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A car accident can turn your life upside down in a moment. On top of shock and pain, you might start worrying about how you will pay your bills, cover your treatments, or support your family in the future.
As a personal injury lawyer in Ontario, I frequently hear these concerns from clients. The auto insurance system here can be confusing, but there are ways to get the compensation you need after a serious motor vehicle accident.
In this blog post, I will explain the basics of Ontario's auto insurance system, your rights, and how you can get compensation after an accident. No matter if you are a driver, passenger, cyclist, or pedestrian, you will find clear answers to common questions, tips for making claims, and guidance on what to do next.
Two Ways to Get Compensated After a Car Accident in Ontario
In Ontario, there are two main ways you can get compensation after a car accident: no-fault benefits and the option to sue the at-fault driver.
- Accident Benefits (No-Fault Insurance): These are paid by your own auto insurer, no matter who caused the accident. They cover medical treatments, some income replacement, and other expenses.
- A Tort Claim (Lawsuit Against the At-Fault Driver): If another driver was at fault, you can sue for damages such as pain and suffering, lost income, future care costs, and compensation for your loved ones.
You can pursue both options at the same time. Accident Benefits give immediate, short-term support, while a lawsuit can address long-term losses and hold the at-fault driver accountable.
Accident Benefits
Accident Benefits are included with every auto insurance policy in Ontario. They are meant to help you immediately after a crash, no matter who caused it.
Who Can Apply?
Drivers, passengers, pedestrians, and cyclists can all apply if they are injured in a car accident.
If you don't have your own insurance, you might be covered by the policy of the car you were in, the policy of the car that struck you as a pedestrian or cyclist, or a family member's policy. If there's no insurance at all, you can apply to Ontario's Motor Vehicle Accident Claims Fund, which helps make sure injured people still get coverage.
How Do You Apply?
If you are involved in a motor vehicle accident, you should notify your insurer within seven days to begin the claims process. The next step is to complete an Application for Accident Benefits (OCF-1) to formally apply for benefits.
Your doctor is required to fill out a Disability Certificate (OCF-3) to confirm the extent of your injuries.
If you were employed at the time of the accident, your employer must complete an Employer's Confirmation Form (OCF-2) to verify your employment status and income.
Treatment providers will also need to submit a Treatment Plan (OCF-18) outlining the recommended medical care.
Throughout this process, it is important to keep copies of all forms and to meet all deadlines, as missing a deadline could result in reduced benefits.
To learn more about applying for accident benefits, please visit this page for details.
What Do Accident Benefits Cover?
Here are the main benefits Accident Benefits provide:
- Income Replacement Benefit (IRB): Pays 70% of your gross weekly income, up to $400/week (unless you bought optional higher coverage).
- Non-Earner Benefit (NEB): $185/week if you weren't working but can't live a normal life due to your injuries.
- Attendant Care: For help with personal care, up to $3,000/month for non-catastrophic injuries and $6,000/month for catastrophic injuries.
- Caregiver & Housekeeping: Typically, only for catastrophic cases, unless optional coverage has been purchased.
- Death & Funeral Benefits: Lump sums for families after fatal accidents.
Medical & Rehabilitation Benefit Categories:
These benefits are designed to help you recover from your injuries and return to as normal a life as possible. The coverage depends on how serious your injuries are and which category you fall into:
- Minor Injury Guideline (MIG): up to $3,500 total.
- Non-Catastrophic Injuries (Non-CAT): up to $65,000 (shared with attendant care).
- Catastrophic Injuries (CAT): up to $1,000,000 for life-changing injuries such as brain or spinal cord damage, or serious mental or behavioural impairments.
A Tort Claim – Suing the At-Fault Driver
Accident Benefits help, but they don't cover everything. For serious or long-term injuries, you may need to sue the at-fault driver through their insurance company.
What Can You Claim?
- Pain and Suffering: Compensation for physical and emotional impact, pain, and loss of enjoyment of life.
- Income Loss: Past and future lost wages. Accident Benefits only cover part of your income losses.
- Future Care Costs: Treatment and assistance not covered by benefits.
- Housekeeping: If you can no longer handle chores or upkeep of your home.
- Family Law Act (FLA) Claims: Loved ones can sue for the loss of your care, guidance, and companionship.
Understanding Thresholds and Deductibles in Ontario
Ontario law makes tort claims more difficult to pursue. To succeed, you must prove that your injuries are both permanent and serious enough to meet a specific legal threshold. Even if you are successful in your claim, a substantial deductible is applied unless your award exceeds the threshold amount.
For 2025, the deductible for pain and suffering is $46,790.05, but is not deductible if your award exceeds $155,965.54.
For Family Law Act claims, the deductible is $23,395.04 but is not deductible if the award is above $77,982.13.
For example, if a judge awards you $80,000 for pain and suffering, approximately $47,000 is deducted, leaving just over $33,000. However, if the award is $160,000, the deductible does not apply.
How the Two Systems Work Together
You can receive both Accident Benefits and lawsuit damages, but you can't get paid twice for the same loss.
For example, if Accident Benefits have already paid income replacement benefits, your lawsuit's income claim will be reduced. If benefits covered part of your treatment, your lawsuit could only claim the remaining costs. That is why it is important to have a lawyer handle both claims. They can help you maximize compensation and avoid double recovery issues.
Special Situations
Certain situations can affect how accident benefits are accessed and what coverage is available following a motor vehicle accident:
Pedestrians and cyclists are eligible for Accident Benefits, regardless of whether they have car insurance.
If you are involved in a hit-and-run or an accident with an uninsured driver, you remain protected through your insurer or the Motor Vehicle Accident Claims Fund.
For workplace accidents, WSIB coverage may apply, and you may need to choose between claiming WSIB benefits or pursuing legal action for damages.
Key Deadlines
Missing a deadline may affect your rights. These are the most important dates to remember:
- Notify insurer within 7 days.
- Submit Accident Benefits forms quickly (within 30 days).
- Lawsuits: 2 years from the date of the accident.
Why Gathering Evidence Matters
Insurance companies and courts rely on proof. The more evidence you have, the stronger your case. Be sure to keep:
- Medical records.
- Pay stubs and tax returns.
- A daily journal of pain and missed activities.
- Receipts for expenses.
- Photos of injuries and the accident scene.
Common FAQs About Car Accident Compensation in Ontario
It is no-fault insurance, so can I sue?
You can sue if your injuries are serious enough. Many people believe that because Ontario operates under a no-fault insurance system, they cannot sue. In reality, no-fault means that your own insurer will pay some benefits regardless of who was at fault. However, you may still sue the at-fault party if your injuries are serious and meet the legal threshold.
Will my insurer cover everything?
No, Statutory Accident Benefits are capped, with limits on medical, rehabilitation, attendant care and income replacement benefits. Additional coverage may be available but only if you purchased optional benefits in your policy.
Is pain and suffering automatic after a motor vehicle accident?
No, pain and suffering is not automatic after a motor vehicle accident. In Ontario, you must meet a statutory threshold for the severity and permanence of your injuries, and a significant deductible applies to any award unless your damages are very high.
If I wasn't working, how can I claim income?
If you weren't working when the accident happened, you might not qualify for income replacement benefits. However, the insurance system provides for different types of benefits. For example, you may be eligible for Non-Earner Benefits if your injuries prevent you from carrying on normal life activities.
Even if you weren't working when the accident happened, you may still have a claim for lost income. This is especially true if you were planning to go back to work in the future.
The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.
