Spotlight on Accident Benefits: Medical, Rehabilitation, and Attendant Care

Accident benefits are an essential part of your car insurance policy. Accident benefits provide compensation if you, one of your passengers or a pedestrian is injured in a car accident, no matter who is at fault.

It can cover rehabilitation treatment, income replacement and other services required for recovery. This coverage is mandatory for all drivers in Canada, except for Newfoundland and Labrador.

What is covered by accident benefits?

The coverage offered by accident benefits is designed to help you recover if you are injured in a collision or to support your family if you pass away. While coverage may vary by province, this type of coverage will usually include:

• Medical and rehabilitation expenses not already covered by a medical plan
• Compensation for loss of income if you can’t work as a result of your injuries
• Funeral expenses if you pass away
• Compensation for your family if you are killed in an accident

In certain provinces, accident benefits may have some additional coverage. For example, in Ontario accident benefits also includes:

• Compensation for an alternative caregiver if you can no longer act as the main caregiver for your dependents due to injury
• Compensation for other expenses like home maintenance, replacement of items damaged in the accident and lost educational expenses
• Compensation if you are completely unable to carry on a normal life and you don’t qualify for income replacement or the caregiver benefit

You might be able to increase the coverage for your basic accident benefits depending on where you live.

From June 16, 2016 auto reform, the standard coverage for non-minor and non-catastrophic injuries is up to $65,000.00 for medical, rehabilitation and attendant care benefits including assessment costs, for a max duration of 5 years or until 28 years old for minors.

The standard coverage for catastrophic injuries is up to $1,000,000.00 for medical, rehabilitation and attendant care benefits, including assessment costs for a lifetime duration.

Whose insurance covers your injuries if you are a passenger in someone else’s vehicle?

Even if you are a passenger in someone else’s car, you will need to go to your own insurer to make an accident benefits claim if you are injured in a collision. If you do not have your own car insurance policy, you would then need to claim accident benefits from the policy which covers the vehicle you were injured in.

What are non-catastrophic injuries and catastrophic injuries?

Non-catastrophic injuries refer to some head injuries, all fractured and broken bones, tears to muscles, tendons and ligaments, dislocations, demonstrable and clinically relevant (confirmed by CT scan, MRI, etc.) damage to the spine and/or neck and any other impairment permanently affecting the ability to function. You may also suffer emotional trauma following a serious accident, impairing your ability to return to a “normal” life after the physical injuries have healed.

Catastrophic injuries refer to claimants who have the appropriate medical professional examine them for catastrophic impairment. The doctor or neuropsychologist who completes the exam must be of the opinion that the claimant meets one of the tests for catastrophic impairment. CAT classification occurs in instances of:

• Paraplegia or quadriplegia
• Amputation or impairment causing the permanent loss of an arm or a leg
• Loss of vision in both eyes
• Severe brain impairment
• An impairment that results in a 55% whole body impairment or a marked-extreme impairment due to mental or behavioural disorder

Medical, Rehabilitation and Attendant Care Benefits

Let’s take a closer look at what medical, rehabilitation and attendant care benefits provide coverage for. In general, this will help with the medical and rehab expenses that are not covered by a private health plan or by the government.

While you will have coverage for this in your standard car insurance policy, you will be able to increase the amount for non-catastrophic injuries up to $130,000.00 and increase catastrophic injuries’ claims to up to $2,000,000.00.

Medical and Rehabilitation Benefits

This covers the cost of healthcare and rehabilitation which includes physiotherapy, prescription medications, chiropractic, counselling and other services not covered under OHIP or through your group plan (if applicable). You can find all the medical care and costs that qualify listed in the statutory accident benefits schedule.

It is very important to be aware of what your private or employer plan covers for physiotherapy, massage, chiropractic, and other health care services. Many have limits of $1,500 or less in a calendar year.

Attendant Care Benefits

This benefit is intended to cover reasonable care needs to a person unable to provide basic care to themselves following an accident. Home care can be provided to assist with daily tasks we take for granted, such as bathing, getting dressed, and transportation to medical appointments. The benefit exists so that you are not a burden on your friends and family to take care of your basic needs.

Optional Increased Accident Benefits

Policyholders are able to increase their protection under the Medical, Rehabilitation & Attendant Care coverage with the following three options:

• Increase your non-catastrophic injury limit to $130,000
• Increase your catastrophic injury limit to $2,000,000
• Increase your non-catastrophic limit to $1,000,000 and your catastrophic injury limit to $2,000,000

Policyholders are usually recommended to purchase one option in additional coverage because the standard policy limits will not provide adequate coverage in most cases. Be sure to speak with your insurance services agency in Oshawa for more information.

Other Optional Increased Accident Benefit Types

• Increased Income Replacement
• Increased Caregiver, Housekeeping and Home Maintenance Expenses
• Dependant Care
• Increased Death and Funeral
• Indexation Benefit

Once optional accident benefits are purchased, your coverage will automatically extend to the Named Insured, the spouse, the dependents of either and to any persons specified in the policy as drivers of the insured vehicle.

To speak to a qualified insurance services agency in Oshawa, call W.B. White at 1-877-727-0757 or contact us here.