16 min read · February 2025
Ontario's motor vehicle accident compensation system is a hybrid of first-party no-fault accident benefits and a restricted tort system. Every motor vehicle accident in Ontario triggers potential claims under both regimes. This guide covers the Statutory Accident Benefits Schedule (SABS), the Insurance Act tort threshold, FSRA dispute resolution, and the limitation periods that govern all of these claims.
Every person injured in a motor vehicle accident in Ontario has access to two potential sources of compensation:
Track 1: Accident Benefits (No-Fault)
Track 2: Tort (Fault-Based)
Ontario accident victims do not have to choose between the two tracks — they may pursue accident benefits AND a tort claim simultaneously, subject to collateral benefits rules preventing double recovery.
The Statutory Accident Benefits Schedule (O. Reg. 34/10, as amended) provides the following benefits. All dollar amounts are standard (non-enhanced) coverage:
| Benefit | Non-Catastrophic Limit | Catastrophic Limit |
|---|---|---|
| Income Replacement Benefit (IRB) | $400/week (70% of net income, up to $400/week max) | Same — $400/week standard |
| Medical and Rehabilitation | $65,000 combined (up to $3,500 in Minor Injury Guideline cases) | $1,000,000 |
| Attendant Care | $36,000 total (max $3,000/month) | $1,000,000 |
| Caregiver Benefit | Not available (removed for non-cat) | $250/week for first dependent + $50/week each additional |
| Housekeeping and Home Maintenance | Not available (removed for non-cat) | $100/week |
| Non-Earner Benefit | $185/week after 26 weeks (unemployed/student claimants only) | Same |
| Death Benefit | $25,000 to spouse + $10,000 each dependent | Same |
| Funeral Benefit | Up to $8,000 | Same |
| Lost Educational Expenses | Up to $15,000 | Same |
The Minor Injury Guideline (MIG) is a medical and rehabilitation treatment protocol under SABS that caps combined medical and rehabilitation benefits at $3,500 for claimants whose injuries fall within the Minor Injury Guideline definition.
"Minor injury" under the MIG means a sprain, strain, whiplash associated disorder (WAD I or II), contusion, abrasion, laceration, or minor fracture that does not result in a serious impairment.
To escape the MIG cap, a claimant must establish:
MIG disputes are the most common accident benefit disputes at the Licence Appeal Tribunal. The evidentiary threshold for escaping the MIG is contested in virtually every LAT proceeding involving soft tissue injuries.
A finding of "catastrophic impairment" under SABS unlocks dramatically higher benefit limits and restores benefits eliminated for non-catastrophic claimants. Catastrophic impairment is defined in SABS s. 2(1) and Appendix to include:
2016 SABS Amendments
The 2016 SABS amendments significantly reduced non-catastrophic benefit limits and eliminated caregiver and housekeeping benefits for non-cat claimants. Accidents occurring before June 1, 2016 are governed by prior SABS regulations with higher non-catastrophic limits. The transition date is critical when advising clients with older accidents.
SABS allows policyholders to purchase optional enhanced coverages:
| Optional Coverage | Standard Limit | Enhanced Limit |
|---|---|---|
| Medical and Rehabilitation (non-cat) | $65,000 | Up to $130,000 or $1,000,000 |
| Income Replacement Benefit | $400/week | Up to $1,000/week |
| Death Benefit | $25,000 spouse / $10,000 dependent | Up to $50,000 spouse / $20,000 dependent |
| Funeral Benefit | $8,000 | Up to $16,000 |
| Indexation (inflation protection) | Not included | CPI-indexed IRBs |
| Caregiver (non-cat) | Not available | Optional purchase restores benefit |
| Housekeeping (non-cat) | Not available | Optional purchase restores benefit |
Section 267.5 of the Insurance Act creates a "verbal threshold" — a qualitative standard for recovery of non-pecuniary general damages (pain and suffering). A plaintiff may only recover these damages if they sustained:
Section 267.5(5) Threshold Test
"...a permanent serious disfigurement or a permanent serious impairment of an important physical, mental or psychological function."
The threshold is assessed on all the evidence at trial. Key principles:
Threshold is a motion or trial issue — defendants typically bring a threshold motion at the close of the plaintiff's evidence. The onus is on the plaintiff to satisfy the threshold.
Even when a plaintiff clears the verbal threshold, Insurance Act s. 267.5(7) imposes a statutory deductible on non-pecuniary general damages. As of January 1, 2025:
The deductible applies only when the award is below a prescribed threshold — currently $158,824.77. Awards above this amount are paid in full with no deductible applied. The deductibles are indexed to inflation and change annually.
Accident benefit disputes are resolved through the Financial Services Regulatory Authority (FSRA) arbitration process and the Licence Appeal Tribunal (LAT), not the courts. The process:
Costs at LAT
The LAT has a costs regime that can result in cost awards against parties who behave unreasonably. Costs are not available for successful claimants as a matter of right — they must be specifically requested and approved based on the conduct of the proceeding.
Limitation periods in Ontario motor vehicle accident claims are multiple and interacting:
| Obligation / Claim | Deadline | Source |
|---|---|---|
| Notify own insurer of accident | 7 days from accident | SABS s. 32(1) |
| Submit accident benefit application forms | 30 days after receiving application from insurer | SABS s. 32(2) |
| Tort action against at-fault driver | 2 years from date of accident (discovery rule may apply) | Limitations Act 2002 s. 4 |
| LAT application (accident benefits dispute) | 2 years from insurer's written refusal or failure to pay | SABS s. 281(5) |
| Notice of accident to municipality (road condition claims) | 10 days from accident | Municipal Act 2001 s. 44(10) |
| Ultimate limitation period (tort) | 15 years from accident | Limitations Act 2002 s. 15 |
Direct Compensation — Property Damage (DCPD) coverage allows Ontario drivers to claim for vehicle damage directly from their own insurer, even when the other driver was at fault. As of January 1, 2024, DCPD is an optional coverage — drivers may opt out.
DCPD applies only when: (1) the accident occurred in Ontario; (2) another vehicle was involved; and (3) the other driver was wholly or partly at fault. Claims are governed by the DCPD Fault Determination Rules (O. Reg. 668) which assign fault percentages based on standardized accident scenarios.
Atticus AI extracts SABS application deadlines, LAT limitation periods, and tort action deadlines from your case documents automatically. Ontario PI lawyers use Atticus to track dozens of concurrent accident files without missing a deadline.
Start Free TrialInsurance Act s. 267.5 imposes a verbal threshold: a plaintiff may only recover non-pecuniary general damages if they sustained a permanent serious disfigurement or a permanent serious impairment of an important physical, mental or psychological function. The threshold is assessed at trial based on all the evidence.
SABS (O. Reg. 34/10) provides: income replacement benefits up to $400/week, medical and rehabilitation up to $65,000 (non-catastrophic) or $1,000,000 (catastrophic), attendant care up to $36,000 (non-cat) or $1,000,000 (cat), death benefits, funeral benefits, and lost educational expenses. Enhanced optional coverages can increase most limits.
Notify your insurer within 7 days. Submit the application within 30 days of receiving forms. For LAT disputes, apply within 2 years of the insurer's written denial. Tort claims must be commenced within 2 years of the accident (discovery rule applies).
As of January 2025, the non-pecuniary general damages deductible is $47,647.43 (indexed annually). The deductible applies only when the award is below $158,824.77 — awards above this threshold are paid without any deductible.