Personal Injury Blog - Strype

How the Statutory Accident Benefits Schedule Works in Ontario

Written by Leyla Shikhzamanova | Mar 4, 2026 12:00:00 PM

 Being injured in a motor vehicle accident can turn your life upside down in an instant. On top of managing your recovery, you are suddenly facing insurance forms, missed income, and mounting medical bills. What many Ontarians don’t realize is that they have immediate access to a set of protections called the Statutory Accident Benefits Schedule (SABS) regardless of who caused the accident. Understanding how Ontario accident benefits work can mean the difference between receiving the support you need and unknowingly leaving it on the table. 

Key Takeaways:

  • SABS provides no-fault benefits to anyone injured in an Ontario motor vehicle accident, including drivers, passengers, pedestrians, and cyclists.
  • Benefits cover lost income, medical treatment, rehabilitation, attendant care, and more, but limits vary by injury severity.
  • As of July 2026, Income Replacement and Caregiver Benefits become optional add-ons. Many Ontarians will lose access unless they update their policy now.
  • Ontario accident benefits and a lawsuit against the at-fault driver can be pursued at the same time.
  • Missing key deadlines, including the 7-day notice and 30-day application window, can result in a denied claim.

What Is the Statutory Accident Benefits Schedule in Ontario?

The Statutory Accident Benefits Schedule is Ontario's no-fault insurance framework that provides financial and medical support to individuals injured in a motor vehicle accident, regardless of fault. Governed by Ontario Regulation 34/10 under the Insurance Act, these benefits are available through your own vehicle insurer and apply to drivers, passengers, pedestrians, and cyclists.

Because SABS operates on a no-fault basis, even a driver who caused the collision is entitled to claim benefits from their own insurer. This is one of the most misunderstood aspects of Ontario's auto insurance system. If you are unsure whether you qualify, assume you do and verify with a lawyer.

The Difference Between Accident Benefits and a Lawsuit

Accident benefits and a tort claim (lawsuit) are separate legal processes that can run simultaneously. SABS delivers immediate, practical support, including income replacement, medical funding, and care assistance while you recover.

A tort claim, on the other hand, is filed against the at-fault driver. The individual who isn’t at fault may file a tort claim because they are seeking compensation for the pain and suffering and long-term losses that SABS does not cover. Pursuing one does not prevent the other, and in serious cases, both options should be considered.

Who Qualifies for Ontario Accident Benefits?

Ontario's SABS eligibility is broader than most people expect. The following individuals can make an accident benefits claim:

  • Drivers and passengers involved in a motor vehicle accident
  • Pedestrians struck by a motor vehicle
  • Cyclists hit by a motor vehicle
  • Immediate family members of an insured person involved in the motor vehicle accident, including spouses, children, parents, grandparents, siblings, and grandchildren, even if they were not present in the vehicle

 

If you don’t have your own auto insurance policy, you may still qualify through a household family member's policy, the insurer of the vehicle you were in, or in some cases, the Motor Vehicle Accident Claims Fund. Don’t assume you have no coverage without speaking to a motor vehicle accidents lawyer first.

Special Rules for Out-of-Province Residents

Accidents that occur in Ontario are generally subject to two primary mechanisms of Canadian insurance law: Section 45 of the Ontario Insurance Act and the Power of Attorney and Undertaking (PAU). The core principle here is that insurance coverage follows the "law of the locality"—meaning if an accident happens in Ontario, Ontario’s rules usually dictate the minimum benefits and legal procedures, even for visitors. Ontario's reciprocal agreements with other Canadian provinces and certain U.S. states generally mean that out-of-province visitors injured here may still access Ontario accident benefits. The rules are complex and fact-specific, so it’s important to consult an Ontario personal injury lawyer if this applies to you.

“Insurers know that Strype will go the distance to ensure our clients’ needs are met.”

What Does Statutory Accident Benefits Coverage Include?

SABS benefits span income support, medical treatment, personal care assistance, and more. Coverage limits vary significantly depending on how your injuries are classified.

1. Income Replacement Benefits (IRBs)

If your injuries prevent you from returning to work, Income Replacement Benefits replace a portion of your lost wages. Standard IRBs are calculated at 70% of your gross pre-accident income, to a maximum of $400 per week, which is a cap that falls well short for many earners. Optional coverage can increase this maximum to $600, $800, or $1,000 per week and is worth purchasing before you ever need it.

July 2026 SABS Reform

Income Replacement Benefits are changing from a mandatory benefit to an optional one in July 2026. If you do not proactively add this coverage to your policy, you may receive nothing for lost income after a crash. It's important to review your auto insurance policy as soon as possible to determine what you currently have.

2. Non-Earner Benefits

For those not employed at the time of the accident (including full-time students or those not in the workforce) Non-Earner Benefits of $185 per week are available if you are completely unable to carry on a normal life. Eligibility criteria are strict and these claims are frequently disputed by insurers.

3. Caregiver Benefits

Under the July 2026 SABS reforms, Caregiver Benefits are also being reclassified as an optional benefit. Parents and primary caregivers for dependents who are injured in an accident will no longer receive automatic support for the caregiving duties they can no longer perform, unless they have purchased optional coverage in advance. Caregiver Benefits remain available without restriction only in catastrophic injury cases. If you are a caregiver, check your policy now.

4. Medical and Rehabilitation Benefits

Medical and rehabilitation benefits fund treatment costs, including physiotherapy, chiropractic care, psychological therapy, assistive devices, and more. Funding limits depend on injury classification:

 

Injury Classification

Medical & Rehab Limit

Attendant Care Combined

Minor Injury (MIG)

$3,500

Not applicable

Non-Catastrophic

$65,000

Up to $1,000,000 combined

Catastrophic

$1,000,000

Up to $1,000,000 combined

 

Table source: Ontario Statutory Accident Benefits Schedule

 

Insurers often default to applying the Minor Injury Guideline (MIG), which caps your benefits at $3,500. If your injuries are more serious, even if they appear minor at first, this classification should be challenged. A personal injury lawyer and in-house medical team can help you build the medical evidence needed to access a higher benefit tier.

5. Attendant Care Benefits

If your injuries leave you requiring in-home assistance with personal care, Attendant Care Benefits fund that support. Entitlement is determined through a Form 1 assessment completed by a qualified health professional. In catastrophic injury cases, combined medical, rehabilitation, and attendant care benefits can reach $1,000,000.

6. Other Accident Insurance Benefits

  • Housekeeping and Home Maintenance: Up to $100/week for catastrophically injured claimants who can no longer perform these tasks. Optional coverage is required for non-catastrophic cases.
  • Death and Funeral Benefits: A death benefit is payable to surviving spouses and dependants, plus a funeral benefit to cover burial costs.
  • Transportation Costs: Reasonable transportation to medical appointments related to your injuries may be reimbursable.

“When The Long Term Disability door is closed, Strype Injury Lawyers find another way in”

MacIvor v. Manulife, Supreme Court of Canada Decision regarding a successful client case

Step-by-Step Process for Filing an Accident Benefits Claim

Filing an Ontario accident benefits claim involves specific forms and strict deadlines. Missing a step can result in your benefits being delayed or denied.

  1. Notify your insurer within 7 days. Report the accident to your automobile insurer as soon as possible, no later than 7 days after the collision. Provide basic accident details, but do not sign documents or give a recorded statement without first consulting a lawyer.
  2. Submit the OCF-1 within 30 days. Your insurer will provide an Application for Accident Benefits (OCF-1). You have 30 days from the accident date to submit the completed form.
  3. Provide supporting medical documentation. Include a Disability Certificate (OCF-3) from your treating physician, plus any medical records and specialist reports that document your injuries. The quality of this evidence directly affects what benefits you receive.
  4. Obtain approval for ongoing treatment plans. Each new course of treatment requires a Treatment and Assessment Plan (OCF-18) submitted to your insurer for approval. Your insurer must respond within set timeframes—unexplained delays should be challenged.

 

Timelines and Deadlines Under the Statutory Accident Benefits Schedule

Missing a deadline can cost you your benefits. The key dates are outlined in the table below.

Deadline

Requirement

7 days (from date of accident)

Notify your insurer

30 days (from date of accident)

Submit OCF-1 application

10 business days (after completed application)

Insurer must respond

2 years (from date of denial)

Dispute denial at the Licence Appeal Tribunal (LAT)

Common Reasons Accident Benefits Claims Are Denied

  • Missed deadlines: Late notification or a late OCF-1 submission gives insurers grounds to deny the claim outright.
  • Insufficient medical evidence: Gaps in treatment or records that fail to clearly link your symptoms to the accident make it easy for insurers to dispute entitlement.
  • Insurer Medical Examinations (IMEs): Insurers commission their own medical assessments which are often by doctors retained to minimize findings. Denials based on IME reports can and should be challenged with independent medical evidence.
  • MIG misclassification: Insurers routinely apply the Minor Injury Guideline to cases where injuries are more serious. Contesting this classification requires strong medical documentation from the outset.

A denied or reduced claim is not the end of the road. An experienced accident benefits lawyer can review your file and advocate at the LAT or in court.

Frequently Asked Questions About Ontario Accident Benefits

How Long Do Accident Benefits Last?

Duration depends on the benefit type and injury severity. Income Replacement Benefits are generally payable for up to 104 weeks for non-catastrophic injuries but the eligibility test then becomes more demanding.

For catastrophic injuries, IRBs can continue beyond two years. Medical and rehabilitation benefits run for up to 10 years (or until age 28 for minors) for non-catastrophic injuries, with no time limit for catastrophic cases. Attendant care is available for up to 104 weeks for non-catastrophic claimants and indefinitely for those with a catastrophic designation.

Can I Claim Both SABS and Sue?

Yes, and in serious cases, you should pursue both. Claiming accident benefits does not prevent a tort claim against the at-fault driver. Statutory Accident Benefits Schedule provides immediate practical support, while a tort claim seeks compensation for pain, suffering, and long-term losses that SABS does not cover. A personal injury lawyer can structure both claims to maximize your total recovery.

What Happens If I Miss a Deadline?

Missing the 7-day notice deadline may be excusable if you can demonstrate a valid reason, such as hospitalization. Missing the 2-year LAT limitation period is far more serious and generally cannot be extended. If you believe your benefits have been wrongly denied or reduced, contact a lawyer without delay.

How Much Is an Accident Benefits Claim Worth?

Claim value ranges from a few thousand dollars for minor soft tissue injuries to hundreds of thousands over a lifetime for catastrophic cases. The biggest risk is settling too early or accepting MIG classification before the full extent of your injuries is understood. A thorough medical-legal evaluation early in the process protects you from low-ball outcomes.

Protect Your Rights: Get a Free Case Evaluation

Ontario's Statutory Accident Benefits Schedule exists to protect you, but insurance companies are not in the business of volunteering the maximum payout. Whether you are dealing with a denied claim, MIG misclassification, an IME that understates your injuries, or uncertainty about the 2026 SABS reforms, having the right legal team makes all the difference.

At Strype Injury Lawyers, we represent seriously injured Ontarians who deserve more than a quick settlement. Our team has the expertise and financial resources to go the distance. We advance all expert costs (which can exceed $50,000) and work on a no win, no fee basis. You pay nothing unless we win.

Check your policy before July 2026. If you are not certain your Income Replacement or Caregiver Benefits coverage will survive the upcoming reforms, now is the time to ask. Do not wait until after an accident to find out what you have.

Contact Strype Injury Lawyers today for a free, no-obligation case evaluation. It is not a sales pitch; it’s a conversation about your rights.

 

Legal Disclaimer: The information in this article is intended for general educational purposes only and does not constitute legal advice. Every personal injury claim is unique, and the facts of your situation may affect your legal rights and options. If you have been injured or believe you may have a legal claim, contact a qualified personal injury lawyer in Ontario as soon as possible.