How Car Accident Benefits Work in Ontario: A Guide To the Statutory Accident Benefits Schedule

A Toronto lawyer can help you understand your rights and get the benefits you deserve after a crash

If you're injured in a car accident in Ontario, your immediate concerns are likely health, finances, and what to do next. Dealing with an insurance claim after a crash can be overwhelming, especially if you’re unable to work or facing steep medical bills. That’s where the Statutory Accident Benefits Schedule (SABS) comes in.

Whether you were driving, walking, or bicycling, if you were injured in a motor vehicle accident in Ontario, SABS may provide financial and medical support. Read on to find out what the benefits are, how to qualify, and what to expect as you pursue a car accident claim in Ontario.

What is SABS?

SABS is a regulation under Ontario’s Insurance Act. It’s part of every auto insurance policy in the province and provides a safety net for people injured in car accidents, regardless of who caused the crash.

Even if you were at fault, or if the driver who hit you fled the scene or didn’t have insurance, SABS still applies. The idea is to make sure that no one is left without access to medical care, income support, or assistance with daily needs after a car accident.

These benefits are “no-fault,” which simply means they’re available to you without needing to prove someone else caused your car accident. They apply to drivers, passengers, bicyclists, and even pedestrians.

What types of benefits are available under SABS?

SABS includes benefits that support your recovery. Which ones you qualify for (and how much you can receive) depends on your injuries, your work situation, and whether you bought additional coverage.

Income replacement benefits

If your injuries prevent you from working, income replacement benefits can help cover lost wages. You can receive 70% of your gross weekly income, up to a maximum of $400 per week. Some people choose to increase that cap through optional insurance, which can raise it to $600, $800, or even $1,000 per week.

Income replacement usually begins one week after the crash and can continue for up to 104 weeks. After that, benefits may continue if you can prove you’re unable to engage in any employment that you’re reasonably suited for by education, training, or experience.

Non-earner benefits

SABS may cover you even if you weren’t working at the time of the car accident. For example, let’s say you were a student or a stay-at-home parent. If your injuries leave you unable to live a normal life, you may qualify for non-earner benefits. You’ll need to show that your ability to carry out your normal activities has been affected.

Caregiver benefits

If you were the main caregiver for a child or dependent before the car accident and now can’t provide that care because of your injuries, caregiver benefits may apply. This coverage reimburses you for reasonable expenses to hire someone else to care for your dependents.

However, this benefit is only available to those with catastrophic injuries, unless you purchased optional coverage that extends it to other injury types.

Medical and rehabilitation benefits

This covers the cost of medical treatments and rehabilitation services not already paid for by OHIP. That can include physiotherapy, chiropractic care, psychological counseling, mobility devices, and more.

Here’s how the coverage limits work:

Minor injuries: up to $3,500
Non-catastrophic injuries: up to $65,000 (combined with attendant care)
Catastrophic injuries: up to $1,000,000 (combined with attendant care)

Additionally, optional coverage can double the non-catastrophic limit to $130,000 or increase the catastrophic cap to $2 million.

Attendant care benefits

If your injuries are serious enough that you need help with personal tasks (e.g., bathing, dressing, or eating), attendant care benefits help pay for that assistance. You’ll need an occupational therapist to assess your needs and complete an “Assessment of Attendant Care Needs” form. The benefits cover up to:

$3,000/month for non-catastrophic injuries
$6,000/month for catastrophic injuries

These are not lump sums. You’re reimbursed based on receipts or invoices for the care services actually provided.

Other benefits

SABS also includes a few other important supports:

Housekeeping and home maintenance: Up to $100 per week, but only available for catastrophic injuries (unless optional coverage was purchased).
Lost educational expenses: Reimbursement for tuition, books, or other expenses if injuries force you to leave school.
Visitor expenses: Covers travel costs for close relatives to visit you during your treatment or recovery.
Death and funeral benefits: Provides a lump sum to your spouse and dependents, and covers funeral expenses (up to $6,000).

How do injury classifications affect your benefits?

SABS benefits are not one-size-fits-all. The amount of support you receive depends largely on how your injuries are classified. Here are some examples:

Minor injuries

These include sprains, strains, and whiplash-type injuries that fall under the Minor Injury Guideline (MIG). The MIG limits your medical and rehabilitation benefits to $3,500. It also excludes access to attendant care or housekeeping unless you meet an exception, such as having a pre-existing condition that exacerbates your recovery.

Non-catastrophic injuries

This is the default category for most injuries that don’t fall under MIG but also aren’t deemed catastrophic. Here, your combined medical, rehab, and attendant care benefits are capped at $65,000 for up to five years.

Catastrophic injuries

These are the most severe cases, such as paralysis, traumatic brain injury, amputation, or blindness. If you’re deemed catastrophically impaired, you gain access to up to $1 million in combined benefits for life, plus additional supports like caregiver and housekeeping assistance.

Getting this designation involves a complex medical and legal assessment. If you think your injury may qualify, it’s wise to get legal help.

How do I apply for SABS benefits?

The application process starts right after your car accident. The sooner you act, the better chance you’ll have of getting the benefits you need. Here’s what to do:

Step 1: Notify your insurer

Let your insurance company know about your car accident within seven days, or as soon as reasonably possible.

Step 2: Complete the OCF-1

This is the Application for Accident Benefits form. You should receive it from your insurer once they’re notified. Return it within 30 days to avoid delays or denials.

Step 3: Submit supporting documents

You may also need to provide:

OCF-2: Employer’s Confirmation of Income
OCF-3: Disability Certificate from a health provider
OCF-5: Permission to disclose medical information

Once your forms are submitted, your insurance provider has 10 business days to respond about your eligibility and begin processing your benefits.

What should I do if my claim is denied or disputed?

Insurance companies likely won’t agree with your assessment of the situation. Maybe they’ll say your injuries fall under MIG when they don’t. Maybe they deny you benefits due to missing paperwork. Or maybe they stop payments prematurely. You have up to two years from the date of denial to file your dispute.

If a denial or dispute happens, here’s what you can do:

Request internal review: Ask the insurance provider to reconsider their decision and submit more evidence.
File a dispute: You can bring your case before the Licence Appeal Tribunal. This is an independent body that hears accident benefit disputes.
Hire an Ontario car accident lawyer: Especially if you’re dealing with major injuries or long-term disability, having an experienced lawyer in your corner can make a big difference.

Can you sue for additional compensation outside of SABS?

You can sue for additional compensation outside of SABS, but only under specific conditions. Ontario's system is no-fault, but it doesn’t prevent you from suing the at-fault driver in a civil lawsuit (also known as a tort claim) if:

Your injuries are permanent and serious (such as a long-term disability).
You’re seeking pain and suffering damages.
You’ve lost income beyond what SABS covers.

There are thresholds and deductibles involved, and lawsuits can take years to resolve. Still, in cases of life-altering injury, a tort claim may be the only way to recover full compensation.

How does optional insurance coverage impact SABS benefits?

When you buy or renew your auto insurance policy, you can choose to purchase optional accident benefits. These add-ons increase the caps or extend the duration of your benefits. Here’s what’s typically available:

Higher income replacement: From the default $400/week up to $1,000/week.
More medical and rehab coverage: Double the standard limits.
Expanded attendant care and access to caregiver and housekeeping benefits for non-catastrophic injuries.

Get trusted legal guidance from an Ontario lawyer who puts your recovery first

If you’ve been injured in a car accident anywhere in Ontario, don’t deal with the insurance system alone. An experienced Toronto car accident lawyer at Smitiuch Injury Law can help you understand your rights, whether you’re seeking damages from SABS or the other driver’s insurance company.

Our legal team treats your case with care, urgency, and respect. We routinely work with medical experts, crash reconstructionists, and financial professionals to build strong cases. We can also help determine whether your injuries meet the catastrophic impairment threshold under SABS.

Your consultation is free, and you don’t pay unless we win. We proudly serve clients throughout Ontario and make it easy to connect with us, whether that’s at one of our offices, in your home, or at your hospital bedside. Contact us today and talk to a Toronto car accident lawyer who knows how to fight and won’t back down.

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