Accident benefits: everything you need to know
Accident benefits coverage is the most expensive part of any standard auto insurance policy. Comparing car insurance quotes from multiple providers is a great way to mitigate the cost of insurance. Compare for free today.
Matt Hands, Business Director, Insurance
If you are injured in an automobile accident, anywhere in Canada, statutory accident benefits pays for health related expenses that are not typically covered by a provincial healthcare plan. These expenses include, but not limited to physiotherapy, attendant care, and replacement income should you not be able to work.
The Statutory Accident Benefits Schedule (SABS), is a requirement on all auto insurance policies across Canada (except Newfoundland and Labrador), with provincial variations on types of compensation and their scheduled amounts payable. Accident benefits are sometimes called “Section B” benefits depending on where you live.
Accident benefit payouts are the costliest of any submitted claim including third-party liability, DCPD, and collision.
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Medical, rehab, and attendant care
Death and funeral benefits
Optional and other expenses
Everyone involved in an incident related to an insured vehicle or vehicles is eligible for accident benefits, even an at-fault driver. Accident benefits payouts come from the auto insurance provider of the at-fault vehicle or vehicles involved in an incident. That means whether you’re the driver, a passenger, a pedestrian, a cyclist struck while sharing the road, or even a family member who suffered losses as a result of an accident, you are eligible. Each party will file a claim with the insurance company of the at-fault vehicle.
If the accident was caused by an illegal act such as racing or driving without insurance, your insurer may still pay for some accident benefits coverage, but could deny payments of income replacement. Your insurance, however, could be cancelled and it will be difficult to get new insurance. As a high risk driver in Canada, you will need to turn to the facility association to help you work with a provider who will insure you, costly as it may be. You could face fines, lose your license, and any convictions stay on your record for 3 years, and any accidents stay on your driving record for up to six years.
After an accident, gather all essential information - driver’s names, licence numbers, license plates, insurance companies, and policy numbers, and your own description of the accident. Then, once everyone is safe and police reports are filed, call your insurance company to begin the claims process.
Once your claim is reported, an insurance claims adjuster will either phone or meet with you in person. They’ll explain the various coverages and help guide you through the claims process. If you’re confused at all, ask for an explanation, they are there to help you.
If you’ve been injured in a claim, you’ll need to file forms that your claims adjuster will provide to you with an Accident Benefits Application Package that includes 5 forms.
Here are Ontario’s Claim forms (OCF) as an example:
If you want a quick and seamless process fill out each form clearly, double check your work, and make sure you sign and date the forms. And if you’re working with anyone else that will need to submit the forms, ask them to fill in their portion and submit as quickly as possible.
Once the insurance company has all the required forms, reviewed the details, they’ll inform you in writing what you can expect to receive. If you’re not happy, call your claims adjuster. If you’re still not happy, there are options to dispute.
In Ontario, it’s the License Appeal Tribunal (LAT), you can read more about that process on our blog: Accident benefits at the license appeal tribunal.
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Prince Edward Island
Newfoundland & Labrador
Can you sue for pain and suffering?
What happens if you run out of accident benefits?
What happens if the other driver is not insured?
Matt started his professional career at CARPROOF where he honed his marketing and analytical skills for over 3 years. Matt then took his wealth of experience to Ratehub.ca’s Toronto offices, working with insurance providers, agents, and brokers to grow and expand the Insurance business unit. He is a thought leader in the community and a valuable insurance resource to respected publications like the Globe & Mail, Toronto Star, Huffington Post, Yahoo News, and 680 news radio in Toronto.read linkedin bio
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