Ontario Accident Benefits (SABS), Explained Without the Jargon
After a car accident in Ontario you have two separate claims. One is the lawsuit against the at-fault driver. The other, which starts right away, is your accident benefits claim. It runs through your own insurer regardless of who caused the crash, which is why people call it no-fault.
Accident benefits are governed by a regulation called the Statutory Accident Benefits Schedule, or SABS. Here is what it actually does.
What the benefits cover
The core benefit pays for medical and rehabilitation treatment that is reasonable and necessary: physiotherapy, assessments, medication, assistive devices and similar care. If your injuries are serious enough, there is also attendant care to help with personal needs at home.
If you cannot work, an income replacement benefit pays a portion of your lost income. There are also benefits for people who were not employed, for caregivers, and for certain expenses like housekeeping where the injuries are severe.
How much it pays
The amount depends on how your injuries are classified. Minor injuries fall under a framework that caps medical and rehabilitation funding at three thousand five hundred dollars. Most other injuries fall into a middle category with a combined medical, rehabilitation and attendant care limit of sixty-five thousand dollars. The most serious injuries can be designated catastrophic, which raises that limit to one million dollars.
The income replacement benefit is generally seventy percent of your gross income, up to a default maximum of four hundred dollars per week, unless you bought optional coverage that raises it. These numbers are why the classification of your injury is one of the most important fights in the whole file.
The deadlines that trip people up
You are expected to notify your insurer of the accident within seven days, or as soon as practicable. Once the insurer sends you the application package, you generally have thirty days to complete and return it. Missing these dates does not always end a claim, but it creates avoidable problems.
The bigger trap is the minor injury label. Insurers default to it because it caps your funding low, and getting out of it usually takes medical evidence. That is the kind of thing worth getting help with early rather than after the funding runs out.
- ·Accident benefits are no-fault and run through your own insurer after any Ontario car accident.
- ·They cover treatment, income replacement, attendant care and more, with limits set by your injury classification.
- ·Minor injury funding caps at $3,500, most injuries at $65,000, and catastrophic injuries at $1,000,000.
- ·Notice is due within about a week and the application within 30 days of receiving the forms.
This article is general information, not legal advice, and every case turns on its own facts. If you have been injured, and especially in a matter involving car accidents, Shah & Shah Lawyers offers a free consultation.