Accident Benefits
The Ontario Automobile Insurance policy includes Accident Benefits coverage, which responds when you or your passengers are injured in an automobile accident. In 2016, reforms to the Accident Benefits portion of the policy were introduced by the provincial government and now affect all policies. Standard Accident Benefits are those provided by the basic policy, with optional increased or additional benefits available for purchase.
We encourage you to review the Accident Benefits provided by your policy and consider additional benefits available for purchase.
Medical, Rehabilitation and Attendant Care Benefit
Medical & Rehabilitation: Reimbursement for reasonable, necessary medical and rehab expenses not covered by OHIP. If you have Employee Group benefits, the insurance provided by your employer responds first. Attendant Care: Reimbursement for an attendant to look after you at home or within a healthcare facility. As of June 1, 2016, payments are limited to 5 years for adults and 10 years for children (non-catastrophic).
Standard Benefits: $65,000 combined limit. Minor injuries are fixed at a maximum limit of $3,500
Optional Benefits:
- Increase limit for serious but non-catastrophic injures to $130,000 or $1,000,000.
- Increase limit for catastrophic injuries from $1,000,000 to $2,000,000.
Caregiver Benefit
Reimbursement to hire someone to care for your dependant(s).
Standard Benefits: Up to $250/week for first dependant, $50 for each additional dependant. Available in catastrophic injuries only.
Optional Benefits: Extend this benefit to respond to non-catastrophic injuries.
Housekeeping & Home Maintenance Expenses
Reimbursement for someone to carry out your household responsibilities. Standard benefits provide coverage only in the case of a catastrophic injury.
Standard Benefits: Up to $100/week. Available in catastrophic injuries only.
Optional Benefits: Extend this benefit to respond to non-catastrophic injuries.
Income Replacement Benefit
A weekly income of 70% of your gross income up to the weekly limit, beginning one week after the accident occurs which prevents you from working. If your annual income is higher than $30,000 you should consider purchasing the increased limits.
Standard Benefits: Up to $400 per week. Non-earners are eligible for up to $185/week limited to 2 years.
Optional Benefits: Increase the weekly maximum to $600, $800, or $1,000.
Dependant Care Benefit
Not provided in the Standard Benefits, this optional coverage provides limited reimbursement for additional expenses to care for your dependant(s) if you are employed and injured in a car accident.
Standard Benefits: No coverage.
Optional Benefits: Up t $75/week for first dependant and $25/week for each additional up to max $150/week.
Death & Funeral Benefit
A lump sum payout to your spouse and dependant(s) in the event of your death, with a separate lump sum for funeral expenses.
Standard Benefits: $25,000 to spouse, $10,000 to each dependant; up to $6,000 for funeral expenses.
Optional Benefits: $50,000 to spouse, $20,000 to each dependant; up to $8,000 for funeral expenses.
Indexation Benefit
Not provided in the Standard Benefits, this optional coverage adjusts the sum of Accident Benefit payments for which you are eligible annually as per the CPI of Canada over the course of time for which you receive benefits.
Standard Benefits: Not included.
Optional Benefits: Adjust annually to CPI.
Tort Deductible
The amount deducted from a settlement or court award for pain & suffering.
Standard Benefits: $36,500 deductible applies to any settlement.
Optional Benefits: Reduced $20,000 deductible is available.
Injuries – Minor Injury Guidelines, Non-Catastrophic & Catastrophic Injuries
Some benefits are activated only when an injury is ‘catastrophic’. While the revised legal definition for ‘catastrophic’ is complex, the criteria includes traumatic brain injury, loss of ambulatory mobility, loss of vision, etc., injuries requiring extensive care and medical attention. Minor injuries include sprains, strains, whiplash, abrasion, etc., insured to a maximum limit of $3,500. Non-Catastrophic injuries lie in the area between the Minor Injury guidelines and the Catastrophic definition.
Third Party Liability Insurance
Your policy also provides Third Party Liability coverage to respond to claims brought against you for bodily injury and/or damage to property of others caused by an auto accident arising out of the ownership or use of your vehicle. With the new changes and reductions in the Standard Accident Benefits, we strongly recommend you also consider purchasing increased limits of Third Party Liability coverage under your auto policy and/or purchasing a Personal Umbrella Liability policy.
Contact our office to discuss your existing limits of insurance or to purchase additional optional coverages.
