Written By: Brandon Pedersen, Associate and Emma Funston-Clarke, Student-at-Law
9 Minute Read
Introduction
Accident Benefits funding is intended to be an immediate source of financial support after a motor vehicle incident in Ontario, yet many people are unaware these benefits exist or assume they only apply if someone else was at fault. In reality, Accident Benefits are designed to help those injured as a result of a motor vehicle access medical care, replace lost income, and manage daily life while they recover.
This blog provides a foundational overview of Accident Benefits after an incident involving a motor vehicle, including what they are, who qualifies, and what coverage is typically available immediately. It is intended as a practical guide that you can return to as questions arise, and as a reference point for future discussions about Ontario’s Accident Benefits system.
What are Accident Benefits?
Accident Benefits are “no-fault” benefits provided through Ontario’s auto insurance system. “No-fault” means that you can access these benefits regardless of who caused the accident. This means that even if you are 100% responsible for an incident involving a motor vehicle, you are still entitled to receive full Accident Benefits. The level of compensation provided to an Accident Benefits claimant depends on the severity of the injuries and the level of impairment.
These benefits are designed to support your recovery and financial stability after a motor vehicle incident. They can help pay for medical treatment, rehabilitation, income replacement, and personal care services while you recover.
It is important to understand that Accident Benefits are separate from any lawsuit. You do not need to sue anyone, or start a lawsuit, to receive Accident Benefits. While a lawsuit may address long-term losses or damages caused by someone else’s negligence, Accident Benefits focus on providing immediate and ongoing support after an incident involving a motor vehicle.
Who Qualifies for Accident Benefits After a Crash in Ontario?
Anyone injured in an incident involving a motor vehicle in Ontario is eligible to claim Accident Benefits. Eligibility is broad and includes:
- Drivers and passengers injured in an accident
- Passengers in a vehicle involved in an accident
- Pedestrians struck by a vehicle
- Cyclists involved in a collision with a motor vehicle
- Persons injured as a result of or in connection with a motor vehicle
If you have your own auto insurance policy, you typically apply for Accident Benefits through your own auto insurer, even if another driver caused the accident. If you do not have auto insurance, you may still be covered through the policy of a spouse or household member.
Pedestrians and cyclists who do not have coverage through a policy of their own or their family members usually apply through the insurer of the vehicle involved in the incident. In limited situations where no insurance is available, an injured person may access Accident Benefits through Ontario’s Motor Vehicle Accident Claims Fund.
Since the rules around eligibility can be confusing, many people assume they do not qualify for Accident Benefits. However, Ontario’s system is designed so that all injured people have access to coverage after an incident through one policy or another.
What Accident Benefits Cover Immediately After a Crash
Some benefits are available very soon after an incident, which makes early reporting and application especially important. Insurers assess Accident Benefits based in part on the severity of a person’s injuries. In simple terms, injuries are generally classified as minor, non-catastrophic, or catastrophic.
This classification matters because it affects the amount of coverage available and the duration of benefits. More serious injuries generally qualify for broader and longer-term support.
The most common categories of benefits include the following:
Medical and Rehabilitation Benefits
Medical and rehabilitation benefits cover treatment that is reasonably necessary as a result of the incident. This can include services such as physiotherapy, chiropractic care, occupational therapy, psychological treatment, and other rehabilitation services. The amount of medical and rehabilitation benefits and the time frame in which the benefits are available depend on the injured person’s age and level of injury. The purpose of these benefits is to help you recover, manage pain and symptoms, and regain function as early as possible.
Income Replacement Benefits, Non-Earner Benefits, or Caregiver Benefits
Depending on your situation before the incident, you may qualify for one of the benefits below. The level of injury a person has suffered does not affect a person’s right to claim income replacement benefits or non-earner benefits. An injured person can claim only one of income replacement benefits, non-earner benefits, or caregiver benefits, not all three.
Income Replacement Benefits
If your injuries prevent you from working after the incident, you may be entitled to income replacement benefits. These benefits are intended to replace a portion (70% of your gross weekly income before the incident, up to $400 per week, for the first 104 weeks after the incident) of the income you would have earned if you were able to work.
Eligibility depends on your employment situation before the incident. Income replacement benefits are significant for people who rely on regular earnings to meet household expenses and financial obligations.
Non-Earner Benefits
Non-earner benefits are available to people who were not employed at the time of the incident, such as students or individuals who had not yet entered the workforce, or who were simply not employed in 26 out of the 52 weeks prior to the incident. These benefits recognize that serious injuries can still have a significant impact on daily life, even if the person was not earning employment income at the time of the incident.
Non-earner benefits begin to be paid four weeks after the incident. At this time, the insurer must pay $185 per week. Non-earner benefits are payable for a maximum of 104 weeks.
Caregiver Benefits
Caregiver benefits may be available to individuals who were primary caregivers for children or other dependents before the incident and are no longer able to provide that care due to their injuries. While not everyone qualifies, these benefits can help offset the cost of replacement care in appropriate cases. To qualify for caregiver benefits, an injured person must suffer a catastrophic injury.
Once eligibility has been established, the injured person is entitled to payment for reasonable and necessary expenses incurred in caring for the person in need of care. These expenses are limited to:
- $250 per week for the first person in need of care; and
- $50 per week for each additional person in need of care
Attendant Care Benefits
For individuals with serious injuries, attendant care benefits may be available to cover assistance with personal care activities. This can include help with tasks such as bathing, dressing, and mobility when injuries limit independence.
These benefits are assessed based on medical needs and functional limitations, and they can play a critical role in maintaining safety and dignity during recovery. The amount of attendant care benefits and the time frame in which the benefits are available depends on the injured person’s age and level of injury.
Why Timing Matters
Accident Benefits are not automatic and must be applied for. Any delay in seeking medical treatment or notifying the insurer can complicate a claim and, in some cases, impact entitlement. Early application helps ensure that benefits begin as soon as possible and that the necessary documentation is in place.
How Do You Apply for Accident Benefits?
Applying for Accident Benefits involves several basic steps:
- Notify the insurer as soon as possible after the incident
- Complete the application forms provided by the insurer
- Submit medical documentation supporting your injuries and limitations
While the forms themselves can feel overwhelming, they are essentially part of the process of accessing benefits. Accuracy and completeness are important, and it is generally wise to keep copies of everything submitted. Medical documentation plays a central role in Accident Benefits claims, so following up with healthcare providers is critical.
Common Mistakes to Avoid When Claiming Accident Benefits
Many Accident Benefits claims run into difficulty due to avoidable issues, including:
- Delayed medical treatment after the incident
- Missing application or reporting deadlines
- Assuming benefits are automatic
- Accepting insurer decisions without understanding available options
- Not seeking clarification when insurer correspondence is unclear
Because Accident Benefits decisions can have a significant impact on recovery and finances, it is important to understand your entitlements and ask questions when something does not seem right.
How Accident Benefits Fit into a Larger Injury Claim
Accident Benefits are intended to support recovery in the immediate term after an incident. They operate alongside, but separately from, any personal injury lawsuit that may arise from the incident.
While Accident Benefits may cover treatment costs and some income loss, a lawsuit may address broader or long-term losses, such as future income loss, pain and suffering, or costs not fully covered by insurance. Understanding this distinction helps injured people make informed decisions about their options.
Upcoming Changes to Ontario’s Accident Benefits System
Ontario’s Accident Benefits system is scheduled to change in July 2026. This article reflects the current structure of accident benefits and will be updated as those changes take effect.
Future blogs will focus specifically on what is changing and how those changes may affect injured individuals, with this guide serving as the foundational reference point.
Conclusion
Accident Benefits exist to provide immediate support after a motor vehicle incident, regardless of who was at fault. They play a crucial role in helping injured people access treatment, replace lost income, and manage daily life during recovery.
Because Accident Benefits are not automatic and the rules can be complex, getting early guidance can make a meaningful difference. If you have been injured in an incident involving a motor vehicle, speaking with a qualified personal injury lawyer can help ensure you receive the full Accident Benefits available to you while you focus on recovery.
