Statutory accident benefits coverage in Canada

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.

If you are found at-fault due to an illegal act your car insurance policy could be cancelled and it will be difficult to find new affordable auto insurance. As a high risk driver in Canada, you will need to turn to the facility association to find insurance - it will be significantly more than you currently pay. Plus, 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. 

In order to qualify for accident benefits your injury sustained must fall under one of the following standard injury qualifications:

• Minor Injury - A minor injury can be generally thought of as a strain, sprain, whiplash, or bruise. (download full guide).
• Non-catastrophic - A major injury like a concussion or broken bone.
• Catastrophic - A life altering injury such as paralysis. Any severe injury to the spine or brain.

Depending on the type of injury will help to determine how much accident benefits coverage amount you are entitled to. The more debilitating the injury the larger the payout you are likely to receive.

Depending on your province, you may be able to sue for more economic loss or pain and suffering, but up to a certain limit. If it’s still not enough, you may look to a long term disability insurance plan with your employer or the province where you live.

If the other driver has no insurance, you can make a claim under the mandatory Uninsured Motorist Coverage of your policy. In Ontario, you can claim up to $25,000 after a $300 deductible. However, you must be able to identify the at-fault driver to qualify, so if you are the victim of a 'hit & run', you will have to use your collision insurance to repair your car. 

You can't sue in Manitoba or Quebec, but in other provinces you can up to specified limits. This would provide you with financial support above and beyond the amount awarded to you from an accident benefits claims payout.