Ontario Statutory

Accident benefits changes

Ontario Statutory

Since 1990, Ontarians have had access to extensive Statutory Accident Benefits payable by their own motor vehicle insurers following a motor vehicle accident, regardless of fault. Benefits have been payable for many goods and services required as a result of a motor vehicle accident, including, most recently, Medical and Rehabilitation Benefits, Attendant Care, Non-Earner Benefits, and Income Replacement Benefits.

Although Ontarians have had the concurrent, limited right to sue in tort, the Statutory Accident Benefits regime has played an important role. Most notably, tort defendants have received credit for benefits paid by the accident benefit carrier. However, as of June 1, 2016, the Statutory Accident Benefits regime has again undergone significant overhaul.

The availability of Non-Earner Benefits have changed dramatically. Immediately prior to the amendments, Non-Earner Benefits were payable for life to claimants who suffered a complete inability to carry on a normal life as a result of a motor vehicle accident in the base amount of $185 per week, subject to continuing entitlement. For students or recent graduates, the Non-Earner Benefit increased to $320 per week at 104 weeks post-accident. Non-Earner Benefits were payable to claimants beginning at age 16.

With the June 1, 2016 amendments, Non-Earner Benefits are now only payable for a total of 104 weeks to claimants at least 18 years old. The benefit is $185 per week, regardless of educational status at the time of the accident.

The availability of Medical and Rehabilitation and Attendant Care Benefits have also changed dramatically. There are effectively three injury classifications, which lead to tiers of coverage: minor injuries, non-catastrophic injuries, and catastrophic injuries. In the amendments, the definition and limits of catastrophic impairment have been updated to reflect more recent medical standards. It remains unknown whether the changes will result in more or fewer claimants being accepted as catastrophically impaired. However, it is anticipated that fewer claimants will be able to satisfy these higher thresholds for entitlement.

Prior to the amendments, for non-catastrophic injuries, claimants had access to $50,000 in Medical and Rehabilitation Benefits, payable for up to 10 years post-accident. Attendant Care Benefits were also payable for up to 104 weeks post-accident at a maximum of $3,000 per month, subject to a maximum limit of $36,000.

For minor injuries, with the amendments, the limits for Medical and Rehabilitation Benefits have not changed; it remains $3,500. Attendant Care Benefits are still not payable for minor injuries.

However, the duration and monetary limits of Medical and Rehabilitation and Attendant Care Benefits have been reduced to a total combined limit of $65,000, payable for up to five years post-accident.

For catastrophic injuries, prior to the amendments, Medical and Rehabilitation Benefits and Attendant Care Benefits were payable for life, each to a maximum limit of $1,000,000. Now, the limits for Medical and Rehabilitation and Attendant Care Benefits have been combined for catastrophic injuries, for a total limit of $1,000,000.

Given the reduction in coverage under the Statutory Accident Benefits regime, the tort regime will play a larger role going forward. As the limits for Medical and Rehabilitation and Attendant Care Benefits have been reduced, the exposure for tort claims will likely rise accordingly.

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