Statutory Accident Benefits: Medical & Rehabilitation Benefits

The most important thing to know after a car accident is that there are benefits in place to help you work through your injury and get back on your feet. These are called Statutory Accident Benefits (“SABS”) and they’re included in every motor vehicle insurance policy in Ontario. Your insurer is responsible for ensuring that these benefits are received after an accident regardless of whether you are at fault. The next few posts will provide a brief description of the more common Accident Benefits you are entitled and may apply for following an accident. 

The most common statutory accident benefit used by those injured in a car accident is the medical and rehabilitation (“med-rehab”) benefit. This benefit is available to those who need treatment for their injuries  following a car accident. Med-rehab includes treatments that are not  covered by the Ontario Health Insurance Plan aka OHIP. This often  includes, physiotherapy, acupuncture, massage therapy chiropractic  therapy. Also included are less common forms of med-rehab treatment such  as speech therapy, dental services, counselling and vocational  services.

Under the SABS, there are three categories that limit the amounts of treatment.

$3,500.00 – for a minor injury defined as, “one  or more of a sprain, strain, whiplash associated disorder, contusion,  abrasion, laceration or subluxation and includes any clinically  associated sequelae to such an injury”;

$65,000.00 – for injuries that are non-minor but also non-catastrophic; and

$1,000,000.00 – for catastrophic injuries, which has several definitions under section 3.1 of the SABS. Typically, catastrophic impairment refers to severe injuries because of a car accident such as, paralysis, loss of a limb(s), loss of vision, traumatic brain injuries or a significant loss of physical or psychological function.

The amount of treatment an injured person is entitled to is determined by the injuries they sustain in a car accident in addition to any medical conditions they may have had before the accident. Unfortunately, many, if not most, people are placed in the minor injury category which limits their treatment amounts hindering their ability to  recover.