If you’ve been injured in a car accident, getting medical care is a priority. Depending on how serious your car accident injuries are, you might need rehab or therapy, too. The emotional and physical toll can be overwhelming, and it might feel like your finances will take a hit as well. But does it have to? Does car insurance in Canada cover your medical expenses? It does with accident benefits coverage.
What is accident benefits coverage?
Accident benefits coverage is one of two types of non-optional insurance coverage across Canada, along with liability insurance. It is a mandatory part of your car insurance policy designed to protect anyone injured in an accident. This includes not just the driver but also passengers and even pedestrians or bystanders.
Accident benefits coverage, and limits may look different depending on what province or territory you live in within Canada. For Ontario, these medical benefits can help cover a range of medical costs, like prescriptions, rehabilitation, lost income, and even funeral expenses.
It also covers travel expenses for the injured person to and from treatment, costs for mobility aids like wheelchairs or crutches, and even replaces clothing damaged in the accident. If a student is injured, it can cover lost tuition costs. Other benefits can include help with housekeeping and home maintenance, assistance from an aide or caregiver, and caregiving benefits if the injured person qualifies.
You can also buy increased accident benefits to raise the limits on certain coverages beyond what the standard policy offers. It's important to know that accident benefits coverage comes after government health plans, like OHIP, and private or employee health plans when it comes to things like medical treatment, rehab, and disability, both short- and long-term.
How much does accident benefits coverage cover?
There are both standard benefits and optional add-ons you can include in your plan. Here's what these benefits cover in Ontario:
Income replacement
This kicks in if the injured person is unable to perform their regular job duties. If they qualify, they can receive 70% of their gross weekly income, up to $400 per week. To qualify, it must be shown that they’re substantially unable to do their job. After two years, they would need to prove that they can't work in any job suited to their education or training. There’s also the option to increase this income replacement benefit, raising the weekly limit to $600, $800, or $1,000.
Non-earner
An injured person can qualify for this benefit if they are completely unable to live a normal life. This standard benefit lasts for two years, providing $185 per week, starting four weeks after the inability to carry on with daily activities begins.
Caregiver
This helps if the injured person can't take care of their primary caregiving duties, like looking after a child or an elderly parent. It reimburses for any expenses needed to hire someone to help with caregiving. The insured can receive $250 per week for the first dependent and $50 per week for each additional dependent.
Medical and rehabilitation
Medical and rehabilitation benefits cover medical and rehab expenses not covered by government or private health plans. This could include things like prescriptions, physiotherapy, massages, chiropractic care, TENS machines, wheelchairs, crutches, or occupational therapy.
If your injury falls under the Minor Injury Guideline (sprains, strains, whiplash, etc.), you’re entitled to $ 2,500. For more serious, non-catastrophic injuries, you could get up to $65,000 over five years. If the injury is catastrophic (like paraplegia, limb amputation, brain injuries, etc.), you can qualify for up to $1 million. You can increase the amount for non-catastrophic injuries to $130,000 and catastrophic injuries to $2 million.
Attendant care
If you’re unable to continue your role as a primary caregiver due to an accident, you can get assistance at home or in a healthcare facility while you recover. Attendant care benefits are meant to support single-parent households, homes with one stay-at-home parent, and families with dependents. With these benefits, you may qualify for up to $250 per week, plus an extra $50 per week for each additional dependent living with you.
Death and funeral
If you (the policyholder) pass away in an accident, your family is entitled to compensation through the death and funeral benefits in your policy. Here’s what may be paid out:
- $25,000 to your spouse
- $10,000 to each of your dependents
- Up to $6,000 for funeral expenses
- $10,000 to former spouses if you had financial obligations to them
With increased coverage, your spouse would receive $50,000, your dependents $20,000 each, and funeral expenses would be covered up to $8,000.
The cost of accident benefits coverage
The cost of accident benefits coverage depends on a lot of things, like what kind of coverage you have on your auto policy and whether you’ve added increased coverage.
We recommend talking to a local insurance broker who can get you several car insurance quotes tailored to your needs. They can explain the accident benefits coverage and costs, helping you choose the best auto insurance policy for your situation.
Why is car insurance accident benefits coverage secondary coverage?
If you’re injured in a car accident, it might seem logical to file a claim for medical and rehabilitation expenses on your auto insurance right away, right? But many people are surprised to find out that you actually have to use any type of insurance benefits on your primary insurance first and max them out before tapping into your car insurance for accident benefits. In Ontario, it’s the law—you have to go through your primary benefits before your auto insurance kicks in.
You can still open a car insurance claim for accident benefits in advance so it’s ready if you need it, but you’ll need to contact your primary insurance provider first and use up their coverage before turning to your car insurance accident benefits. While this might feel a bit backward, it actually works in your favour, giving you extra coverage to help with your recovery.
Who pays for medical expenses in a car accident?
Ontario follows a no-fault insurance system, which means that insurance companies are required to cover medical bills from motor vehicle accidents, no matter who caused the crash.
So, if you’re in a car, bike, motorcycle, or truck accident in Ontario, you’re entitled to accident benefits from your own insurance provider. If there are medical expenses that your own insurance (or any private plan you have) doesn’t cover, you can still go after the at-fault driver and their insurance company to cover those costs.
Learn more about car insurance with BrokerLink
Want to learn more about accident benefits coverage? Get in touch with BrokerLink today! Our insurance advisors are experts in auto insurance and will help you find coverage that not only meets provincial requirements but also suits your specific needs.
Give us a call to speak with one of our experienced brokers, or visit us in person at any of our locations across Canada. You can also use our online quote tool to get a free, no-obligation quote. However you choose to reach out, BrokerLink is here to help with all your car insurance needs.
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