All Ottawa drivers, passengers, cyclists and pedestrians are entitled to claim for accident benefits if they are injured in a motor vehicle accident. This is true, regardless of who was a fault for the accident or whether the injured person has his/her own insurance.
The Statutory Accident Benefits are also known as SABS or no-fault benefits.
Here is a summary of what you could be eligible to receive:
Income Replacement Benefits (Up to 2 years post accident)
The income replacement benefit (IRB) compensates the insured person for lost income up to $400.00/week if any injury resulting from an automobile accident or other vehicle accident prevents you from working at your own occupation. The benefit is available for up to 104 weeks (2 years). For accidents before September 2010, it is based on 80% of your net employment income. For accidents after September 2010, it is based on 70% of gross employment income.
No benefit is payable for the first week following the accident.
Some insurance policies provide for higher amounts of income replacement benefits benefits.
Income Replacement Benefits (Post 2 years)
The IRB continues after 104 weeks of payments if your injuries prevent you from the pursuit of any occupation for which you are reasonably suited by education, training or experience.
Non Earner Benefit (also called NEB)
If you were unemployed and you suffer a complete inability to carry on a normal life, you may be eligible to receive a non-earner benefit of $185.00/week. There is a 6 -month waiting period to receive non-earner benefits.
Student Non Earner Benefit
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 applies to people caring for children, elderly persons or disabled persons.
After September 2010, this benefit is only available if you purchased this optional benefits.
Note: You can only receive ONE of the “weekly benefits”, even if you qualify for more than one. You will have to the one most favourable to you.
This benefit compensates insured persons for the expense of someone assisting you with your personal care. 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 these expenses, for a period of up to 2 years. There is a $72,000.00 maximum for accidents before September 2010. There is a maximum of $36,000 for non-catastrophic injuries after September 2010 unless your purchased optional benefits.
If you 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 a motor vehicle accident injury. These are expenses that are not covered by any other medical plan, such as OHIP, another provincial health insurance or supplementary medical expense recovery plans (extended benefits) available through your employer or another family member’s employer’s plan.
For accidents that happened before September 2010, the maximum amount available for expenses incurred up to 10 years after the accident is $100,000.00, unless your policy has supplemental coverage. After September 2010, the amount has been reduced to $50,000.
If your injuries are catastrophic, the maximum coverage available for med/rehab expenses, during your lifetime, is $1 Million.
Reimbursement or payment is available for certain family members’s reasonable expenses in visiting you during treatment recovery. This includes mileage, other travel expenses and food expenses. These expenses, with receipts, get submitted to the adjuster on an OCF-6 Form.
Housekeeping and Home Maintenance
For accidents before September 2010, you may also be eligible to claim for any additional expenses you must incur for home maintenance and housekeeping activities that you performed before 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.
For accidents after September 2010, you will only be entitled to housekeeping if you purchased optional benefits.
Lost or Damaged Personal Items
There is also limited coverage for the cost of repairing or replacing personal items lost or damaged in the accident, with some restrictions.