Accident Benefits in Ontario: Coverage Guide

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By <span>Aren Mirzaian</span>
By Aren Mirzaian

Updated on January 17, 2024

Visit author page
By <span>Aren Mirzaian</span>
By Aren Mirzaian

Updated January 17, 2024

Visit author page

3 minute read

Article Contents
Accident Benefits in Ontario: A Comprehensive Guide to What's Covered

No driver is entirely safe from getting seriously injured in an accident or, in the worst-case scenario, even killed. This is why accident benefits coverage is extremely important in auto insurance. This guide delves into the intricacies of accident benefits in Ontario, clarifying what’s covered under standard policies and the optional benefits available. Whether you’re a new driver or a seasoned road veteran, comprehending these benefits is essential for ensuring you’re adequately protected.

Understanding Accident Benefits in Ontario

In Ontario, driving without car insurance is illegal. Thus, it’s mandatory for any individual who owns and operates a vehicle to obtain one. The insurance policy must encompass certain coverages such as liability coverage, uninsured automobile coverage, and accident benefits coverage. Accident benefits are a critical component of auto insurance. They cover individuals injured in a car accident, regardless of who is at fault. These benefits cover a range of expenses, including medical and rehabilitation costs, income replacement, and more.

Standard & Optional Accident Benefits Coverage

Ontario drivers can either get standard accident benefits coverage or enhance it with additional perks. These optional benefits offer increased protection and peace of mind. Here’s is a list of accident benefits, both standard and optional:

  • Medical and Rehabilitation Benefits: This covers expenses for medical and rehabilitation services not covered by provincial health plans.
    • Standard: The standard benefit amount for non-catastrophic injuries is $65,000, and for catastrophic injuries, $1,000,000.
    • Optional: The increased benefit amount for non-catastrophic injuries is $130,000, and for catastrophic injuries, it’s $2,000,000.
  • Income Replacement Benefits: If you’re unable to work due to an accident, this benefit compensates for lost income.
    • Standard: You may qualify for benefits amounting to 70% of your gross income, capped at a weekly maximum of $400.
    • Optional: The weekly limit can be increased to $600, $800 or $1000 per week.
  • Caregiver Benefits: This benefit covers such expenses for those who require personal care assistance due to an accident.
    • Standard: For catastrophic injuries, you can receive a weekly benefit of up to $250 for the first dependent, plus an additional $50 weekly for each subsequent dependent.
    • Optional: It provides up to $250 per week for the first dependent plus $50 for each additional dependent, available for all injuries.
  • Funeral and Death Benefits: In the unfortunate event of a fatality, these benefits assist with funeral expenses and provide financial support to the deceased’s dependents.
    • Standard: A $25,000 lump sum goes to an eligible spouse; a $10,000 lump sum goes to each dependent; a maximum of $6,000 funeral benefits.
    • Optional: It allows additional death and funeral expenses up to $50,000, raises dependents to $20,000, and gives a maximum of $8,000 funeral benefits.
  • Housekeeping and Home Maintenance Expenses: This benefit helps if you’re recovering and unable to manage household tasks.
    • Standard: Provides up to $100 weekly to assist with housekeeping and home maintenance costs, available only for catastrophic injuries.
    • Optional: Provides up to $100 per week to assist with housekeeping and home maintenance costs, available for all injuries.

Other Expenses Covered By Standard Accident Benefits Coverage

  • Non-Earner Benefits: If you’re ineligible for income replacement benefits due to being a student and unable to resume your regular daily activities post-incident, you may be entitled to a weekly sum of $185.
  • Lost Educational Expenses: This covers reimbursement for educational losses, including tuition, books, and other related academic costs, up to a maximum of $15,000.
  • Visitor Expenses: This benefit covers the reasonable travel expenses incurred by your family and friends who visit you during your recovery and treatment.
  • Compensation for Personal Belongings: This includes compensation for items such as clothing, glasses, and other personal medical devices damaged in the accident.
  • Examination Costs: You are entitled to compensation covering the costs of examinations necessary for treatment and recovery following the accident.

Accident Benefits That Only Come With Optional Coverage

  • Dependant Care Benefit: Assuming you were employed at the accident and are not receiving a caregiver benefit, the policy offers up to $75 per week for the first dependent and $25 for each additional dependent, provided you incur extra childcare expenses due to the accident.
  • Indexation benefit: This provides an annual update to account for yearly inflation rates based on the Canadian Consumer Price Index. It applies to income replacement, non-earner, caregiver, and medical and rehabilitation benefits.
Standard and optional accident benefits coverage

Why Consider Optional Accident Benefits?

Canada generally ranks high regarding road safety, but it’s still imperfect. In 2021, there were 1,768 fatalities due to motor vehicle accidents, a 1.3% increase from 2020. Serious injuries rose to 8,185, marking a 4% increase from the 7,868 in 2020. The total number of injuries climbed to 108,018 in 2021, up 3.6% from the previous year. While standard accident benefits provide a safety net, the optional benefits cater to those seeking extra security. They are particularly beneficial for:

  • Individuals with high-income jobs where standard income replacement would not suffice.
  • Families with dependents would need additional financial support in case of a serious accident.
  • People without comprehensive health insurance would benefit from increased medical coverage.

What Do Accident Benefits Entail for Passengers?

Every passenger involved in a vehicle accident is entitled to these benefits. Regardless of the nature of the accident or who is to blame, insurance coverage is typically assured. To access these benefits, you must initiate a car insurance claim against the driver involved.

Navigating Claims and Understanding Your Policy

Understanding your policy and knowing how to navigate claims is crucial. Here are some key points:

  • Policy Review: Regularly review your policy to understand the extent of your coverage.
  • Claim Process: Get to know the claim process well to guarantee the prompt and precise submission of all necessary documents. For example, to apply for these benefits, you must complete a form (OCF-1), which is integral to the application process. This form must be submitted to your insurer as a necessary step in the procedure.
  • Consultation: Don’t hesitate to consult your insurance provider for clarifications or additional information.

The Bottom Line

Accident benefits in Ontario are designed to provide financial support and peace of mind in the wake of a vehicular accident. Understanding what’s covered and the available optional benefits empowers you to make informed decisions about your auto insurance needs. If you want even more protection, the thing we recommend that will provide financial security in case the car accident is fatal is life insurance. Remember, the right type of coverage can make a significant difference in times of need for you and your family.

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