If you’ve been hurt in a car accident, one of the first questions you might have is whether your car insurance will cover your injuries.
The answer in Ontario is yes—up to a point.
Ontario has a no-fault insurance system, which means that regardless of who caused the accident, you can access certain benefits through your own auto insurance policy. In more serious cases, you may also be able to sue the at-fault driver for additional compensation.
Here’s how it works.
Accident Benefits: What Your Insurance Covers
All Ontario auto insurance policies include what’s called Statutory Accident Benefits. These are mandatory benefits that cover medical and income-related losses after an accident. You can access them whether you were a driver, passenger, pedestrian, or cyclist.
These benefits can include:
- Medical and rehabilitation expenses (e.g., physiotherapy, chiropractic care, counselling)
- Income replacement benefits (up to 70% of your gross income, to a maximum of $400/week unless optional coverage was purchased)
- Attendant care benefits (if you need care and assistance with activities of daily living)
- Non-earner benefits (if you are unable to live a normal life and don’t qualify for income replacement)
- Caregiver benefits (in certain cases, if you’re unable to care for dependents)
- Other out-of-pocket expenses (like transportation to medical appointments)
To access these benefits, you will need to notify your insurance provider and complete an accident benefits application package. There are deadlines involved, so it’s important to act quickly.
Suing the At-Fault Driver: When Accident Benefits Aren’t Enough
In many situations, the benefits provided through your own insurance will not fully compensate you for what you’ve lost. If the other driver or some other party, was at fault, or partially at fault, you may have the option of starting a lawsuit—also called a “tort claim”—to recover additional compensation.
This can include:
- Pain and suffering for physical and emotional distress
- Loss of income beyond what accident benefits cover
- Out-of-pocket costs not reimbursed through your insurer
- Costs for future care and treatment not provided by accident benefits
- Loss of care, guidance, and companionship for close family members
It’s important to note that Ontario law has thresholds and deductibles for pain and suffering claims, which can limit eligibility in minor injury cases. A personal injury lawyer can help you understand whether your situation meets the criteria for a lawsuit.
What if You Don’t Have Insurance?
If you’re injured and don’t have auto insurance yourself—for example, if you were a pedestrian or passenger—you may still be eligible for accident benefits through the insurer of the other driver or through Ontario’s Motor Vehicle Accident Claims Fund.
Car insurance in Ontario is designed to provide support after an accident, but the system can be complex. If you’re struggling to navigate your options or believe your injuries go beyond what your insurer is covering, we’re here to help. Contact our team at info@nelliganlaw.ca.
