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What are Accident Benefits

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What are Accident Benefits

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Individuals injured in motor vehicle accidents in Ontario may be eligible for assistance, in the form of “Accident Benefits”, under an auto insurance policy. Consult with a lawyer to understand your rights.

In Ontario, Accident Benefits (commonly referred to as “AB”) are governed by regulation under the provincial Insurance Act, R.S.O. 1990, c.I.8, known as the Statutory Accident Benefits Schedule (“SABS”). Under Ontario legislation, there is a standard auto insurance policy which is required to be purchased by every vehicle owner. This standard auto insurance policy includes a minimum set of AB coverage, designed to provide injured parties with basic necessities, regardless of who caused the accident, such as medical rehabilitation benefits, attendant care benefits, and income replacement benefits. Additional accident benefits coverage may also be purchased in order to customize policies of insurance to suit individual needs. Here is a brief overview of the commonly claimed AB’s provided by Ontario’s standard auto insurance policy (not including additional coverage that may be purchased).

Medical and Rehabilitation Benefits (“MRB”):
This benefit covers reasonable and necessary medical and rehabilitation expenses incurred (i.e. physiotherapy, prescription medication or workplace/home/vehicle modifications) as a result of the accident related injuries that are not covered by a government health plan or a private health plan that you may have through work or your spouse. Here is what you need to know about Medical and Rehabilitation Benefits (“MRB’s”):
• Payment of MRB’s are based on 1 of 3 classifications of your accident related injuries: (i) minor injury; (ii) non-minor injury; and (iii) catastrophic injury
• For minor injuries, such as whiplash, sprains, cuts or bruises, MRB’s are payable to a cap of $3,500
• For non-minor injuries, such as broken bones or internal organ damage, MRB’s are payable for a maximum of 10 years to a cap of $50,000
• For catastrophic injuries, such as amputation of a limb, spinal cord injuries or severe brain damage, MRB’s are payable to cap of $1,000,000

Income Replacement Benefits (“IRB”):
This benefit compensates you for loss of your income if you cannot work because of the injuries caused by a motor vehicle accident. To qualify, you must have been employed, or have been receiving Employment Insurance (“EI”), at the time of the accident. Otherwise, you must have worked at least 26 of the 52 weeks before the accident. Here is what you need to know about Income Replacement Benefits (IRB’s):
• IRB’s are calculated at 70 % of your average gross income based on your employment history
o Your income is calculated as the higher of either (i) the 52 weeks before the accident OR (ii) the 4 weeks before the accident multiplied by 13
o Self-employed income is calculated as the higher of either (i) the 52 weeks before the accident OR (ii) the last fiscal year
o If you are receiving other income replacement assistance, such as short term or long term disability benefits, those amounts are deductable from the amount of your IRB eligibility
• IRB’s are capped at $400 per week
• The first 7 days of your disability are not covered by IRB’s
• IRB’s are payable for a 104 week (2 year) period, but you may be eligible to continue receiving this benefit past the 2 years indefinitely, if after the 2 year mark you are unable to do any occupation for which you are reasonably suited by way of your education, training and experience
• The age 65 marks changes in IRB’s
o If you are already over the age of 65, IRB’s are payable up to 208 weeks and gradually reduced over that period
o If you reach the age 65 while already receiving benefits, the IRB is converted to a lifetime pension at a reduced rate based on an established formula

Non-Earner Benefits (“NEB”):
If you do not qualify for IRB’s, you may be eligible for the Non-Earner Benefit (“NEB’s”) if you suffer a complete inability to carry on your normal activities as a result of the injuries caused by the accident. Here is what you need to know about NEB’s:
• You must be at least 16 years of age and a full time student at the time of the accident, or have completed your education the year before the accident and not yet secured employment
• NEB’s are capped at $185 per week
• The first 26 weeks of your disability are not covered by NEB’s
• NEB’s are payable for a 104 week (2 year) period, but you may be eligible to continue receiving this benefit past the 2 years indefinitely after which point the maximum amount payable increases to $320 per week
• The same age 65 mark changes apply as in IRB’s

Attendant Care Benefits:
If you are unable to carry out personal care activities as a result of the accident (i.e. bathing or dressing) you may receive reimbursement for reasonable and necessary expenses incurred for an aide, attendant or long-term care facility to assist you with such personal activities. Here is what you need to know about Attendant Care Benefits:
• Your accident related injuries must not be considered a “minor-injury”
• If your accident related injuries are considered to be “catastrophic” the benefit is capped at $6,000 per month to a total of $100,000
• If your accident related injuries are not considered to be “catastrophic” but are also severe enough not to be found as “minor injuries” then the benefit is only payable for a 2 year period and is capped at $3,000 per month to a total of $36,000

Caregiver Benefits:

If you were a primary caregiver at the time of the accident, but cannot continue that role due to catastrophic injuries suffered as a result of the motor vehicle accident then you may receive reimbursement for expenses incurred to have someone assist in the caregiving. Here is what you need to know about Caregiver Benefits:
• Caregiver Benefits is capped at $250 per week for the first person in need of care and $50 per week for each additional person in need of care for whom you were the main caregiver
• This benefit is payable for a 104 week (2 year) period, but you may be eligible to continue receiving this benefit past the 2 years indefinitely if after the 2 year mark you are completely unable to carry on a normal life

For more information, visit our accident benefits section. If you have any questions, book a free consultation or call 1-855-446-7765 for immediate assistance.

Disclaimer: The content of this article is a general guideline made available for educational purposes only and is not intended to be used as legal advice for the reader’s specific situation nor in general. By reading our blog and website content, the reader acknowledges the above and understands there is no lawyer-client relationship created between you and Himelfarb Proszanski through this content. To get specific legal advice, we encourage you to book a free consultation with one of our lawyers to clarify the legal aspects of your situation.

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Don’t delay discussing your matter with us to find out how to build a winning case.

Please enable JavaScript in your browser to complete this form.

You don’t pay us unless we win your case. No Out of pocket expenses required.

Note: Your Privacy is Safe with us. We will never disclose your information to external parties.

Timing is Critical. Help is Free.

Don’t delay discussing your matter with us to find out how to build a winning case.

Please enable JavaScript in your browser to complete this form.

You don’t pay us unless we win your case. No Out of pocket expenses required.

Note: Your Privacy is Safe with us. We will never disclose your information to external parties.

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Sherene AlySherene Aly
16:02 23 Mar 24
I was very pleased with my decision to retain David and his team for my case. Melissa Gizzo was simply amazing and was able to secure a fair settlement for me.
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Experienced and excellent law firm. Their lawyers are wonderful, articulate, dilligent, amicable, calm, respectful, responsible, resourceful and have good human and customer relationships Especially DAN HOLLAND 👌 He is an amazing lawyer as regards dealing with any of the Accident case.I was involvedIn an accident in 2019 February. He was God sent as he dutifully and relentlessly worked hard until the case was settled
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22:43 18 Jan 24
I highly recommend Dan Holland as a disability lawyer. His commitment to my case made the process seamless. Dan's clear communication and ability to simplify complex legal matters made it easy for me to understand every step. He demonstrated genuine concern for my best interests, making him not only a skilled attorney but also someone easy to talk to.Dan’s support extended beyond legal expertise; he alleviated my stress during the long-term disability case. His calm approach and unhurried demeanour ensured that there was no rush in our collaboration. This, coupled with his dedication, made the entire experience more manageable, fostering confidence in his ability to handle the case with meticulous care.I wholeheartedly endorse Dan for anyone seeking a lawyer who not only gets results but also prioritizes your peace of mind.
Neeshanth SritharanNeeshanth Sritharan
21:49 01 Jan 24
My mom was involved in an accident impacting her daily life and ability to work. Dan Holland has worked with us during the duration of our case and has been helpful in fighting for her and supporting us, and organizing the things we needed. Our family is incredibly grateful of the outcome Dan was able to obtain for us. I would highly recommend him!
Faiza HamidFaiza Hamid
01:26 22 Dec 23
I'm so happy I chose Mena Brar and her team represet us . We could not ask for a better team she is so kind, loyal, and honest. she spoke to me as an equal and made me feel as if my case was definitely important and that I deserved to be fairly compensated. I appreciate you. Did it for me and how this will help me get back on track with my life. keep helping others. You are doing amazing works, Mena Brar. I wish you all the best.
Brenda FurtadoBrenda Furtado
23:38 12 Dec 23
Many thanks to Silene Malhao for settling my husband's TORT claim and to Mena Brar for settling his accident benefits claim. These ladies made themselves available any time we had a question. They were very understanding and compassionate. We were completely taken care of throughout this process. We would definitely recommend this team to friends and family!
ShaunaShauna
15:52 06 Dec 23
We are so happy that we had David and his team represent us. We couldn't have asked for a better team. Not only is David incredibly skilled and experienced, he is kind and compassionate and it is clear how much he cares for his clients. Megan was also absolutely amazing to work with and was always on top of everything and there to answer any questions we had! Thank you!
Andrew CoutoAndrew Couto
23:10 21 Nov 23
I'm so happy I chose David as my lawyer. I spoke to a few lawyers before finding David and I noticed majority of them spoke to me in a way that felt demeaning or that my case wasn't big enough or important enough to take. One phone call with David and my opinion on lawyers changed. He spoke to me as an equal and made me feel as if my case was definitely important and that I deserved to be fairly compensated. The whole process was wonderful. From dealing with David's law clerk Ingrid whom is an amazing and kind woman to his legal assistant Melissa whom is another amazing kind and talented young woman. I was so stressed about this case but from day 1 they helped ease that stress and always answered all my questions promptly and respectfully. I couldn't believe David got me to mediation within 6 months of being cut off my LTD and got me a settlement way beyond my expectations. I can't say enough good things about this law firm but I guarantee you that if you need a lawyer to fight for you David is your guy! . Believe me when I say this is the law firm for anyone dealing with personal injuries especially LTD denial claims. Thank you so much to David, Ingrid and Melissa you truly don't know how much I appreciate all you did for me and how this will help me get back on track with my life. Keep helping others you guys are doing amazing work! I wish you all the best!
Rose RegazziRose Regazzi
21:15 11 Oct 23
I sustained a relatively painful injury, affecting me long term.I wouldn't otherwise had pursued it, as it involved a relatively large corporation, but felt it necessary to do so. However, many lawyers were daunted, with one, who actually referred me to HIMPRO.I was connected with Dan Holland, who reviewed the case, provided with me realistic expectations, sound advice and had a willingness to move forward and represent me.His calm and professional demeanor, brought me to a place of reassurance. His ease in addressing all facets of this process, clearly demonstrated a wealth of experience. There was never any hesitation, when being challenged, and felt my best interest was always in the forefront.This case has since been resolved, to my complete satisfaction.Without reservation, HIMPRO (and Dan Holland, in particular), would be the only firm I would recommend for these type of cases.
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