Changes to Statutory Accident Benefits Effective June 1, 2016

In an effort to reduce standard insurance premiums, Ontario’s Statutory Accident Benefits Schedule (SABS) have changed. To this end, policies renewed on or after June 1, 2016 are subject to new accident benefits maximums, while policies renewed before are subject to the old maximums. Accident benefits are paid to a claimant by an insurance company without any consideration of fault or liability in a motor vehicle accident.

The most significant changes occur to the Medical, Rehabilitation and Attendant Care benefits. For claimants who are catastrophically injured in an accident (i.e. severe brain injuries, paralysis, etc.), Medical/Rehabilitation and Attendant Care benefits have been combined to $1,000,000 over a lifetime (from $1,000,000 each over a lifetime). For claimants who are non-catastrophically injured (i.e. those who suffer a broken leg, etc.), Medical/Rehabilitation and Attendant Care benefits available have been combined to $65,000 over five years (from $50,000 over 10 years and $36,000 over five years, respectively). Medical/Rehabilitation benefits for minor injuries are unchanged at a maximum limit of $3,500.

The optional benefits available for Medical, Rehabilitation and Attendant Care have also changed. A new optional benefit for catastrophic injuries now exists that increases the combined Medical, Rehabilitation and Attendant Care from $1,000,000 to $2,000,000.​ For non-catastrophic injuries, the optional benefits of $72,000 and $100,000 have been eliminated. In turn, a combined Medical, Rehabilitation and Attendant Care optional benefit of $130,000 is now available. It remains to be seen how many policyholders will purchase optional benefits.

The provincial government has created a Website that outlines these changes in greater detail.

It is important for consumers to understand what these new provisions mean so they can make an informed decision about whether to purchase additional insurance coverage in light of these changes. By spreading the word about these changes now, insurance companies and law firms specializing in personal injury can help prevent situations in the future when an injured claimant may discover he or she will not receive the level of compensation previously anticipated.

I anticipate fewer mediations dealing exclusively with SABS disputes. This may be due to fewer insurance dollars available, shorter duration of coverage (other than CAT claims) and due to the advent of the LAT (Licensing Appeals Tribunal).

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