If you are seriously injured in an auto accident in Ontario, Statutory Accident Benefits pay for expenses not covered by healthcare, to treat you, replace your income, and more.
The Statutory Accident Benefits Schedule, or SABS, for short, is a mandatory no-fault auto insurance coverage in Ontario, and is included with all basic auto insurance policies.
Administered by the Automobile Accident Benefits Service of Ontario, accident benefits are paid through the auto insurer covering your vehicle (or the vehicle in which you were a passenger). If you suffer injuries when hit by a vehicle as a pedestrian or bicyclist, you will have to file a claim with the insurance company of the vehicle that hit you.
Statutory Accident Benefits, or SABS, include:
The combined mandatory minimum coverage for Medical, Rehabilitation and Attendant Care Benefits is $65,000 for non-catastrophic injuries, and $1M for catastrophic injuries (loss of limb, quadra/paraplegia).
For an additional premium, you can increase the limits as follows:
If you die as a result of an auto accident, benefits include payments of:
Benefits may be increased to:
Learn more about all mandatory and optional auto insurance coverage options in Ontario.
Read or download the complete Statutory Accident Benefits Schedule from the Government of Ontario website.
An EUO is an in-person interview of a person claiming Accident Benefits. It is conducted by the insurance company, with the goal of verifying the authenticity of the claim. Insurers have the discretion to conduct such an examination whenever an Accident Benefits claims is made, but typically it is used in instances where the insurance adjuster suspects fraud. The results of the examination can be used to deny the claim or limit benefits. If the claimant refuses to submit to the examination, the insurer can suspend benefits. The claimant is allowed to have their lawyer present.
In order to make sure that insurance benefits go where they are most needed, different policy limits have been created under the SABS for different classes of injury. Medical and rehabilitation benefits for a minor injury, for example, are limited to a maximum of $3,500. On the other hand, if a motor vehicle accident leads to a catastrophic impairment, the injured party is entitled to up to $1 million in rehab benefits.
The definition of a catastrophic impairment is quite complex, but essentially, to be considered catastrophic, injuries need to significantly impact the person’s ability to function, and the impairment must be permanent. Examples include blindness, paralysis and permanent brain damage.
See the full definition in section 3.1 of the SABS.
In cases where victims of a motor vehicle accident suffer minor injuries, the minor injury guideline allows expedited access to rehab services like chiropractic and physiotherapy to ease symptoms like pain and minor disability. It also caps benefits in these instances to prevent minor sprains and strains from costing the auto insurance system tens of thousands of dollars over several years of treatment.
Typically, sprains, strains, whiplash injuries and subluxations fall under the guideline, which promotes quick access to treatment and a quick resolution of the claim. Medical and rehabilitation benefits for minor injuries are limited to $3,500.
In Ontario, there are a number of official forms that must be filled out when an auto insurance claim is made. OCF stands for “Ontario Claims Form”. The OCF-19 would be completed if you wanted to apply to an insurance company to have your injuries deemed “catastrophic”. If you are successful in getting the catastrophic designation, you will have access to much higher limits in terms of medical and rehabilitation benefits. Benefits for a non-catastrophic injury are typically capped at $65,000, whereas a catastrophic designation gives you access to up to $1 million in benefits.
Give our insurance experts a call to determine what amount of coverage is best for you and your family at 1-800- 731-2228 or request an auto insurance quote. We’d be happy to help you any type of insurance.