Ontario Accident Benefits Explained: Your Complete SABS Guide (2026)

Statutory Accident Benefits are a form of no-fault insurance coverage that every motor vehicle insurance policy in Ontario must include. "No-fault" means you receive these benefits from your own insurance company regardless of who caused the accident. You do not need to prove that someone else was negligent to qualify.

SABs are governed by the Statutory Accident Benefits Schedule (SABS), a regulation under Ontario's Insurance Act. These benefits are entirely separate from any tort claim (lawsuit) you may pursue against the at-fault driver for pain and suffering and other damages.

Understanding this distinction is critical: even if you plan to sue the at-fault driver, you should simultaneously apply for accident benefits from your own insurer. These two streams of compensation serve different purposes and are not mutually exclusive.

Medical and Rehabilitation Benefits cover the cost of treatment not covered by OHIP, including physiotherapy, chiropractic care, psychological counselling, occupational therapy, and assistive devices. For non-catastrophic injuries, the standard coverage limit is $65,000. For catastrophic injuries, the limit increases to $1,000,000 — making the catastrophic impairment designation one of the most important determinations in any serious injury claim.

Income Replacement Benefits (IRBs) provide 70% of your gross pre-accident income, up to a maximum of $400 per week, if your injuries prevent you from working. For those designated as catastrophically impaired, this benefit continues until age 65. For non-catastrophic injuries, IRBs are available for up to 104 weeks, with the possibility of extension if you remain unable to work in any occupation.

Attendant Care Benefits cover the cost of a caregiver if your injuries are severe enough that you need assistance with daily activities such as bathing, dressing, eating, or mobility. The standard limit is $3,000 per month for non-catastrophic injuries and $6,000 per month for catastrophic injuries. Non-professional caregivers, including family members, can be compensated under this benefit.

Additional benefits include: Housekeeping and Home Maintenance benefits ($100 per week if you are unable to perform household tasks), Caregiver Benefits (if you were the primary caregiver for a dependent before the accident), Visitor Expense Benefits, and a Death and Funeral Benefits provision.

Time is critical when applying for accident benefits. You must notify your insurance company of the accident within 7 days, and you must submit a completed Application for Accident Benefits (OCF-1) within 30 days of the accident. Missing these deadlines can jeopardize your entitlement to benefits.

After submitting the OCF-1, your insurer will begin processing your claim and may request additional documentation, including medical records, employer verification, and treatment plans from your healthcare providers. Your insurer is required to begin paying benefits within 30 days of receiving a completed application.

It is strongly recommended to have a personal injury lawyer assist you with the application process from the very beginning. Insurance companies have experienced adjusters reviewing your claim, and a lawyer ensures that your application is thorough, accurate, and positions you for the maximum benefits available under your policy.

The difference between a catastrophic and non-catastrophic injury designation in Ontario is enormous — it can mean the difference between $65,000 and $1,000,000 in medical benefits, and between 104 weeks and lifetime income replacement. Insurance companies aggressively resist catastrophic designations because of the significantly higher costs involved.

Under the current SABS, catastrophic impairment includes: paraplegia or quadriplegia, severe traumatic brain injury (Glasgow Coma Scale score of 9 or less), total and permanent blindness in both eyes, amputation of an arm or leg, and impairments rated at 55% or more of whole person impairment under the AMA Guides.

If you believe your injuries may qualify as catastrophic, securing experienced legal representation immediately is essential. The designation process involves complex medical assessments, and having a knowledgeable lawyer ensures the right experts are retained and the strongest possible application is submitted. At Kanevsky Law, we have successfully obtained catastrophic impairment designations for numerous clients, unlocking the full scope of benefits they needed for long-term recovery.

Denied or reduced accident benefits claims are unfortunately common in Ontario. Insurance companies may deny coverage by arguing that your treatment is not "reasonable and necessary," that your injuries are not related to the accident, or that you have reached maximum medical improvement.

If your claim is denied, you have the right to dispute the decision. The first step is a formal reconsideration request to the insurer. If the denial is upheld, you can file an application with the Licence Appeal Tribunal (LAT), which is the administrative body that resolves SABS disputes in Ontario. LAT hearings are similar to court proceedings, and having experienced legal representation significantly improves your chances of a successful outcome.

Do not accept a denial without a fight. Insurance companies deny claims knowing that many people will simply give up. A personal injury lawyer experienced in accident benefits disputes can review the denial, identify the weaknesses in the insurer's position, and pursue every available avenue to restore your benefits.

Many Ontario drivers have optional accident benefits coverage on their auto insurance policies without realizing it. These optional coverages can significantly increase the benefits available to you after an accident.

Common optional benefits include: increased medical and rehabilitation coverage (up to $1,000,000 or $2,000,000), increased attendant care coverage, increased income replacement (up to $1,000 per week), caregiver benefits, housekeeping and home maintenance benefits, and coverage for dependent care expenses.

Review your insurance policy carefully or have your lawyer do so. Many accident victims miss out on optional benefits they are entitled to simply because they are unaware the coverage exists. Your lawyer should conduct a thorough review of all available insurance coverage as one of the first steps after being retained.