Accident benefits are an important part of protecting yourself and your family in the event of an automobile accident. However, understanding the Statutory Accident Benefits Schedule (SABS) can be confusing. In this blog post, we’ll explain what the SABS is, how it works, and how you can use it to ensure you have the right coverage in the event of an automobile accident in Ontario. We’ll also discuss some common misconceptions about SABS and provide tips on getting the most out of your coverage.

Understanding Statutory Accident Benefits Schedule

In Ontario, every motor vehicle insurance policy includes the accident benefits available under the SABS. SABS operates on a no-fault insurance model and provides specific benefits to anyone injured in a car accident, regardless of fault. This coverage applies to drivers, passengers, motorcyclists, pedestrians, and anyone harmed by an insured motor vehicle.

SABS covers medical expenses that Ontario Health Insurance Plan (OHIP) doesn’t cover, compensation for lost income, caregiver costs, and more. It’s an essential part of your motor vehicle insurance policy, so it’s important to review it carefully to understand the types and amount of coverage available in case of an accident.

If you’re injured in an auto accident, it’s crucial to seek advice from an experienced auto accident lawyer who can help you navigate the complexities of SABS. They can guide you through its provisions and assess the possibility of making a benefits claim. Having legal expertise is invaluable to ensure a smooth claims process under SABS.

Categories of SABS Benefits

Individuals who are injured in vehicular accidents can receive financial aid through SABS, regardless of who is at fault. These benefits cover a variety of expenses, such as healthcare costs, income replacement, caregiver benefits, funeral expenses, and more. Being knowledgeable about these benefits can help individuals obtain necessary coverage after an accident and aid in their recovery process. We discuss these benefits in detail below:

• Medical, Rehabilitation and Attendant Care Benefits

If you have been in an accident, you are entitled to medical and rehabilitation benefits that can aid in your recovery. These benefits cover essential services like physiotherapy, chiropractic care, psychological treatment, and more. Attendant care benefits are also available for those with non-catastrophic or catastrophic injuries. For catastrophic injuries, the combined medical, rehabilitation, and attendant care benefits can reach up to $1,000,000, while for non-catastrophic injuries, the maximum amount is $65,000. In the case of minor injuries, medical and rehabilitation benefits are capped at $3,500.

It is important to note that additional coverage is available to increase your limits for medical and rehabilitation benefits. If you have catastrophic injuries, you can raise your coverage to $2,000,000; for non-catastrophic injuries, you can increase your coverage to $130,000.

It is crucial to understand that insurance companies may attempt to minimize payouts by downplaying injuries, such as alleging your injuries are only minor injuries and subject to the $3,500 cap, when they are not. This is why it is imperative to work with an experienced SABS lawyer in Ottawa who can help you obtain the benefits you are entitled to. These lawyers will negotiate with insurance companies to ensure you receive the compensation you need to assist in your recovery.

• Income Replacement, Non-Earner, and Caregiver Benefits

Income Replacement Benefits are available to individuals who have suffered an inability to work as a result of an automobile accident. Typically, these benefits amount to 70% of their gross income, capped at $400 per week. Such benefits are provided for a period of up to 104 weeks following the accident or longer if the accident victim suffers a complete inability to perform any occupation; in both cases, only until they resume work or are earning more than the level of income replacement benefits being paid.

Non-Earner Benefits extend to individuals ineligible for Income Replacement Benefits, including students and recent unemployed graduates. The Non-Earner Benefit amounts to $185 per week and is dispensed for a duration of up to 104 weeks following the accident. 

Meanwhile, Caregiver Benefits are designed to cover the costs of hiring a caregiver to tend to dependents, such as children or elderly parents. This benefit encompasses a maximum of $250 per week for the first dependent, with an additional $50 for each additional dependent. While these benefits are only granted to those who have suffered catastrophic injuries, they can be obtained at an additional cost through optional benefits.

• Death and Funeral Expenses

Regrettably, some vehicular accidents lead to fatalities. In such heartbreaking scenarios, SABS extends lump sum death benefits and funeral expenses to the surviving family members of the deceased. The death benefit amount varies based on the marital and family status of the deceased. For instance, the surviving spouse receives $25,000, while each dependent of the deceased receives $10,000. Additionally, SABS permits up to $6,000 in funeral expenses.

Individuals can opt for additional benefits in certain situations by procuring optional benefits under their insurance policy. For instance, optional death and funeral benefits enable individuals to elevate their coverage amount to $50,000 for the surviving spouse and $20,000 for each dependent of the deceased, along with up to $8,000 in funeral expenses. It’s important to realize that additional benefits may require extra payments, and it’s advisable to speak with a car accident attorney to determine if these benefits are suitable for your particular situation.

• Miscellaneous Expenses

SABS encompasses various additional benefits contingent on individual circumstances. Among these are:

– A visitor’s fee for the family who visits you in the hospital

– Examination costs

– Lost educational expenses

– Compensation for damaged personal belongings, including medical devices

– Coverage for housekeeping and home maintenance costs (for catastrophic impairments)

Applying for Statutory Accident Benefits

If you find yourself involved in a car accident in Ontario and are eligible for SABS, it is imperative to familiarize yourself with the application process for the benefits you are rightfully entitled to. The SABS presents an array of compensatory avenues, including medical and rehabilitation benefits, income replacement benefits, caregiver benefits, and death and funeral expenses.

The initial step in the process entails notifying the concerned insurance company within seven days of the accident and completing the application (OCF-1) for accident benefits. The insurance company will provide you with copies of the requisite documents to complete the application for accident benefits. It is of utmost importance to accurately complete all paperwork and provide all supporting medical documentation (such as the OCF-3; disability certificate) within the prescribed timelines.

Consulting an Experienced Car Accident Lawyer at SG Injury Law

If you have experienced a vehicular accident and are seeking access to the benefits available under SABS, seeking counsel from an experienced car accident lawyer is advisable. At SG Injury Law, our team of lawyers is proficient in navigating the legal system regarding injury and automobile claims and can help you get the justice you deserve.