Coping with an Accident Injury: What accident benefits and expenses are covered in my claim?

When you find yourself injured from an accident, there are so many different things to think about, it can be overwhelming and leave you unsure where to start. Medical bills and rehabilitation costs can add up quickly after an accident injury, and the last thing you want to be doing is dealing with the stress of trying to understand what rights and benefits you are entitled to when making an accident injury claim. Before starting the process, it’s important to know your rights as an accident victim and the benefits that are available to you as an Ontario resident.

Your Rights as an Accident Victim

If you are seriously injured in an auto collision, your rights and accident benefits (AB) coverage entitle you to compensation for expenses relating to medical and rehabilitation treatment, income replacement and other benefits and care items that assist in your recovery.

It is generally assumed that once you make an accident injury claim and provide the required documentation, you will go through the claims process and receive your accident benefits and compensation. However, the legislated systems in Ontario can often seriously limit your ability to sue or recover damages and a common first step used by insurance companies is to deny or limit claims.

If your claim is denied, you have the right to launch a dispute to review your insurance company’s decision. You can also seek help from an injury lawyer for experienced advice and support throughout the claims process. Accident victims backed by the guidance and support of an experienced and knowledgeable personal injury lawyer find insurance companies far less argumentative.

Accident Benefits available in Ontario

In order to receive the benefits you are entitled to in an accident injury claim, it is important to understand and learn more about what is available to you. To make this process a little easier, we have provided an overview of the accident benefits in Ontario.

*subject to the terms and conditions listed in Ontario’s Statutory Accident Benefits Schedule

Medical Expenses

Medical benefits cover all expenses deemed “reasonable and necessary” on behalf of the insured person as a result of the accident.

Medical includes:

• medical, surgical, dental, optometric, hospital, nursing, ambulance, audiometric and speech-language pathology services
• chiropractic, psychological, occupational therapy and physiotherapy services;
• medication;
• prescription eyewear;
• dentures and other dental devices;
• hearing aids, wheelchairs or other mobility devices, prostheses, orthotics and other assistive devices;
• transportation for the insured to and from treatment sessions, including transportation for an aide or attendant;
• other goods and services of a medical nature that the insured person requires, other than goods or services for which a benefit

Rehabilitation Costs

This benefit covers measures necessary to help with the effects of an accident, including a disability or reintegration into family, society or the workplace. Depending on the type of injury, your benefits may also include visits to a chiropractor, physical therapist, psychologist, speech or occupational therapist, and/or massage therapist, and a number of other rehabilitation providers.

Rehabilitation may also include:

• life skills training;
• family counselling;
• social rehabilitation counselling;
• financial counselling;
• employment counselling;
• vocational assessments;
• vocational or academic training;
• workplace modifications and workplace devices, including communications aids
• home modifications and home devices
• vehicle modifications to accommodate needs of the insured person
• transportation for the insured person to and from counselling and training sessions, including transportation for an aide or attendant;

Income Replacement

For those injured and employed before the accident, this bi-monthly income replacement payment can help to replace income lost during recovery, or while unable to return to the workplace.

Home Maintenance/Housekeeping

When dealing with an injury, it can be difficult or impossible to maintain your home. This benefit provides up to $100 a week for housekeeping and other home maintenance expenses.

Attendant Care

For those with injuries needing home care, this benefit covers all reasonable and necessary expenses covers services from an aide or attendant while at home or in a long term care facility or chronic care hospital,

Making an Injury Claim

After a car accident, anyone who has been injured can make a claim regardless of whether or not they were at fault for the accident. This includes drivers of involved vehicles, pedestrians, cyclists and passengers. Although anyone injured in a vehicle accident can make a claim, the entity responsible for compensation will vary.

Click here for more about claiming car accident injury compensation and accident benefits.