Statutory Accident Benefits in Ontario: What You Can Claim After a Car Accident

Statutory Accident Benefits in Ontario can help pay for treatment, income replacement, and other support after a motor vehicle accident, even if you caused the crash. Since 2005, Auger Hollingsworth Accident & Injury Lawyers has helped injured Ontarians understand and access these benefits when they need them most.

Many people know they need to report vehicle damage after a collision. Far fewer realize that their own auto insurance policy may also provide access to medical, rehabilitation, and income replacement benefits. These benefits are often called Accident Benefits, SABS, SABs, or no-fault benefits. They all mean the same thing.

If you were injured in a car accident in Ontario, understanding these benefits early can make a real difference in your recovery.

What Are Statutory Accident Benefits?

Statutory Accident Benefits are benefits attached to every Ontario auto insurance policy. They are available to injured people after a motor vehicle accident regardless of fault.

That means you may still qualify for benefits if:

• you caused the accident
• you were a passenger
• you were a pedestrian hit by a car
• you were a cyclist hit by a car

These benefits are meant to provide immediate support after an accident. They are separate from any lawsuit against an at-fault driver.

ALSO READ: How SABS Changes Have Made Ontario Insurers Less Accountable

What Do Accident Benefits Cover?

Brenda Hollingsworth explained that these benefits can cover a wide range of losses and expenses.

Depending on the facts of your case, Accident Benefits may include:

• physiotherapy
• chiropractic treatment
• psychology or counselling
• occupational therapy
• repair or replacement of damaged clothing
• income replacement benefits
• other rehabilitation and care expenses

For many people, the most important early benefit is treatment funding. After an accident, access to physio, therapy, and rehabilitation can be essential.

Income replacement is also important. As Brenda noted, it is often $400 per week tax-free. That amount may not fully replace a paycheque, but for some families it can mean the difference between managing basic expenses and falling behind.

Why Many People Never Apply

One of the most important points from the segment is that many eligible people never access these benefits.

Sometimes that happens because the injured person only thinks about the damage to the vehicle. If the car is not badly damaged, or if the person does not have coverage to repair it, they may never contact their insurer about the accident at all.

Other times, the person does not realize their own auto policy may still matter.

This often happens in cases involving:

• pedestrians hit by vehicles
• cyclists hit by vehicles
• drivers whose vehicles were not significantly damaged
• people with psychological injuries after a crash

For example, a pedestrian may not think to call their own auto insurer because their car is sitting untouched in the driveway. But depending on the circumstances, Accident Benefits may still be available.

Don’t Avoid Benefits Because You Were at Fault

Some injured people minimize their symptoms because they believe admitting injury will make the accident seem worse or hurt their position with the insurer.

That is a mistake.

As Brenda explained, these are benefits you have already paid for through your premiums. If you have been paying into your auto insurance policy for years, you should not hesitate to access the support that comes with it.

Being at fault does not prevent you from claiming Accident Benefits.

ALSO READ: Understanding Ontario’s No-Fault Insurance

Common Mistakes People Make on the Application

Applying for Accident Benefits seems straightforward, but the forms often cause problems.

One common mistake is trying to squeeze too much information into the small section that asks you to describe the accident and your injuries.

If you are completing the application, do not limit yourself to that little box. Use extra pages if needed. Be thorough.

List every injury, not just the obvious one

This is one of the most practical pieces of advice from the segment.

After an accident, people naturally focus on the injury that feels most serious at the time. If you broke your wrist, that may be what you mention first. But other injuries can become more significant over time.

For example:

• your knee may seem minor at first, but become a long-term problem
• a headache may signal something more serious
• a bruise or nerve symptom may matter later
• emotional symptoms may develop after the physical shock fades

Brenda’s advice was clear: list every body part that hurts, head to toe, even if it seems minor in the moment.

Why the Doctor’s Disability Certificate Matters So Much

Another major issue involves the form completed by your doctor, often called the Disability Certificate.

Doctors are busy. They often complete forms quickly and in good faith. But if the form is incomplete, vague, or misses part of the diagnosis, it can affect how much coverage you receive.

Brenda explained that the type of injury identified on the form can directly affect the level of benefits available.

For example:

• a minor injury may be limited to $3,500 in medical and rehabilitation benefits
• a non-minor injury may allow access to $65,000 in benefits

That difference is significant.

What can go wrong on the form?

A doctor might write down only the body part, but not the full nature of the injury. For example:

• “ankle sprain” may be recorded
• but nerve damage is left out
• headaches are missed
• psychological symptoms are not noted

Those details matter because they may take you out of the minor injury category.

Before leaving the doctor’s office, review the form if possible. If something important is missing, ask for it to be added. This is not because your doctor is doing anything wrong. As Brenda said, they are often simply rushed and may not realize how important specific wording is in the accident benefits system.

Should You Go Straight to Physio or Chiro?

Technically, you can start with a physiotherapist or chiropractor. But Brenda cautioned that doing so can be risky if your condition is more complex than it first appears.

That is because a treatment provider may focus on the obvious physical injury and unintentionally place you in the minor injury category. They are not usually diagnosing broader issues such as:

• nerve damage
• concussion symptoms
• psychological injuries

If possible, it is often better to start with your doctor and ensure the Disability Certificate is completed properly.

Mistakes People Make With Income Replacement Benefits

Income replacement claims also cause problems, especially when people do not fully document all of their sources of income.

Brenda noted that injured people sometimes report only their main job and forget about:

• a side business
• part-time work
• multiple employers in the last year
• recent changes in employment history

That can affect whether you receive the full weekly amount or a reduced benefit.

It can also affect a later lawsuit if there is one. If the income information submitted to the insurer is incomplete, it can create complications later when loss of income is assessed more fully.

The safest approach is simple: give the insurer complete and accurate information about all of your income sources.

ALSO READ: A Guide to Income Replacement Benefits

What If Your Claim Is Denied?

Even when someone tries to fill out the forms properly, denials still happen.

That does not mean the matter is over.

Brenda explained that when benefits are denied, this is often the first time people contact a personal injury lawyer. At that point, the denial can be reviewed and challenged.

In Ontario, disputes over Accident Benefits are often handled through the Licence Appeal Tribunal. This tribunal deals specifically with these kinds of insurance benefit disputes.

There is also a time limit. If you have been denied benefits, you generally have a two-year limitation period to challenge the denial.

That means it is important not to wait too long to get advice.

Why Early Legal Advice Helps

Many problems in Accident Benefits claims come down to paperwork, wording, and missing detail. Those issues are often avoidable when the claim is reviewed carefully from the start.

At Auger Hollingsworth, we help injured people:

• understand what benefits may be available
• review forms before they are submitted
• identify missing medical details
• respond to insurer denials
• challenge decisions at the Licence Appeal Tribunal when needed

These benefits exist to help people recover. But they are not always easy to access without guidance.

Get Help Understanding Your Accident Benefits

If you were injured in a motor vehicle accident in Ontario, do not assume you are not entitled to support because you caused the crash, your car was not badly damaged, or the insurer denied your request the first time.

You may still have options.

Not sure if you need a car accident lawyer? That’s okay. Start with a free consultation and a conversation.