Understanding Statutory Accident Benefits in Ontario: Your Guide to SABS

October 22, 2024, Kitchener, Ontario

Posted by: Robert Deutschmann, Personal Injury Lawyer

Statutory Accident Benefits Schedule (SABS) is a crucial component of Ontario's auto insurance system, providing essential support to individuals injured in motor vehicle accidents, regardless of fault. At Deutschmann Law, we recognize the importance of understanding these benefits to ensure you receive the full support you're entitled to following an accident.

What are Statutory Accident Benefits?

Statutory Accident Benefits are a set of benefits provided under Ontario law to individuals injured in motor vehicle accidents. These benefits are designed to provide financial support and access to necessary medical care and rehabilitation services.

Key Categories of Statutory Accident Benefits

1. Income Replacement Benefits (IRB)
   1. Provides compensation for lost income if you're unable to work due to your injuries
   2. Generally pays 70% of your gross income, up to a maximum of $400 per week
   3. Can be paid for up to 104 weeks, or longer if you suffer a complete inability to engage in any employment

1. Medical and Rehabilitation Benefits
   1. Covers necessary medical treatments and rehabilitation services not covered by OHIP
   2. Standard limit is $65,000 for non-catastrophic injuries
   3. Increased to $1 million for catastrophic injuries

1. Attendant Care Benefits
   1. Provides funding for personal care assistance if needed due to your injuries
   2. Up to $3,000 per month for non-catastrophic injuries, with a $36,000 total limit
   3. Up to $6,000 per month for catastrophic injuries, with a $1 million total limit

1. Caregiver Benefits
   1. Available only in catastrophic injury cases
   2. Provides compensation if you're unable to continue caregiving duties for dependents

1. Non-Earner Benefits
   1. For individuals who were not employed at the time of the accident and suffer a complete inability to carry on a normal life
   2. $185 per week, payable after a 4-week waiting period

1. Death and Funeral Benefits
   1. Provides financial support to family members in case of a fatality
   2. Includes funeral expense benefits

Applying for Statutory Accident Benefits

1. Notify Your Insurance Company: Report the accident to your insurer as soon as possible.
2. Complete the Application for Accident Benefits (OCF-1): This form initiates your claim for benefits.
3. Provide Supporting Documentation: This may include the Disability Certificate (OCF-3) completed by a healthcare practitioner.
4. Submit Additional Forms: Depending on the benefits you're claiming, you may need to submit additional forms such as the Treatment and Assessment Plan (OCF-18).

Important Timelines

• You have 7 days to notify your insurer of your intention to apply for benefits
• The completed application for benefits should be submitted within 30 days of receiving the forms
• There's a 2-year limitation period for disputing a denial of benefits

Challenges in Accessing SABS

1. Benefit Denials: Insurance companies may deny or limit benefits based on their interpretation of your injuries or the policy.
2. Disputes Over Treatment Plans: Disagreements can arise over the necessity or reasonableness of proposed treatments.
3. Termination of Benefits: Insurers may attempt to terminate benefits prematurely.
4. Catastrophic Impairment Designation: Insurers may attempt to deny the severity and qualification of your injuries.

If you have been injured in a car accident, motorcycle accident, or if you have been hit by a car on a bicycle of as a pedestrian you may be entitled to benefits. You should call our experienced personal injury lawyers at Deutschmann Personal Injury Law first for you expert free initial consultation today!

About Deutschmann Law

Deutschmann Law serves South-Western Ontario with offices in Kitchener-Waterloo, Cambridge, Woodstock, Brantford, Stratford and Ayr. The law practice of Robert Deutschmann focuses almost exclusively in personal injury and disability insurance matters. For more information, please visit www.deutschmannlaw.com or call us at 1-519-742-7774.

It is important that you review your accident benefit file with one of our experienced personal injury / car accident lawyers to ensure that you obtain access to all your benefits which include, but are limited to, things like physiotherapy, income replacement benefits, vocational retraining and home modifications.