Accident Benefits Coverage 101: Part 1

We’ll begin the first part of the Ontario Accident Benefits reform beginning with the Medical and Rehabilitation and Attendant care coverage.

How much you receive in benefits depends on the type of injury you sustain from a car accident.

Your injuries will be placed in one of three categories:

Minor Injuries – Non Catastrophic

Serious Injuries – Non Catastrophic

Catastrophic Injuries.

 * For minor injuries such as sprains and whiplash the Medical, Rehabilitation and Attendant Care benefits are fixed at a maximum limit of $3,500. *

Medical and Rehabilitation coverage is for reasonable, necessary medical and rehabilitation expenses like physiotherapy not covered by OHIP or a group insurance plan.

These reasonable and necessary expenses can include:

  • medical, surgical, dental, optometric, hospital, nursing, ambulance, audiometric and speech-language pathology services;
  •  chiropractic, psychological, occupational therapy and physiotherapy services;
  • medication;
  •  prescription eye wear;
  •  dentures and other dental devices;
  •  hearing aids, wheelchairs or other mobility devices, prostheses, orthotics and other assistive devices;
  • transportation to and from treatment including transportation for an aide or attendant; and
  • other required goods and services of a medical nature that are not covered elsewhere.

Attendant Care is reimbursement for an attendant to look after you either at home or within a healthcare facility.

Let’s go over what your current standard policy has, what will change, and what you can do to improve  upon your coverage.

Please remember that you will require a quote by your broker for the cost of increasing your accident benefits.

Non-Catastrophic Injuries

This is what is in the standard policy before June 1st, 2016:

Medical and Rehab: $50,000

Attendant Care: $36,000

After June 1st, 2016 the standard policy will include:

Medical, Rehab and Attendant Care coverage will be combined and reduced to $65,000.  This means that coverage has been reduced by $21,000.

What can I do?

You can increase your Medical, Rehab and Attendant Care coverage to $130,000 for an additional premium.

You can also purchase a buy up to $1 Million by purchasing the Medical, Rehab and Attendant Care, all injuries Option.

Catastrophic Injuries

This is what is in the standard policy prior to June 1st, 2016:

Medical and Rehab:  $1 Million

Attendant Care:  $1 Million

After June 1st, 2016 the standard policy will include:

Again, Medical, Rehab and Attendant care are being combined and reduced to a limit of $1 Million.  This means there is a missing Million.

What can I do?

You can increase your coverage by purchasing up to $ 2 Million for an additional premium.

You can increase your coverage to an eligible benefit amount of $3 Million by purchasing the coverage for Medical, Rehab and Attendant Care, all injuries option.

The thing to remember and to ask your self is this:

  • Do you know and understand your Accident Benefits coverage?
  • If you have a group insurance plan, do you know what coverage you have?
  • Are you able to incur all those extra costs OHIP won’t cover in the event you have been injured in a car accident?
  • There is a reduction of $42,000 if the increase in coverage for Non-Catastrophic has been purchased.
  • The Catastrophic has been reduced by $1 Million in the standard policy.

Contact your broker if you have already purchased and increase or optional Accident Benefits and how these changes affect you.

Your best advisor is your insurance broker to explain your Accident Benefits coverage.