After a motor vehicle accident, it is likely that you’ll have a number of interactions with your insurance company to seek compensation. In Ontario, there are several types of insurance coverage that work together to provide a payout to the drivers. Statutory Accident Benefits are described in O.Reg. 34/10.

Mandatory Automobile Insurance in Ontario

The Financial Services Commission of Ontario (FSCO) outlines several types of auto insurance that all drivers in Ontario are required to have. Included in this is a no-fault policy that compensates persons injured in accidents (based on the severity of their injuries) which may cover costs such as medical care, lost wages, and other qualifying damages. 

The mandatory coverage on all Ontario auto insurance policies includes: 

• Statutory accident benefits
• Third-party liability 
• Uninsured automobile
• Direct compensation – property damage (DC-PD)

In addition to any insurance coverage that you may be eligible for, you may also be able to file a lawsuit if certain criteria are met. 

Additional benefit options

In addition to the mandatory coverage that Ontario motorists must have, they also have the option to invest in increased optional benefits such as: 

• Increased income replacement benefits
• Caregiver benefit
• Housekeeping and home maintenance expenses
• Additional third-party liability coverage
• Tort deductible reduction

What coverage is included in the Statutory Accident Benefits?

The amount of coverage mandated through the Statutory Accident Benefits changed in 2016. Currently, the coverage must include: 

• Up to $65,000 combined coverage for medical, attendant, and rehabilitation care for non-catastrophic injuries.
• Up to $1 million for combined coverage for medical, attendant, and rehabilitation care for catastrophic injuries.
• Up to $400 per week to replace lost wages.
• Up to $185 per week in non-earner benefits.

For minor injuries, there is a maximum benefit of $3500 for medical and rehabilitation costs. 

How much additional coverage can I get?

Some Ontario drivers opt to purchase additional coverage, the maximums for which are outlined by the FSCO. 

• A maximum of $130,000 combined coverage for medical, attendant, and rehabilitation care for non-catastrophic injuries.
• An increase of $1 million combined coverage for medical, attendant, and rehabilitation care for catastrophic injuries.
• Optional benefit of $1 million combined coverage for medical, attendant, and rehabilitation care for non-catastrophic or catastrophic injuries.

The role of fault in some Ontario accident claims

Although Ontario drivers have no-fault accident insurance and some injured parties can qualify for benefits regardless of who is at fault, fault can still play a role in some claims. After the accident is reported to your insurance provider, they may still make a determination of who is liable in certain situations as outlined in R.R.O. 1990 Reg. 668. 

Repairs to your vehicle may be covered through your DC-PD coverage. 

If you meet the criteria to be eligible to pursue a lawsuit based on fault, it may allow you to receive additional compensation and receive a higher payout than you would get through your no-fault coverage. 

Pain and suffering claims

In order to file a lawsuit for non-pecuniary damages such as pain and suffering, loss of enjoyment of life, or future medical treatment, car accident victims must meet very strict criteria as outlined in R.S.O. 1990, C.I.8. These criteria include situations where: 

• The victim dies as a result of the accident. 
• The victim is left with “permanent serious disfigurement”
• The victim is left with “permanent serious impairment” of an important physical, mental, or psychological function. 

Contact Hoffman Law today

If you have been injured in an automobile accident, we may be able to represent you to help you recover Standard Accident Benefits or to pursue a lawsuit. Contact us today to arrange a free consultation with one of our personal injury lawyers. We don’t get paid unless you do.