Ontario Auto Accident Benefit Details

Providing More Choice to Consumers:

What You Need to Know About Changes to Auto Insurance in Ontario: The Details

The Ontario government is introducing reforms to the auto insurance system, in order to provide consumers more choice over the coverages and price they pay for insurance. These additional accident benefit choices will allow you to customize your policy to suit your needs. These measures are aimed at reducing fraud and abuse of the system, which increase premium.

Standard Auto Insurance Policy

In Ontario, the Insurance Act determines the standard coverage that consumers must purchase. As a result of the reforms, some of the features under the Standard Auto Insurance Policy have changed. Beginning June 1, 2016, if you are either buying a new auto insurance policy or renewing an existing one, you will have more options to purchase a level of coverage that is right for you.

By law, all auto insurance policies at minimum must include:

Third-Party Liability
Accident Benefits
Direct Compensation-Property Damage
Uninsured Automobile coverage

Beginning June 1, 2016, if you are buying a new policy or renewing an existing one, you have the following options with respect to Accident Benefits (also see the Auto Reform Coverage Summary Page):

Accident Benefits Coverage		Prior Coverage	Coverage as of June 2016	Options Available
Medical, Rehabilitation and Attendant Care Benefits	Medical and Rehabilitation: Reimbursement for reasonable, necessary medical and rehabilitation expenses like physiotherapy not covered by OHIP or Group Insurance Plans. Attendant Care: Reimbursement for an attendant to look after you either at home or within a healthcare facility. Non-Catastrophic Injuries: Minor injuries (sprains, whiplash) + Serious injuries (broken bones, severe strains). Catastrophic injuries: Loss of limb, para/quadraplegia.	*Non-Catastrophic Injuries:* $50,000 for Medical and Rehabilitation $36,000 for Attendant Care *Catastrophic Injuries:* $1,000,000 for Medical and Rehabilitation $1,000,000 for Attendant Care	*Non-Catastrophic Injuries:* $65,000 total for Medical, Rehabilitation and Attendant Care *Catastrophic Injuries:* $1,000,000 total for Medical, Rehabilitation and Attendent Care.	*Non-Catastrophic Injuries:* Increase to $130,000 for Medical, Rehabilitation and Attendant Care *Catastrophic Injuries:* Increase to $2,000,000 total for Medical, Rehabilitation and Attendant Care All Injuries: Increase non-catastrophic injuries to $1,000,000 and $2,000,000 for catastrophic injuries for Medical, Rehabilitation and Attendant Care to total of $3,000,000.
Caregiver Benefit	Reimbursement to hire someone to care for your dependents	Up to $250/week for the first dependent, $50/week for additional dependant; (Catastrophic injuries only)	No Change	Extend benefit to cover serious and minor injuries (not just Catastrophic)
Housekeeping and Home Maintenance Expenses	Reimbursement to hire someone to care for your dependents	Up to $100/week, available only for catastrophic injuries.	No Change	Extend benefit to cover Serious and Minor injuries (not just Catastrophic)
Income Replacement Benefit	Reimbursement for someone to carry out household responsibilities	70 % of gross income up to $400 per week.	No Change	Can be increased to $600, $800 or $1000 per week.
Dependent Care Benefit	Reimbursement for additional expenses to care for your dependents if you’re employed and injured from a car accident	Not provided.	No Change	Can purchase up to $75/week for first dependant and $25/week for each additional dependant to a maximum of $150/week.
Death and Funeral Benefits	A lump sum payout to your spouse and dependent(s); a second lump sum payout to cover the cost of funeral expenses.	$25,000 lump sum to an eligible spouse; $10,000 lump sum to each dependant; Up to $6,000 for Funeral.	No Change	Can increase to $50,000 lump sum to an eligible spouse; $20,000 lump sum for each dependant; Can increase to $8,000 for Funeral
Indexation Benefit	Adjustment of benefits to account for changes in inflation.	Not provided.	No Change	Annual adjustment according to the Consumer Price Index for Canada.
Tort Deductible	The amount deducted from a settlement or court award for pain and suffering	$36,500 deductible	No Change	Reduce deductible by $10,000 regardless of annual indexation

You Also Have New Choices to Customize Your Deductibles – The Portion of a Loss That You Are Required to Pay.

Tort Deductible – You have the option to reduce the deductible associated with court awarded compensation for pain and suffering by $10,000 from $36,500.

What Else is New?

The government’s reforms lay the foundation for an auto insurance system with greater price stability and more customized coverage best-suited to your lifestyle. Other key changes include:

Minor Accident – Insurers can no longer use a minor at-fault accident that occurs on or after June 1, 2016 meeting certain criteria to increase your premiums. The criteria include that no payment has been made by any insurer, that there are no injuries, and that damages to each car and property were less than $2,000 per car and were paid by the at-fault driver. This provision is limited to one minor accident every three years.
Interest Rate for Monthly Payment Plans – The maximum interest rate that insurers can charge if you make monthly premium payments has been lowered from 3% to 1.3% for one year policies, with corresponding reductions for shorter terms.
Comprehensive Deductible – The standard deductible for Comprehensive coverage has been increased from $300 to $500.
Non-Earner benefit – The six-month waiting period for people who are not working to receive benefits has been reduced to four weeks. Benefits can now only be received for up to two years after the accident.
Duration of Medical, Rehabilitation and Attendant Care benefits – For all claimants except children, the amount of time that you can receive this standard benefit is now five years for non-catastrophic injuries, and it will be paid only as long as you remain medically eligible.

What do the Coverages Mean?

Accident Benefits: Benefits you receive if you are injured in an auto accident, regardless of who caused it. Cover expenses not covered by OHIP. Most of the new reforms affect these benefits.

Third Party Liability: Claims made by a driver against another driver who causes an accident. Legally in Ontario you must carry at least $200,000 in liability.

Uninsured Auto coverage: Protects you and your family if you are injured or killed by a hit-and-run driver or by an uninsured motorist. It also covers damage to your vehicle caused by an identified uninsured driver.

Direct Compensation-Property Damage (DC-PD): Covers damage to your vehicle or its contents and equipment (stereo, speakers) including loss of use if another person was at fault for the accident. It is called direct compensation because even though someone else causes the damage, you collect directly from your own insurer. The accident must also occur in Ontario and both drivers must be insured by an insurance company licensed in the province.

Collision or Upset coverage: Pays for losses caused when your vehicle is involved in a collision with another object, including another vehicle, or rolls over.

Comprehensive Coverage: Pays for losses for certain perils, such as falling or flying objects, and vandalism.

Medical and Rehabilitation Benefit: Covers the cost of reasonable and necessary medical and rehabilitation expenses (e.g., physiotherapy, prescriptions) that are not covered by OHIP or your disability insurance plan.

Attendant Care Benefit: Pays for an aide or attendant to look after you if you have been seriously injured in an accident.

Catastrophic injury: If you suffer an injury in an accident, you can apply for a determination of whether your injury qualifies as “catastrophic” (e.g. loss of a limb, paraplegia). If the injury qualifies as “catastrophic,” you are eligible for an increased level of benefits.

Caregiver Benefit: If you are providing full-time care to dependents and can no longer provide that care as the result of an auto accident, you may be eligible for caregiver benefits to reimburse you for your expenses to hire someone to care for your dependents.

Housekeeping and Home Maintenance Expenses: If you are unable to perform your usual duties due to your injuries, this benefit pays for reasonable and necessary additional expenses for someone to complete your usual duties.

Income Replacement Benefit: If you cannot work as the result of an auto accident, you may be eligible for basic weekly income replacement benefits of up to $400. This benefit commences after one week.

Dependent Care Benefit: Pays for additional expenses incurred to care for your dependants if you are employed and are injured in an auto accident.

Death and Funeral Benefit: If you die as a result of an auto accident, the death benefit provides a lump sum payout to your spouse and your dependant; the funeral benefit provides a lump sum payout to cover the cost of your funeral expenses.

Indexation Benefit: The automatic adjustment of the income replacement benefit, non-earner benefit, attendant care benefit or medical and rehabilitation benefit according to the Consumer Price Index for Canada to compensate for inflation.

Tort Deductible: The amount that is deducted from a settlement or court award for pain and suffering.

OPCF 44R: Covers you for the difference between the at-fault driver’s Third Party Liability limit and your own Third Party Liability limit if someone with less liability coverage than you injures you in an accident.

Injured in a Motor Vehicle Accident?

A number of rules governing accident benefit claims change June 1, 2016. For updates on these changes, please contact your insurance company.
Many injuries received in an auto accident are minor. If you have a minor injury due to an auto accident, your medical and rehabilitation accident benefits are limited to $3,500 regardless of the coverage level you have selected.

For more information on your coverage choices, or to modify your policy, contact your Rhodes & Williams Insurance Broker representative:

Rhodes & Williams Insurance Brokers
1050 Morrison Drive
3rd Floor
Ottawa, ON
K2H 8K7

613-226-6590

For general information about changes to auto insurance in Ontario, contact:

Financial Services Commission of Ontario

(416) 250-7250
Toll-free 1-800-668-0128
TTY (416) 590-7108
1-800-387-0584
www.fsco.gov.on.ca

Consumer Information Centre
Telephone (416) 362-9528
Toll-free 1-800-387-2880
www.ibc.ca