Statutory Accident Benefits
Motor vehicle accidents can be life-changing and present many challenges. Apart from the stress of the experience itself, you may not be able to work as a result of your injuries and may require treatment that is not covered by OHIP.
The following blog outlines some important facts about statutory accident benefits and will help to answer some of the most frequently asked questions that we hear from our clients.
What are statutory accident benefits?
Whether or not you have a claim against an at fault driver for your injuries, if you are at fault for the accident, or no one else is involved in the accident, statutory accident benefits may be available.
These benefits can provide support in the form of certain weekly benefits, or to pay for medical and rehabilitation expenses, among other things. That is why they are often called “no-fault benefits” — because your degree of fault for the accident has no bearing on the amount of benefits you could receive.
How do I apply for benefits after a car accident?
The first step in the claims process is to report the accident and your injuries to your automobile insurer — you must do this within seven days of the accident, or as soon after as practicable.
In most cases, if you do not have auto insurance, you will still have access to statutory accident benefits. There is a priority list that determines where you should direct your application and, ultimately, if no options on the list apply your application, you would be directed to the Motor Vehicle Accident Claims Fund.
Once the accident, and the fact that you were injured, are reported to the insurance company, you will be sent an application package. There are time limits for submitting the forms and for responding to requests for information from the insurance company that need to be followed — otherwise, your access to benefits could be affected, or you could experience a delay in obtaining certain benefits.
What sort of accident benefits am I eligible to receive?
The Statutory Accident Benefit Schedule (SABS) provides for various benefits, the amount of each benefit, and the tests to qualify for them. There are also limits to when and for how long certain benefits are available.
Benefits may include:
- Weekly benefits
- Income replacement benefits
- Non-earner benefits
- Caregiver benefits
If you qualify for more than one of these benefits, you may need to choose which to apply for. In most cases, you will be held to your choice. Accordingly, it is important to understand the tests for eligibility and the duration and amount of each particular benefit before you choose.
Are there additional accident benefits available?
Another set of benefits available under the SABS are medical and rehabilitation benefits.
Medical and rehabilitation benefits are for reasonable and necessary goods and services incurred in relation to your accident related injuries. There are different monetary limits to these benefits depending on the nature of your injuries.
Other benefits available under the SABS include:
- Attendant care benefits
- Lost education expenses
- Housekeeping and home maintenance benefits (if you purchased optional insurance that provides for this, or are catastrophically impaired)
- Funeral and death benefits — in the event of a fatality
If you suffer a psychological or mental injury as a result of a serious, or fatal, injury of a family member as outlined in the SABS, you could have access to certain benefits, even if you were not involved in the accident.
The SABS provides for minimum limits that some people may find inadequate. Optional benefits can be purchased to increase benefit limits and should be considered. We recommend that you speak with your insurance provider, or agent, for more details.
A statutory accident benefit claim can be a complicated process, but the first step is knowing that statutory accident benefits are available. A personal injury lawyer can assist you in completing the forms, navigating the process, and ensuring you are receiving the benefits you are entitled to.
For more information about statutory accident benefit coverage, or any other accident benefit coverage questions, contact the experts at Brown Beattie O’Donovan. We’ll be happy to help you.