What Are Accident Benefits?

Most people I talk to after a car accident have no idea what they're actually entitled to. They call their insurance company, get handed a stack of forms, and assume whatever the adjuster tells them is the final word. It usually isn't.

Ontario's accident benefits system — formally called the Statutory Accident Benefits Schedule (SABS), is one of the most underutilized protections available to injured people in this province. Here's what you need to know

The basics: What are accident benefits?

Accident benefits are no-fault insurance benefits that come with every Ontario auto insurance policy. No-fault means exactly what it sounds like — it doesn't matter who caused the accident. You could have been the driver, a passenger, a pedestrian, or a cyclist. You could have been partly at fault. It doesn't matter. You're still entitled to claim these benefits from your own insurer.

They cover things like physiotherapy, chiropractic care, psychological treatment, income replacement if you can't work, and attendant care if you need help with daily tasks. They are not the same as suing the at-fault driver — that's a separate process, and you can do both at the same time.

How much can you actually claim?

This is where it gets important — and where insurers tend to lowball people.

Your benefits depend on how your injuries are classified. There are three categories:

Minor injuries (MIG): Sprains, strains, whiplash, bruising. If your insurer puts you here, your medical and rehab benefits are capped at up to $3,500 total. That sounds like a lot until you've had a few months of physio. And to be clear — that's the ceiling, not a guaranteed payout. Your insurer only covers treatment they approve as reasonable and necessary, so what you actually receive depends entirely on what gets approved. Insurers push hard to classify claims as minor. Many shouldn't be — especially if you have a pre-existing condition, chronic pain, or anxiety and depression following the accident.

Non-catastrophic injuries: More serious injuries that don't meet the catastrophic threshold. The combined limit is up to $65,000 for medical, rehab, and attendant care — again, that's the maximum available, not a cheque you automatically receive. What you actually access depends on the treatment your healthcare providers recommend, what your insurer approves, and how your recovery unfolds. These benefits expire five years from the accident date whether you've used them or not.

Catastrophic impairment: Spinal cord injuries, serious brain injuries, amputations, severe mental disorders — injuries that fundamentally change how you live. The combined limit is up to $1,000,000 with no time limit. Same principle applies — it's a cap on what's available, not a guaranteed amount. But for people with catastrophic injuries who need lifelong care, having access to that full pool can make an enormous difference. Getting this designation is often a fight, but it's a fight worth having.

Income replacement: the benefit most people don't claim properly

If you can't work because of your injuries, you're entitled to 70% of your gross pre-accident income, up to $400 per week under a standard policy (more if you bought optional coverage). It starts one week after the accident.

That weekly cap is genuinely low — $400/week is well below minimum wage for full-time work in 2025. If you bought optional enhanced coverage, the cap can go up to $800 or $1,000. If you didn't, you're stuck at $400. Check your policy now, before you ever need it.

After two years, the test changes. Instead of proving you can't do your job, you have to prove you can't do any job you're reasonably suited for. That's a higher bar, and insurers know it.

If you weren't working at the time — student, retiree, stay-at-home parent — you may qualify for the non-earner benefit of $185/week instead, after six months of being significantly prevented from your normal activities.

Important — this is changing in July 2026. Right now, income replacement benefits are automatic. Every Ontario policy includes them. Starting July 1, 2026, that changes — IRBs become an optional add-on you have to purchase separately. If your policy renews after that date and you haven't opted in, you could be seriously injured, unable to work for months, and receive nothing for lost income. Not $400/week. Nothing. This is one of the most significant cuts to accident benefits in Ontario's history and most drivers have no idea it's coming. Call your broker before your next renewal and specifically ask to add income replacement coverage.

What to do when your insurer denies your claim

It happens constantly. Insurers deny or underpay claims for all kinds of reasons, they say your injuries are minor when they're not, they reject treatment plans, they cut off income replacement after a few months. When they do, they have to give you written reasons.

From there, you have two years to file a dispute with the Licence Appeal Tribunal (LAT), which is the body that handles accident benefits disputes in Ontario. It's not a court, but it's binding. Hearings can take 12–18 months or more, and one of the frustrating realities of the LAT is that even if you win, you generally can't recover your legal costs from the insurer.

That said, many disputes settle before a hearing. And having a lawyer involved often changes how quickly and seriously an insurer responds.

Questions? We can help.

If you've been in a car accident in Mississauga, Brampton, Toronto, or anywhere in the GTA and you're not sure whether you're getting the full benefits you're entitled to, call us. The consultation is free, and we handle accident benefits claims on a contingency basis — meaning you pay nothing unless we get results.

Injured in a Car Accident? Call Asaad Law.

Call (289) 910-0819 or book a free consultation. , serving clients across Ontario.

This article is for general information only and does not constitute legal advice. Every situation is different — speak to a lawyer about yours.