This is a summary of the various types of benefits that you are eligible to receive if you have been injured in an automobile accident. Full details of the benefits are in the Statutory Accident Benefits Schedule of the Insurance Act.
Income Replacement Benefits (First 2 years)
This benefit compensates the insured person for lost income up to $400.00/week if any injury resulting from an automobile accident prevents you from working your own occupation. This benefit is available for up to 104 weeks of payment (2 years) and is based on 80% of net employment income. Self-employed individuals may receive 80% of actual income loss and/or up to 80% of losses to a combined maximum of $400.00. No benefit is payable for the first week following the accident.
Income Replacement Benefits (After 2 years)
This benefit will continue after 104 weeks of payments, only if your injuries prevent you from the pursuit of any occupation for which you are reasonably suited by education, training or experience.
Benefit for Non Earners
If you were not employed, or do not meet the expanded definition of “employed” under the policy, and suffer a complete inability to carry on a normal life, you may be eligible to receive a non-earner benefit of $185.00/week, following a 6 month waiting period. Students who are unable to continue their education may be reimbursed for actual expenses incurred before the accident of up to $15,000.00 for lost tuition, books, and room and board. Students over 16 may also qualify for the $185.00 weekly non-earners benefit. After 2 years or 104 weeks of payments, the payment increases to $320.00/week.
Caregivers who are unable to engage in their caregiving activities may be reimbursed for additional incurred expenses of up to $250.00/week plus $50.00/week for each additional dependant.
This benefit compensates insured persons for the expense of an aide or attendant. Unless your policy has an enhanced level of coverage, or your injuries are deemed to be catastrophic, you have up to $3,000.00/month available for incurred expenses, for a period of up to 2 years ($72,000.00 maximum). If you are deemed to have suffered catastrophic injuries, you may be eligible for up to $6,000.00/month during your lifetime to a maximum of $1,000,000.00.
Medical and Rehabilitation Expenses
This benefit pays for medical expenses required as a result of an automobile accident injury. These are expenses that are not covered by any other medical plan, such as your provincial health insurance or supplementary medical expense recovery plans available through your employer or another family member’s employer’s plan from which you are entitled to coverage. The maximum amount available for expenses incurred over a period of 10 years (or 25 years minus your age, which is greater) after the accident is $100,000.00, unless your policy has enhanced coverage. If your injuries are deemed to be catastrophic, the maximum coverage available for such expenses, during your lifetime, is $1,000,000.00.
Specifically, within this particular coverage, is a provision for recovery of reasonable transportation expenses, to and from treatment necessitated by your accident-related injuries. Please note that each return trip is subject to a 50-kilometer deductible.
Coverage is available for certain individual’s reasonable expenses in visiting you during treatment recovery.
You may also be eligible to claim for any additional expenses you must incur for home maintenance and housekeeping activities that you performed prior to the accident for the period that you can not complete these activities as a result of your injuries. The maximum amount available under this coverage for additional expenses you must incur as a result of your injuries is $100.00/week for a period of 2 years.
There is also limited coverage for the cost of repairing or replacing personal items lost or damaged in the accident, with some restrictions.