Accident Benefits – Explained
The Accident Benefits section of your Ontario Automobile Policy deals with Bodily Injury you sustain due to an automobile accident. There are three classes of injury: (1) minor injury; (2) non-minor injury; (3) catastrophic injury. Generally speaking, minor injuries, include sprains and strains, cuts and bruises. Catastrophic injuries, include amputation of a limb, spinal cord injuries and severe brain damage. Non-minor/non-catastrophic injuries are everything in between. These “in between” injuries would include broken bones or some kinds of internal organ damage, such as a ruptured spleen.
We have a choice – we can accept the “Standard” mandatory Accident Benefits coverage as stated in Section 4 of the Automobile Policy or we can increase these coverages, for an additional premium.
INCOME REPLACEMENT BENEFIT
If you cannot work because of the injuries caused by a motor vehicle collision and if you are eligible, this benefit will partially compensate you for the loss of your income.
Standard Benefit: 70% of your gross income to a maximum of $400 a week.
Option: Increase this to $600, $800 or $1,000.
Do you have an income continuation plan or collateral benefit sources from work? If you do not, the following is recommended.
(a) Do you earn more than $59,500 a year of $28.60 an hour? If yes, increase this benefit to $1,000 a week.
(b) Do you earn more than $44,600 a year or $21.45 an hour? If yes, increase this benefit to $800 a week.
(c) Do you earn more than $29,750 a year or $14.40 an hour? If yes, increase this benefit to $600 a week.
If you cannot continue as a primary caregiver and if you are eligible, this benefit will cover the expense of purchasing caregiver services.
Standard Benefit: Catastrophic Injury only – $250 a week for the first dependant plus $50 for each additional dependent.
Option: To include non catastrophic injury whereby you are unable to perform your caregiver activities
(a) Do you have any children under the age of 16 residing in your home for whom you are a primary caregiver? If yes, purchase this option.
(b) Do you take care of a disabled child over the age of 16 or a person residing in your household who has a disability or is infirm? If yes, purchase this option.
(c) Do you have family support in close proximity to your residence? If no, purchase this option.
DEPENDANT CARE BENEFIT
This covers expenses for caring for your dependents if you are injured in a motor vehicle collision, employed at the time of the collision and not receiving the Caregiver Benefit.
Standard Benefit: None
Option: Up to $75/week for the first dependant and $25/week for each additional dependant to a maximum of $150/week.
Recommendation: Same as the Caregiver Benefit
MEDICAL AND REHABILITATION BENEFIT
This benefit will pay for reasonable and necessary medical and rehabilitation expenses that are not covered by a government health plan or a private health plan that you may have through work or your spouse.
Standard Benefit: $50,000 non-catastrophic injury and $1,000,000 catastrophic injury
Option: $100,000 non-catastrophic injury and $1,100,000 catastrophic injury
(a) Are you self-employed? If yes, purchase the this option.
(b) Do you have any collateral sources through your business or through your employer to offset any cost of medical, rehabilitation or prescription medication. If no, purchase this option.
(c) Do you have any pre-existing conditions or injuries that may delay your recovery from an injury resulting from a motor vehicle accident? If yes, purchase this option.
Note: All medical/rehabilitation and assessment/examination expenses for minor injuries are capped at $3,500.
ATTENDANT CARE BENEFIT
If you are unable to carry out certain personal care activities (such as bathing, toileting, dressing or feeding yourself) as a result of severe injuries sustained in a motor vehicle collision and if you are eligible, this benefit will pay reasonable and necessary expenses for an aide, attendant or long-term care facility.
Standard Benefit: $36,000 non-catastrophic injury and $1,000,000 catastrophic injury
Option: $72,000 non-catastrophic injury and $1,072,000 catastrophic injury
(a) Do you have a pre-existing condition? If yes, purchase this option.
(b) Do you live alone with little/minimal family support close to you? If yes, purchase this option.
(c) If you live with family, would they be able to support you with personal care during your recovery? If no, purchase this option.
HOUSEKEEPING & HOME MAINTENANCE BENEFIT
If you are unable to maintain housekeeping and home maintenance that you normally performed prior to the motor vehicle collision, this benefit will pay reasonable and necessary expenses.
Standard Benefit: $100 a week for catastrophic injury only.
Option: To include non-catastrophic injury whereby you are unable to perform these tasks.
(a) Do you live alone? If yes, purchase this option.
(b) Do you attend to your own housekeeping/home maintenance duties? If yes, purchase this option.
The above is intended to be a guide only. Consult with your broker.
ONTARIO BUDGET 2015
The provincial government has proposed numerous changes to the above in their 2015 budget. Stay tuned for if/when these changes come into effect.
A MIXTURE OF
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