Accident Benefits in Ontario: What You’re Entitled to Under the SABS

If you are injured in a car accident in Ontario, you’re likely entitled to accident benefits—whether you are at fault or not.

You can access these benefits through Ontario’s Statutory Accident Benefits Schedule (SABS), which helps cover lost income, medical expenses, and recovery support. But most people don’t know what they qualify for—or how to claim it.

In this guide, we’ll explain how accident benefits in Ontario work, what’s covered, and what to do if your insurance company denies your claim.

What Is the Statutory Accident Benefits Schedule (SABS)?

SABS is short for Statutory Accident Benefits Schedule—a regulation under Ontario’s Insurance Act. It outlines the minimum benefits that your auto insurance must provide if you’re injured in a crash.

Who Can Get Accident Benefits in Ontario?

You can apply for SABS if you are:

• A driver, passenger, cyclist, or pedestrian injured in an accident involving a vehicle
• A family member or dependent of someone injured or killed in an accident
• Someone injured while working, depending on WSIB eligibility

You must have either an auto insurance policy or coverage under someone else’s.

What Do Accident Benefits Cover?

If you’ve been injured in a car accident in Ontario — whether the injury is minor or catastrophic — you may be entitled to a range of accident benefits under the Statutory Accident Benefits Schedule (SABS). These benefits are available regardless of who caused the crash.

Here’s an overview of the main categories:

💼 Income Replacement Benefits

• Receive up to 70% of your gross weekly income, to a maximum of $400 per week (higher if you purchased optional coverage).
• Applies to employed or recently self-employed individuals whose injuries prevent them from working.

👩‍⚕️ Attendant Care Benefits

• Covers the cost of a personal support worker or informal caregiver.
• Up to $3,000/month for non-catastrophic injuries.
• Up to $6,000/month for catastrophic injuries.

🏥 Medical and Rehabilitation Benefits

• Pays for necessary treatment and recovery costs not covered by OHIP or private insurance.
• Includes physiotherapy, chiropractic care, mental health therapy, prescription medication, assistive devices, and more.

🚫 Non-Earner Benefits

• Up to $185/week if you’re age 16+ and unable to perform your usual daily activities.
• Increases to $320/week after 104 weeks in certain cases.

👪 Caregiver Benefits (Optional)

• Available if you were the primary caregiver for a dependent and can no longer provide care due to your injuries.
• Only included for catastrophic injuries or if optional coverage was purchased.

⚰️ Death and Funeral Benefits

• Funeral expenses: $6,000 to $8,000.
• Lump sum to a surviving spouse: $25,000.
• Lump sum to each dependent: $10,000.

What Forms Do You Need? (OCF Forms)

To apply for accident benefits, you’ll need to complete and submit various OCF forms (Ontario Claims Forms). The most common include:

• OCF-1: Application for Accident Benefits
• OCF-3: Disability Certificate
• OCF-6: Expenses Claim
• OCF-18: Treatment Plan
• OCF-19: Determination of Catastrophic Impairment

How Long Do You Have to Apply?

You must notify your insurer within 7 days of the accident and submit your completed OCF-1 form within 30 days.

If you’re applying for income replacement or non-earner benefits, you’ll also need your doctor to fill out an OCF-3 Disability Certificate.

What If Your Accident Benefits Claim Is Denied?

It’s common for insurance companies to deny or limit benefits—even when you’re clearly entitled to them.

Common reasons include:

• “Insufficient medical evidence”
• “Pre-existing conditions”
• “Not catastrophic impairment”
• “You’re not totally disabled”

If your claim is denied, you can:

1. Request reconsideration
2. File a dispute with the Licence Appeal Tribunal (LAT)
3. Speak to a personal injury lawyer

How Does Ontario’s No-Fault Insurance Work?

Ontario operates under a no-fault system, which means:

• You claim accident benefits through your own insurance company, no matter who caused the crash.
• You can still sue the at-fault driver for damages like pain and suffering, future care costs, or income loss beyond what SABS covers.

Can You Get More Than the Standard Coverage?

Yes. Many drivers purchase optional benefits to increase their:

• Weekly income replacement (from $400 to $600, $800, or $1,000)
• Medical and rehab limits
• Attendant care benefits
• Housekeeping and caregiving coverage

Common Misconceptions About Accident Benefits

❌ “I wasn’t at fault, so I don’t need to use my insurance.”
✅ You always claim accident benefits through your own insurance first.

❌ “My employer benefits will cover everything.”
✅ Group benefits may help, but they don’t replace what SABS provides.

❌ “I can wait to apply.”
✅ Strict timelines apply. Late applications can hurt your claim.

Speak to a Lawyer About Accident Benefits

Accident benefits are complex. Insurers make it difficult to access the full support they owe you—especially if your injuries are serious, long-term, or disputed.

A personal injury lawyer at Samfiru Tumarkin LLP can:

• Review your entitlement
• Challenge unfair denials
• Ensure you access all available benefits
• Represent you at the LAT if needed

Key Takeaways

• SABS covers income loss, rehab, care, and other post-accident expenses
• Ontario’s no-fault system means your own insurance pays first
• You must apply within 30 days using the correct OCF forms
• Benefits can be denied or underpaid—but decisions can be appealed
• Talk to a lawyer if your claim is delayed, denied, or cut off early

FAQs About Accident Benefits in Ontario

Why Choose Samfiru Tumarkin LLP?

We’re not just any personal injury firm. Samfiru Tumarkin LLP has a national reputation for client advocacy and proven results. We take the time to understand your situation and build the strongest possible claim.

• 💰 No Win, No Fee — you don’t pay unless we succeed
• 👥 Personalized legal support throughout your case
• 📍 Deep local experience in Ontario courts, tribunals, and negotiations
• ⭐ Thousands of 5-star reviews from injury, disability, and employment law clients
• 🗺️ Serving clients across Ontario in-person and virtually, wherever you’re located

Free Consultation with a Personal Injury Lawyer Today

Wondering how much your car accident claim in Ontario is worth? Don’t rely on estimates or insurance adjusters. Get real legal advice from a personal injury lawyer in Toronto that’s on your side.

Call us at 1-855-821-5900 or request a callback through our online form.