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David Hollingsworth team

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Changes to Accident Benefits can hurt those who need it most.

Changes to Accident Benefits Means Reduction in Coverage for Ontario Drivers

Do you know about the changes to accident benefits? When accidents happen, we expect that our health care system will be there to provide only the best care to see us through, but what about all of the other expenses that are not covered under the Ontario Healthcare System?  Few of us stop to consider who will pay for replacement income if we cannot work, childcare as we recuperate, rehabilitation and home maintenance?  Are these expenses automatically covered by our insurance policies?    Yes, they are and they fall under the Statutory Accident Benefits Schedule.

New Changes to Accident Benefits: Will you be covered?

Statutory Accident Benefits apply to anyone involved in a car accident, bicycle accident, motorcycle accident, pedestrian & car accident and any other type of motor vehicle accident.  These benefits fall under the Insurance Act of Ontario and apply to:

  • Income Replacement BenefitsDriver
  • Non-Earner Benefits
  • Caregiver Benefits
  • Housekeeping and Home Maintenance Benefits
  • Attendant Care Benefits
  • Medical and Rehabilitation Benefits

Will you have enough coverage?

On June 1, 2016, the changes to accident benefits and coverage in standard auto insurance policies was implemented to help make insurance more affordable.  Some claim amounts were reduced and some options for increased coverage were eliminated or changed.

This is an overview of the changes to accident benefits.

  • Medical & Rehabilitation and Attendant Care benefits have been combined into one category.
  • Persons with catastrophic injuries may be entitled to a maximum combined benefit of up to $1,000,000 over their lifetime. This has been reduced from $2,000,000.
  • Persons with non-catastrophic injuries may be entitled to a maximum combined benefit of up to $65,000 over 5 years reduced from $50,000 over 10 years for Medical, Rehabilitation and $36,000 for Attendant Care over 2 years.
  • Persons with minor injuries may be entitled to a maximum benefit of $3,500. The claim period has been reduced from 10 years to 5 years.

In order to meet the definition of catastrophic for car accident cases in Ontario, a licensed doctor must complete and submit an OCF-19 form. This form is called an Application for Determination of Catastrophic Impairment.  Given that the Statutory Accident Benefit amount vary greatly depending on which category the victim may fall under, it is important to learn more about the difference between catastrophic injury accident benefits and non-catastrophic injury accident benefits .


Should you purchase additional coverage?

In addition to these changes came the opportunity to purchase Optional Benefits for Medical, Rehabilitation and Attendant Care.  You may want to purchase optional benefits to increase coverage levels, but first take time to understand your existing plan and impact the of the new changes.

  • Read your policy and compare it to the new policy to see what changes have been made. If you have benefits from your employer or another policy, you may already have some level of coverage for some or all of the changes made. You should consider these benefits as you review your coverage options.
  • Understand your policy. Call your insurance representative and ask questions, or do some additional reading, to make sure you understand your insurance and what your coverage means.  Make sure you know what options are available to increase or purchase other benefits, or to reduce premiums by increasing deductibles or taking advantage of discounts.
  • Shop around. There are many insurance companies competing on price and service in Ontario, and you should make sure that you compare at least three quotes for the same coverage before making a decision.

If you or a loved one has been injured in an accident, it’s important you get the information you need. Ontario Accident Benefits are your benefits and benefits you are most likely entitled to. If you are unsure of your rights or what benefits you are entitled to, contact our personal injury lawyers and we will be happy to provide you with the information you need to get the benefits you deserve.

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