Accident benefits coverage in Ontario

Accident benefits coverage is a type of medical car insurance coverage that is mandatory in (almost) all Canadian provinces and territories. Accident benefits are a part of Ontario’s no-fault system that works whether you caused the crash or not. Essentially, if you’re injured in a car accident, whether you're the driver, passenger, or even a pedestrian, accident benefits can help cover your medical care, rehabilitation, lost income, and even housekeeping support. In Ontario, accident benefits are built into every policy. That means, right from the start, you have coverage for things like supplementary medical, rehabilitation, and attendant care or caregiver expenses for catastrophic and non-catastrophic injuries and even income replacement.

According to Transport Canada, in 2023, Canada recorded 118,838 injuries from motor-vehicle collisions, with 1,964 fatalities, up 1.7% from 2022. And in Ontario alone, almost 50,000 drivers were involved in fatal and personal injury collisions, with tens of thousands injured. These numbers show just how common crashes are and how vital accident benefits are for covering unexpected medical and financial gaps. Basically, what it comes down to is that accident benefits offer quick, reliable support after a crash so you can focus on recovery. It's no-fault, it's automatic, and it's built to protect you from the unpredictable.

Latest regulation updates for accident benefits in Ontario

Since October 2022, the Ontario Statutory Accident Benefits Schedule (SABS) has seen several important updates aimed at keeping benefits aligned with inflation and modernizing the system:

Annual indexed benefits inflation

The Financial Services Regulatory Authority of Ontario (FSRA) has been updating SABS amounts yearly based on the Consumer Price Index (CPI):

• A 6.9% increase took effect January 1, 2023, boosting thresholds and deductibles under SABS parts like income replacement and medical/rehab benefits

• A 3.8% increase took effect January 1, 2024

• A 1.6% increase took effect January 1, 2025

Indexed benefits mean that as everyday costs rise, your coverage, like income replacement or medical allowances, can adjust automatically, helping maintain real-world value.

Upcoming benefit optionality reform

As part of Ontario’s 2024 auto-insurance reform plan, many accident benefits like income replacement, non-earner, caregiving, housekeeping, and death/funeral benefits are set to become optional starting July 1, 2026. The FSRA states that mandatory coverage will remain in place only for:

• Medical

• Rehabilitation

• Attendant care

While this change gives consumers more choice and premium control, it also raises concerns that vulnerable individuals might skip essential coverage to save money.

What is covered by accident benefits in Ontario?

Since accident benefits coverage is mandatory in Ontario, you can expect to receive the following coverage under the accident benefits portion of your car insurance policy:

Medical and rehabilitation benefits

While OHIP covers emergency care and some treatments, many rehabilitation and therapy costs fall on you. Accident benefits step in to pay for expenses such as:

• Physiotherapy

• Chiropractic care

• Psychological counselling

• Prescriptions

Coverage limits under standard Ontario policies include:

• Up to $65,000 for medical and rehabilitation expenses for non-catastrophic injuries

• Up to $1 million for catastrophic injuries

You can also buy optional coverage to increase these limits to $130,000 (non-catastrophic) and $2 million (catastrophic). Given the cost of long-term rehabilitation, many drivers choose to increase these limits for extra peace of mind.

Attendant care benefits

If your injuries mean you need personal assistance with daily activities like dressing, bathing, or eating, attendant care benefits cover the cost of hiring a support worker at home or in a healthcare facility.

The standard policy combines attendant care with medical and rehabilitation coverage, sharing the same limit $65,000 or $1 million, depending on injury severity. With optional coverage, you can boost these amounts to match your needs.

Caregiver benefits

If you’re the main caregiver in your household and can’t provide care after an accident causing catastrophic injuries, you might qualify for caregiver benefits. These help pay for someone to take over your caregiving responsibilities, ensuring your dependents are looked after. You could receive:

• Up to $250 per week for the first dependant

• $50 for each additional dependant

Death and funeral benefits

In the unfortunate event that a crash is fatal, accident benefits help support your family financially during an incredibly difficult time. By default, these benefits include:

• $25,000 to a spouse

• $10,000 to each dependent

• Up to $6,000 for funeral expenses

• $10,000 to former spouses if there was a financial obligation

Optional upgrades allow you to increase these amounts to $50,000 for a spouse, $20,000 for each dependent, and $8,000 for funeral costs, giving your family more security if the unexpected happens.

Income replacement benefit

If you are unable to work following the accident, you can receive up to 70% of your weekly gross income, capped at $400 per week. But many Ontarians choose to buy additional coverage to increase that cap to as much as $1,000 per week, which can make a big difference, especially if you have higher living expenses.

Non-earner benefits

Not everyone has an income. For example, full-time students, recent graduates, or stay-at-home parents. If you don’t qualify for income replacement but can’t continue your usual activities, you might receive non-earner benefits. These pay up to $185 per week, starting after a waiting period of four weeks, to help support your daily needs while you recover.

Additional expenses

Other expenses that may be covered by accident benefits insurance include the following:

Talking to an insurance advisor can help you decide whether additional optional benefits make sense for your family and lifestyle. After all, accident benefits aren’t just numbers on paper; they’re what help you get back on your feet after one of life’s most stressful events. A more detailed description of the coverage included with accident benefits in Ontario can be found in the SABS.

Optional benefits coverage in Ontario

A basic form of accident benefits coverage is mandatory in Ontario. However, additional benefits are available to Ontario drivers should they wish to purchase more coverage. For example, drivers can choose to increase the coverage limits for many of the benefits listed above or purchase extra types of accident benefits. A few examples of optional accident benefits coverage are listed below:

Dependent care benefits

If you were employed at the time of the accident and are responsible for one or more dependents, dependent care benefits might come in handy. With this type of coverage, your insurance company may pay you:

• $75 per week for your first dependent

• $25 per week for each additional dependent (to a maximum amount of $150 per week)

Indexation benefits

Indexation benefits can be added to your accident benefits policy to give you an annual adjustment for yearly inflation rates. Adjustments are always made per the Consumer Price Index of Canada.

How accident benefits work in Ontario

Whether you’re a driver, passenger, pedestrian, or cyclist, if you’re injured in a car accident in Ontario, you can apply for accident benefits. You don’t have to prove who was at fault to receive support. At BrokerLink, we know how stressful it can feel after an automobile accident. Beyond the shock and immediate worries, there’s paperwork, calls, and lots of questions. That’s why it helps to understand exactly what happens next, and how your accident benefits work to support you:

1. Get medical help first

Your health always comes first. Call 911 if needed and get immediate medical care. Even if you feel okay, it’s important to see a doctor, as some injuries (like soft tissue or whiplash) don’t show up right away.

2. Notify your insurer

You should call your insurance company as soon as possible, ideally within 24 hours. However, you must report it within seven days, or as soon as reasonably possible if you’re unable to. Your insurance company will then send you an Accident Benefits Application Package, which includes the OCF-1 form (application for Accident Benefits).

3. Complete and submit forms

Once you get the forms, you have 30 days to fill them out and return them. Besides the OCF-1, you might also need:

• OCF-2: Employer’s Confirmation of Income (if you’re applying for income replacement)

• OCF-3: Disability Certificate (completed by your healthcare provider)

• OCF-5: Permission to disclose health information, so your insurer can coordinate your care

It’s important to submit these on time; delays can slow down or complicate your claim.

4. Get your first payments

If approved, benefits like income replacement can start as soon as 10 days after your insurance company receives all required documents. Medical and rehab benefits may also kick in right away, covering treatment costs directly so you don’t have to pay out of pocket first.

5. Stay in regular contact with your insurer

Your claim doesn’t stop after the first payment. You’ll need to provide regular updates, like medical progress reports, to keep receiving benefits. Your insurance provider might also schedule independent medical assessments to review your recovery status.

How long does income replacement take?

In Ontario, income replacement benefits begin after a one-week waiting period, meaning you won’t receive a payment for the first seven days following the accident. Once your insurance provider has received your completed forms (like the OCF‑1, OCF‑2, and OCF‑3), they have up to 10 business days to start income replacement payments, which are often issued bi-weekly.

What if your claim is denied?

Sometimes, a claim or specific benefit (like certain treatments or income replacement) may be denied. If this happens, don’t panic, because you still have options. Actions you could take in this situation include:

• Ask for clarification on why your claim was denied. Your insurer must explain why in writing.

• You can resubmit your claim and include new medical evidence or further details to support your case.

• You can apply to the Licence Appeal Tribunal (LAT), an independent body that helps resolve disputes between accident victims and insurers in Ontario.

Many people also find it helpful to talk to a lawyer or a licensed insurance representative at this stage to understand their rights and next steps.

Other mandatory car insurance coverage in Ontario

To legally drive here, your auto insurance policy needs to include a few key coverages. According to the Insurance Bureau of Canada (IBC), mandatory coverage in Ontario includes third-party liability, accident benefits, and uninsured automobile coverage. Now that you’ve got a better handle on accident benefits coverage, let’s quickly look at the other types of coverage that are mandatory in Ontario:

Third-party liability coverage

Third-party liability coverage provides legal protection if you accidentally injure someone else or damage someone’s property while driving. It can help pay for things like medical bills, vehicle repairs, and even legal fees or settlement costs, up to your coverage limit. In Ontario, you’re required to carry at least $200,000 in third-party liability coverage, but many drivers choose higher limits (like $1 million or $2 million) for extra peace of mind, especially since lawsuits can get expensive fast.

Uninsured automobile coverage

This coverage is there to protect you if you’re in a crash with someone who doesn’t have insurance (or doesn’t have enough of it). It also covers situations like hit-and-runs. With uninsured automobile coverage, you and your passengers can still get compensation for injuries or damage, even if the at-fault driver can’t pay.

Tips to help you maximize your accident benefits coverage

Insurance isn’t one-size-fits-all. Whether you're raising a family, freelancing, or enjoying retirement, customizing your coverage to match your lifestyle is essential, and that’s where a broker shines. Here are some practical tips to help you get the most out of your auto insurance:

Match your coverage to your situation

If you're a parent, remote worker, or high-mileage driver, consider upgrading limits like income-replacement, medical, or collision coverage. These extras can make a significant difference when life throws a curveball.

Take advantage of indexation

With indexation benefits, many accident‑benefit limits (like income replacement or medical expenses) are automatically indexed to inflation each year, keeping pace with the rising cost of living in Ontario.

Think about optional add‑ons

Some options to consider:

• Boost your income replacement cap beyond the standard $400 per week

• Increase non‑earner, caregiver, or funeral benefits

• Add comprehensive coverage to protect against theft, hail, or vandalism

Review your policy annually

Ontario drivers continue to face some of the highest average premiums nationwide. According to the FSRA, as of October 2024, Ontario drivers pay on average $2,006 for car insurance. With premiums rising due to higher claims costs, like a 190% composite claims-to-premium ratio in 2023, what fit you last year might not fit today. An annual check ensures your policy still matches your life and budget.

Why work with a broker to find auto insurance in Ontario

When it comes to auto insurance, it’s easy to feel overwhelmed by all the options, limits, exclusions, and fine print. That’s where a broker like BrokerLink can make all the difference. A broker acts as your personal insurance guide, helping you find the right policy for your unique needs. Instead of offering just one company’s products, our brokers shop around with multiple top insurance companies to compare prices and coverage options. We’ll make sure your policy has the right limits, optional add-ons, and benefits, so you’re not left underinsured or paying for things you don’t need.

Contact BrokerLink today

Contact BrokerLink to learn more about accident benefits coverage in Ontario. Our insurance advisors know the ins and outs of the auto insurance industry and will ensure you find accident benefits coverage that not only complies with provincial law but also meets your needs.

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