List of Benefits
Here you will find out about most of the benefits, treatments and products that drivers and passengers (even pedestrians) are entitled too after being involved in a car accident. This page focuses on information that any person injured in a car accident will find very useful.
What are Accident Benefits?
Benefits are treatments, products and financial help given by your insurance company to you as a result of your car accident injuries and damages. Statuary accident benefits schedule or SABS are standardized procedure in Ontario among insurance companies, providing benefits and financial help to those who were involved in car accident regardless if you are at fault or not, as long as you have a valid insurance.
When should I report my injuries?
Injuries should be reported right away. If you feel sever pain you can be taken to hospital by ambulance right from the car accident location. This is covered by OHIP or by your auto insurance company and will be free for you. If you did not feel pain at the time of the accident and the symptoms occurred hours or days later you can still report your injuries. By legislation you have 2 years to open a claim however the sooner you do it the better it is. After you report your injuries to your insurance company, you will be requested to fill out the application for accident benefits called OCF-1 form. After you receive the OCF-1 form you have 30 days to fill it out and send it back to your insurance company. Your lawyer usually fills out the OCF-1 form but if you don’t retain one you can fill it out yourself. You can download the OCF-1 Form here. We recommend retaining a legal representative to assist you with filling out the form accurately and representing your interests. Legal representatives such as injury lawyers and paralegals will do so under the “No Win No Pay” commitment which mean – if you don’t get money compensation from your insurance company, you don’t pay for their legal services.
Who can claim for accident benefits?
The people who are entitled to claim for benefits are:
- Drivers and passengers
- Pedestrians who got hit
- Any person involved in a car accident and who suffer physical pain or/and emotional disturbances
Who will not be covered for injury benefits?
- Criminal activity that leads to the car accident
- Drivers who were excluded specifically from the policy
- The driver that was driving with expired /suspended or no driver license
I am ready to get my benefits, where do I begin?
The first step is to fill out the OCF-1 form and send it to your insurance company, the sooner the better. After your insurance company will receive the OCF-1 form they will request the Disability Certificate (OCF-3). Disability Certificate (OCF-3) is usually completed by your treating practitioner or your family physician. Disability Certificate will list all your sustained injuries and will comments on your ability to perform activities of daily livings after the accident.
You can download the forms here:
The Complete List of Benefits
Treatments and medical rehabilitation
This benefit will cover necessary expenses in regards to medical treatments such as massage therapy, physiotherapy and chiropractic treatments, acupuncture and other rehabilitation treatments which are not covered by government health plan or your current private insurance plan.
Income replacement
This benefit will partially compensate your weekly income. You will receive 80% of your income and it will be calculated by the last 54 weeks of your income before the accident. If you are self employed your income will be calculated by the last 52 weeks prior to the accident. The maximum payable is $400 per week unless you purchased higher optional benefits.
Care giver benefit
This benefit will reimburse your weekly expenses if you cannot continue to care for a member of your household who is under 16 years of age or who is over 16 years but have his own disability issues. When you get approved for the care giving benefit you will receive $250.00 for the first person and $50.00 per each additional person in your household who is a dependent and to whom you are the main care giver. If you purchased optional care giver benefits from you insurance company you can be eligible for $325.00 reimbursement for the first dependent and $75.00 for each additional dependent.
Non earner benefits
This benefit will be an option only if you do not qualify (or didn’t apply) for income replacement benefits or for caregiver benefits. To qualify for this benefits you must be unable to carry any of your day to day normal activates. With this benefit you will be getting (if approved) $185.00 every two weeks. Payments will begin only 26 weeks after your injuries were reported. The non earner benefit will increase to $320.00 per week after 104 weeks.
Attendant care benefit
This benefit will cover expenses relating to caregiver attendant who will assist you in your normal daily living activity. To be approved for this benefit you must suffer injuries that will disable you from performing your daily living activities as the result of the car accident. In some cases attendant care assessment will be required to begin or continue this benefit. For non catastrophic injuries the coverage per month is up too $3,000.00 and up to $72,000.00 for two years. If your injuries are catastrophic then you are entitled for up too $6,000.00 per month and $1,000,000.00 total with no time limit.
