Optional Accident Benefits

You should have them, so they’re not really “Optional” – but even with them, you’re still paying more and getting less.

The insurance lobby has successfully eroded the standard package of Statutory Accident Benefits (SABS) available in Ontario every couple years, and this has occurred under governments from both parties. Many of the core benefits under the SABS have been stripped away from individuals and families suffering the fallout of motor vehicle accidents, and these benefits have been stripped away in the name of reducing premiums for the rest of drivers in Ontario.

Unfortunately, the premiums have not been reduced – just the benefits. Yes, you’re still paying more, and just getting less.

In this climate of falling benefits and rising premiums, it is imperative that all drivers look at the available optional SABS to plug the gaps left by the benefits that have been stripped away. We also believe that insurers should be mandated to make the availability of these optional benefits readily known to Ontario drivers and to explain them in intelligible language. It’s not right firstly that most people don’t know how SABS work, don’t know that their premiums remain the same or are higher than in the past, and don’t know that their benefits have been reduced by a string of governments, and then secondly that they also don’t know that there are optional benefits that might assist them when they are injured.

We’ve written on the specifics of optional benefits in the past, the way these coverages work, and who should obtain optional SABS and when:

When you renew your automobile insurance policy, you have a variety of options to increase your coverage in the event that you are injured. The basic policy may seem appealing to most, as it has the lowest premiums. However, if you ask anyone who has been injured in an accident, the standard coverage is simply not enough.

That said, the types of optional benefits available to you are numerous and overwhelming. Depending on the person, not every benefit is worth purchasing. In an attempt to provide clarity, included below is a summary of the optional benefits available to you and a description of the circumstances under which you should consider purchasing them.

Medical and Rehabilitation/Attendant Care Benefits:

Medical and rehabilitation benefits are the most important category of benefits available to you in the event that you are injured in a motor vehicle accident. These benefits provide funding for treatment such as physiotherapy, psychological counselling, massage therapy, and exercise rehabilitation. Similarly, attendant care benefits provide compensation for any professional services you may require to care for you, such as a Personal Support Worker.

The standard automobile policy provides up to $3,500 in medical and rehabilitation benefits for minor injuries (available for a maximum of 5 years); up to $65,000 for medical, rehabilitation, and attendant care benefits for injuries deemed “non-catastrophic” (available for a maximum of 5 years); and up to $1,000,000 for medical, rehabilitation, and attendant care benefits for catastrophic injuries (available for life).

There are two options available to increase your limits in the event of a non-catastrophic injury:

OPTION 1: Can increase limit to $130,000 (available for 5 years)
OPTION 2: Can increase limit to $1,000,000 (available for life)

There is one option available to increase your limits in the event of a catastrophic injury:

OPTION: Can increase limit to $2,000,000 (available for life)

When you should purchase the optional benefit: Always. It is recommended that everyone increase their Medical & Rehabilitation Benefits in whatever capacity they can afford. The standard policy simply does not provide enough coverage, especially the catastrophic injury coverage.

Income Replacement Benefit:

In the event that you are injured and cannot return to your employment in full capacity, this benefit offers up to $400 per week (or up to 70% of your gross income- whichever is less) to the age of 65, so long as you continue to meet the eligibility test. The benefit can continue after the age of 65, but in a significantly reduced quantum.

OPTION 1: Can increase limit to $600 per week
OPTION 2: Can increase limit to $800 per week
OPTION 3: Can increase limit to $1,000 per week

When you should purchase the optional benefit: If you make significantly more than $400 per week ($20,800/year) and have no other type of income replacement benefit available to you in the event of injury (ex. If you do not have a long-term disability policy).

Caregiver Benefit:

Under the standard policy, this benefit is only available for those catastrophically injured. In the event that you are injured and unable to care for your children or dependents to the extent you could prior to the collision, it provides $250 per week for the first dependent and $50 for each dependent, for a duration of 2 years.

OPTION: Can make benefit available for all level of injuries (MIG and Non-CAT)

When you should purchase the optional benefit: If you are the primary caregiver for your children or other dependents and are not employed (you cannot receive this benefit and an income replacement benefit).

Housekeeping and Home Maintenance Expenses:

Under a standard policy, this benefit is only available for applicants who are catastrophically injured. It provides up to $100 per week, for life, to pay for professional housekeeping or home maintenance assistance.

OPTION: Can make benefit available for all level of injuries (MIG and Non-CAT) in the amount of $100 per week, for a maximum duration of two years.

When you should purchase the optional benefit: If you are the person primarily responsible for looking after your home, and you don’t already pay for professional housekeeping assistance.

Death and Funeral Benefits:

In the event that a motor vehicle collision results in your death, this benefit provides a $25,000 lump sum payment to your spouse; a $10,000 lump sum payment to each of your dependents; and up to $6,000 for funeral expenses.

OPTION: Can increase the lump sum payment to your spouse and dependents to $50,000 and $20,000, respectively, and increase the funeral expenses to $8,000.

When you should purchase the optional benefit: If you have a spouse or dependents who would struggle financially in the event of your death (ex. if you are the primary breadwinner).

Dependent Care Benefit:

This is a purely optional benefit, which means it is not available under the standard policy. It provides payment for any additional expenses you may incur as a result of your injuries in caring for your dependents (ex. hiring child care, babysitters, etc.). Unlike the caregiver benefit, you can receive an income replacement benefit, and this benefit at the same time. It provides up to $75 per week for the first dependent and up to $25 per week for each additional dependant, to a maximum of $150 per week, for life.

When you should purchase the optional benefit: If you are the primary caregiver for your children or other dependants and are employed.

Indexation Benefit:

This is another benefit that is not available under the standard policy. If purchased, it provides for the automatic annual adjustment of your other benefits according to the Consumer Price Index for Canada.

For example, your income replacement benefit of $400 per week will be adjusted for inflation, resulting in an increased maximum weekly amount.

When you should purchase the optional benefit: This benefit is of lesser priority than the others. If you have extra money to spend, purchasing this option will slightly increase your maximum benefits; however, your money is better spent on the aforementioned options.