every car insurance policy in Ontario that protects you if you are injured in a collision.

It’s an important part of your policy should you need time to recover from an accident, as it pays any medical bills you may have while rehabilitating. As part of Ontario’s no-fault insurance system, the provincial statutory accident benefits schedule outlines the coverage available, and the related costs for anyone injured in a collision whether you’re the driver (determined to be at-fault for the accident or not), a passenger, pedestrian or cyclist. The benefits are paid through the provider insuring the vehicle.

Ontario accident benefits contain four main types of coverages:

  1. Income replacement, non-earner, and caregiver benefits
  2. Medical, rehabilitation, and attendant care benefits
  3. Death and funeral benefits
  4. Other or miscellaneous benefits

Let’s go over how each benefit type works.

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Understanding Ontario accident benefits

If you’ve had the misfortune of being injured in an auto accident, one (or all) of these benefits will pay out to help you get back on your feet. If you’re a pedestrian or cyclist who was injured by a driver who hit you, you would file a claim for benefits with the insurer of that vehicle.

Income replacement, non-earner, and caregiver benefits

As its name suggests, the income replacement benefit kicks in if you are unable to work because of your injuries. Typically, you may be able to claim 70% of your gross income up to $400 per week. However, you can hike this benefit up to $1,000 per week.

Non-earner benefits figure into the equation if you don’t qualify for income replacement, are a full-time student, and are unable to live your life as you did before suffering injuries from a collision. Your non-earner benefits may entitle you to $185 per week in compensation.

Caregiver benefits come into play if, as a result of a catastrophic injury, you are unable to adequately care for a dependent such as a child or senior parent. This benefit will reimburse you for expenses you incur to hire someone else to care for your dependents while you heal. This particular coverage is usually only applicable if you suffer a catastrophic injury, however, you do have the option of extending it to cover any collision-related injury.

Medical, rehabilitation, and attendant care benefits

Medical and rehabilitation benefits apply for any expenses that are not covered by the Ontario Health Insurance Plan (OHIP) or your employer or private health care insurance. This benefit will pay for things such as surgery, dental care, hospitalization and ambulance, prescription eyewear, mobility devices, physiotherapy, psychological and occupational therapy, family and financial counselling, and chiropractic care.

Attendant care benefits, meanwhile, will pay for the cost of having to hire someone to care for you either at home or in a health care facility if, for example, you require assistance to bathe, dress, and use the washroom.

Medical, rehabilitation, and attendant care coverage is usually limited to $65,000 for non-catastrophic injuries, and $1 million for catastrophic injuries. You do have the option of increasing those limits to $130,000 for non-catastrophic injuries and $2 million for catastrophic injuries.

Death and funeral benefits

No one wants to think about dying from a car accident, but unfortunately, it can happen. The death and funeral coverage within your accident benefits entitles your spouse to $25,000 if you die as a result of a collision, and up to $10,000 for each of your dependents (children). An additional $6,000 is available to pay for your funeral expenses. These coverage limits can be increased as well to $50,000 to your spouse, $25,000 to each dependent, and $8,000 for funeral expenses.

Other or miscellaneous benefits

Your statutory Ontario accident benefits also provides coverage for what is referred to as other or miscellaneous expenses if your injuries prevent you from managing or continuing any of the following:

  • Lost educational expenses. If you’re a student – elementary, secondary, postsecondary or enrolled in a continuing education program – but you can’t continue your schooling as a result of injuries from an accident, coverage is available for tuition, books and materials, and room and board related to the educational program year to a maximum of $15,000.
  • Damage to clothing and medical devices. Your insurer will also pay to replace damaged clothing you were wearing at the time of the accident, as well as prescription eyewear, hearing aids, dentures and other medical devices lost or damaged in the accident.
  • Cost of examinations. As part of your rehabilitation while recovering from an accident, your insurer will compensate you for the cost of medical examinations you incur.
  • Expenses of visitors. While you’re recovering from your injuries, some expenses incurred by family members or others who lived with you at the time of the accident who visit you may be claimed for a maximum of 104 weeks (two years). That two-year limit, however, does not apply if you sustain a catastrophic injury.
  • Housekeeping. If you suffer a catastrophic injury from a car accident and must hire someone to maintain the upkeep of your home, you can claim up to $100 per week to pay for that expense. You have the option to extend this benefit to include non-catastrophic injuries.

Know that increasing your accident benefits coverage limits will, in turn, increase the overall cost of your premium.

Talk to your broker or insurance provider about increasing your accident benefits coverage if you’re concerned about your limits or what your current policy includes. Before your car insurance policy is due for renewal, shop your rate to see if you can get the coverage you need at a lower premium.

Liam Lahey

Liam Lahey is a versatile, seasoned writer and editor. He worked as both a staff writer and freelance writer for many business and technology publications as well as for several newspapers. He writes about home, auto, and travel insurance, and is a media spokesperson for RATESDOTCA.

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