Ontario has a “no fault” accident benefits scheme, meaning that even if you are declared at fault for a motor vehicle accident, you are still entitled to accident benefits through your own car insurance. The type of accident benefits available to you will depend on the severity of your injuries, and whether you have opted for increased optional benefits. In Ontario, your entitlement to benefits is broken down into three categories: 1) minor impairments, 2) non-catastrophic impairments and 3) catastrophic impairments. Your insurance will determine which of the three categories your injuries fall under, and your access to medical rehabilitation benefits will be determined accordingly.

The following is an explanation of the accident benefits scheme in Ontario, and importantly what benefits become available to you at each level.

Minor Impairments

The first level of benefits covers minor impairments. These injuries are covered under the Minor Injury Guidelines, commonly referred to as MIG. The types of injuries covered under this category may include, but are not limited to, sprains, strains, whiplash associated disorder, contusions, or abrasions.

Under this level of benefit, you are entitled to up to $3,500 in medical-rehabilitation benefits. There is no access to attendant care benefits under this level.

MIG covers very minor injuries, and typically the amount available for treatment under this category is not enough to cover necessary medical and rehabilitation treatments.

NON-CAT (non-minor injury)

The second tier of benefits covers injuries that are more severe than MIG, but not catastrophic. There is no set definition for the types of injuries that are classified as non-catastrophic. At this level, you are entitled to $65,000 in medical-rehabilitation.

CAT

The catastrophic injury category covers a number of life altering injuries, and the difference in benefits you are entitled to significantly increases if you are determined to be catastrophically impaired. This determination is based on numerous factors, and the criteria to be deemed catastrophically impaired are very technical and somewhat complicated.

If you are deemed to be catastrophically impaired by your insurance company, you are entitled to up to $1,000,000 in medical-rehabilitation benefits. This level covers injuries such as:

• Paraplegia or tetraplegia;
• Impairment of mobility of arms or amputation;
• Loss of vision in both eyes;
• Certain traumatic brain injuries;
• Physical or mental impairments that exceed a determined threshold;
• Certain impairments that preclude functioning due to mental or behavioural disorders.

As you can see, the definition of catastrophic injury is highly technical and the determination of whether you are catastrophically impaired is highly specific to your individual injuries.

On top of medical-rehabilitation benefits you may be entitled to, there are a number of other benefits you may be able to access. Read more about the other types of benefits that may be available to you here.

Remember – your insurance company may try and categorize your injuries as minor as possible in order to limit your entitlement to benefits. Speak with our team about your accident benefits claim. We will work hard to ensure you receive necessary treatment and rehabilitation services.