Ontario Accident Benefits (SABS), Explained Without the Jargon
After a car accident in Ontario you have two separate claims. One is the lawsuit against the at-fault driver. The other, which starts right away, is your accident benefits claim. It runs through your own insurer regardless of who caused the crash, which is why people call it no-fault.
Accident benefits are governed by a regulation called the Statutory Accident Benefits Schedule, or SABS. Here is what it actually does.
What the benefits cover
The core benefit pays for medical and rehabilitation treatment that is reasonable and necessary: physiotherapy, assessments, medication, assistive devices and similar care. If your injuries are serious enough, there is also attendant care to help with personal needs at home.
Other benefits depend on the coverage on your policy. They include income replacement if you cannot work, a benefit for people who were not employed, a caregiver benefit, and housekeeping and home maintenance. Since July 1, 2026 these are optional coverage, which is explained below.
What changed on July 1, 2026
Medical, rehabilitation and attendant care benefits are still mandatory on every Ontario auto policy. Everything else, including income replacement, non-earner, caregiver and housekeeping benefits, became optional. A policy that renewed after July 1 keeps the benefits it already had unless the policyholder agreed in writing to drop or change them.
Two other changes matter after a crash. The optional benefits now only cover the named insured, their spouse and dependants, and the drivers listed on the policy, so a passenger or pedestrian who is not on any policy can still get treatment and care funding but may have no income benefit. And for accidents in Ontario on or after July 1, 2026, your auto insurer pays medical and rehabilitation expenses first, other than medication, even if you also have health benefits through work.
The practical point: find out exactly what coverage your household carries, because it now decides much of what you can claim.
How much it pays
The amount depends on how your injuries are classified. Minor injuries fall under a framework that caps medical and rehabilitation funding at three thousand five hundred dollars. Most other injuries fall into a middle category with a combined medical, rehabilitation and attendant care limit of sixty-five thousand dollars. The most serious injuries can be designated catastrophic, which raises that limit to one million dollars.
Where your policy includes it, the income replacement benefit is seventy percent of your gross weekly income, up to the weekly maximum set by your coverage. The medical funding limits above are why the classification of your injury is one of the most important fights in the whole file.
The deadlines that trip people up
You are expected to notify your insurer of the accident within seven days, or as soon as practicable. Once the insurer sends you the application package, you generally have thirty days to complete and return it. Missing these dates does not always end a claim, but it creates avoidable problems.
The bigger trap is the minor injury label. Insurers default to it because it caps your funding low, and getting out of it usually takes medical evidence. That is the kind of thing worth getting help with early rather than after the funding runs out.
- ·Medical, rehabilitation and attendant care benefits are mandatory on every Ontario auto policy and are paid regardless of fault.
- ·Since July 1, 2026, income replacement and the other benefits are optional, and they only cover the named insured, their spouse and dependants, and listed drivers.
- ·For accidents on or after July 1, 2026, your auto insurer pays medical and rehabilitation costs first, other than medication.
- ·Minor injury funding caps at $3,500, most injuries at $65,000, and catastrophic injuries at $1,000,000.
- ·Notice is due within about a week and the application within 30 days of receiving the forms.
This article is general information, not legal advice, and every case turns on its own facts. If you have been injured, and especially in a matter involving car accidents, Shah & Shah Lawyers offers a free consultation.
