What is a No-Fault Benefit Claim?

No-fault insurance benefits in Ontario are known as Statutory Accident Benefits. In Ontario, victims of motor vehicle accidents are entitled to no-fault insurance accident benefits. If the victim of a motor vehicle accident does not have recourse to a motor vehicle insurance policy, then he or she may make a no-fault benefit claim or Statutory Accident Benefits from the Motor Vehicle Accident Claims Fund. He or she must be a resident of Ontario and was involved in motor vehicle accident in Ontario.

In a no-fault insurance system, you can have access to various benefits even if you are at fault for the accident. There is no fault assessment when claiming Statutory Accident Benefits. The no-fault insurance system was created in Ontario to ensure victims of motor vehicle accidents have access to various benefits regardless of fault.

The Benefits Available Under the No-Fault Benefit Claim System in Ontario Include:

Medical Rehabilitation Benefits:

When making a no-fault benefit claim, you have coverage for treatment that you may need for injuries sustained in a motor vehicle accident, such as physiotherapy, chiropractic therapy, massage therapy, acupuncture, and psychology. Rehabilitation benefits can include expenses associated with retraining or home modifications.

Attendant Care Benefits:

If your injury is not considered a Minor Injury, your no-fault benefit claim, if you qualify, may include attendant care benefits, which cover expenses for personal care assistance.

Income Replacement Benefits:

No-fault benefits claim can also include, if you qualify, income replacement benefits. Generally, this benefit is limited to 70% of your gross employment income, up to a maximum weekly benefit of $400.00. This maximum weekly benefit can be increased to $600.00, $800.00, or $1000.00 per week for an extra charge. The first week off-work following the accident is not compensable.

Non-Earner Benefits:

If you do not qualify for an income replacement benefit, you may qualify for a non-earner benefit. If your accident took place after June 1, 2016, the non-earner benefit is $185.00 per week, with payments not payable for the first four weeks after the accident. It is payable to a maximum of two years. If your accident took place before June 1, 2016, then you may qualify for a higher non-earner benefit, for a longer period.

Other Benefits:

If you have sustained a catastrophic injury or have purchased the optional benefit, you may qualify for housekeeping and home maintenance benefits up to a maximum of $100 per week if you need to hire someone to carry out your housekeeping and home maintenance responsibilities. If you have sustained a catastrophic injury or have purchased the optional benefit, you may qualify for caregiver benefits if you cannot care for your dependents because of a motor vehicle accident.

No fault benefits also include compensation for the repair or replacement of some items lost or damaged in the accident, lost educational expenses, visitor’s costs of visiting you during treatment or recovery, and death and funeral benefits.

If a family member sustains a serious or fatal injury in a motor vehicle accident, you may qualify for certain benefits if you suffer a psychological or mental injury as a result of your family member’s death or serious injury.

Optional Benefits:

You can enhance the Statutory Accident Benefits available to you through your automobile insurance policy beyond the mandatory minimum coverage. Your insurance broker can assist you with purchasing enhanced benefits. However, when making a no-fault benefit claim in Ontario, it is essential to contact an experienced personal injury lawyer to guide you through this confusing and emotional time and insure you are getting all the compensation you are entitled to.