— ACCIDENT BENEFITS

Experienced guidance through Ontario's accident benefits system.

After a serious motor vehicle accident, many people are left trying to recover while also dealing with insurance forms, treatment approvals, income loss, rehabilitation needs, medical appointments, and financial pressure. Ontario’s accident benefits system is supposed to provide support after an accident, but the process can quickly become confusing, delayed, and overwhelming.

Oatley Vigmond’s Accident Benefits Specialists have helped injured Ontarians secure the accident benefits they are entitled to following serious motor vehicle accidents. Insurance companies know our reputation for thorough preparation, strategic advocacy, and a deep understanding of Ontario’s accident benefits system.

Toronto • North York • Scarborough • Vaughan • Brampton • Mississauga

AT A GLANCE

Accident Benefits at a Glance

What Are Accident Benefits in Ontario?

Why Are Accident Benefits Claims Denied?

Insurance companies may deny treatment plans, reduce or terminate accident benefits, delay payments, dispute medical evidence, classify injuries under the Minor Injury Guideline, end income replacement benefits, or reject a catastrophic impairment designation. These decisions can leave injured people without the medical care, rehabilitation, and financial support they need during recovery.

Common reasons accident benefits claims are denied:

  • Missing or incomplete medical evidence
  • Missed application or documentation deadlines
  • Minor Injury Guideline designation
  • Disputed catastrophic impairment designation
  • Surveillance evidence
  • Unfavourable insurer examination reports
  • Policy coverage disputes
  • Failure to attend an insurer examination

Before and After the July 1, 2026 SABS Changes

Before July 1, 2026

After July 1, 2026

Common Types of Accident Benefits Claims

The benefits available depend on the facts of your case, your insurance policy, your injuries, and the applicable SABS rules.

Medical & Rehabilitation

Income Replacement

Attendant Care

Housekeeping & Home Maintenance

Caregiver Benefits

Non-Earner Benefits

Lost Educational Expenses

Death & Funeral Benefits

Catastrophic Impairment Claims

Read More ▼

Qualifying for a catastrophic impairment designation is not simply a matter of showing a serious injury. Ontario's SABS sets out specific criteria, and meeting them often requires a combination of neurological, psychiatric, orthopaedic, and functional evidence assembled over time as the full effect of an injury becomes clear. These cases often require extensive medical assessments, expert reports, rehabilitation planning, functional evidence, and long-term care evaluations.

Insurers frequently dispute catastrophic impairment because the financial stakes are significant. A denied designation can mean the difference between adequate long-term funding and benefits that run out long before recovery does. Oatley Vigmond has a dedicated Accident Benefits Specialists team that works alongside our litigators to pursue catastrophic impairment designation when the evidence supports it, coordinating with treating physicians, rehabilitation professionals, and independent experts to build a complete picture of the injury's lifelong impact.

The Minor Injury Guideline and Accident Benefits Disputes

Early After the Accident

As Recovery Progresses

When Medical Evidence Supports It

Insurer Examinations in Accident Benefits Claims

In an accident benefits claim, an insurance company may ask the injured person to attend an insurer examination. These assessments are arranged by the insurer and may be used to decide whether benefits should be approved, continued, reduced, or denied. 

Insurer examinations may involve: medical assessments, psychological assessments, occupational therapy assessments, functional assessments, catastrophic impairment assessments, income replacement assessments and attendant care assessments.

These assessments can have major consequences. A negative insurer examination report may lead to denied treatment, terminated income replacement benefits, rejected attendant care, or a disputed catastrophic impairment application. 

Oatley Vigmond helps clients understand the insurer examination process, prepare for assessments, respond to unfair conclusions, and gather evidence from treating providers and independent experts. 

Licence Appeal Tribunal (LAT) Accident Benefits Disputes

How the LAT Dispute Process Works

1. Application Filed

An application is filed with the LAT when a dispute cannot be resolved directly with the insurer.

2. Case Conference

The parties attend a case conference to identify the issues, exchange information, and explore settlement.

3. Evidence Exchange

The parties exchange medical records, expert reports, witness evidence, and written submissions.

4. Hearing and Decision

The LAT holds a hearing and issues a written decision on entitlement to accident benefits or the amount payable.

Motor Vehicle Accidents and Accident Benefits

In Ontario, accident benefits are available to many people injured in motor vehicle accidents, regardless of who caused the collision. You may qualify whether you were a driver, passenger, pedestrian, cyclist, motorcyclist, rideshare passenger, or public transit passenger.

Accident benefits may be available after:

Even lower speed collisions can lead to chronic pain, soft tissue injuries, concussion symptoms, psychological injuries, or long term disability. Serious collisions can cause catastrophic injuries, including brain injuries, spinal cord injuries, orthopaedic injuries, amputations, and severe psychological trauma. 

Oatley Vigmond helps injured people pursue accident benefits while also assessing whether a lawsuit against an at fault driver may be available. 

How Serious Motor Vehicle Accident Injuries Can Affect Your Future

What Compensation and Accident Benefits Are Available After a Motor Vehicle Accident?

After a serious motor vehicle accident in Ontario, you may have access to both accident benefits through your own insurance policy and a tort claim against the at-fault driver. These are separate legal processes that can provide different types of financial support and compensation.

Accident benefits provide no-fault insurance coverage for medical treatment, rehabilitation, income replacement, attendant care, and other prescribed benefits. A tort claim allows an injured person to pursue compensation from the at-fault driver or another negligent party for losses that are not fully covered by accident benefits.

Accident benefits may help cover:

A tort claim may seek compensation for:

Accident benefits and tort claims often proceed at the same time, but they are closely connected. Benefits paid through the accident benefits system may affect certain damages claimed in a lawsuit, making it important to coordinate both claims carefully.

Oatley Vigmond regularly manages accident benefits claims alongside personal injury lawsuits. Coordinating both claims helps protect an injured person’s legal rights and ensures all available compensation is properly considered.

Lawyers and Accident Benefits Specialists Serving Toronto, the GTA, and All of Ontario

Troy Lehman

Managing Partner

View Profile
Adam Little

Managing Partner

View Profile
Brian Cameron

Partner

View Profile
Robert Durante

Partner

View Profile
Kevin Henderson

Partner

View Profile
Karen Vigmond

Partner

View Profile
Lara Fitzgerald-Husek

Partner

View Profile
Liane Brown

Partner

View Profile
Ben Irantalab

Partner

View Profile
Charles Jung

Partner

View Profile
Kimberly Barratt

Accident Benefits Specialist

View Profile
Helen Barsby

Accident Benefits Specialist

View Profile
Bill Kirwin

Accident Benefits Specialist

View Profile
Sean Power

Accident Benefits Specialist

View Profile
Steven Smyth

Accident Benefits Specialist

View Profile
Lisa Stark

Accident Benefits Specialist

View Profile
Josie Skelly

Accident Benefits Specialist

View Profile
Tara Anderson

Accident Benefits Specialist

View Profile

You Do Not Need Money to Hire Us

— WHY OATLEY VIGMOND

A Firm Built for Accident Benefits Claims

Personal Injury Is All We Do

Oatley Vigmond practises exclusively in personal injury law. Our experience includes accident benefits, catastrophic injuries, traumatic brain injuries, spinal cord injuries, orthopaedic injuries, motor vehicle accidents, car accidents, motorcycle accidents, truck accidents, pedestrian accidents, bicycle accidents, boating accidents, medical malpractice, long-term disability, and wrongful death.

Because personal injury is our sole focus, we have the experience and resources to handle complex accident benefits claims and serious injury cases.

We Build Strong Accident Benefits Claims

Insurance companies may deny treatment, delay payments, reduce benefits, dispute medical evidence, schedule insurer examinations, place injuries in the Minor Injury Guideline, or challenge the severity of an injury.

Successfully resolving these disputes often requires strong medical evidence and a well-developed legal strategy. Depending on the case, we work with physicians, surgeons, neurologists, psychiatrists, psychologists, occupational therapists, physiotherapists, speech-language pathologists, vocational experts, accountants, life care planners, and future care specialists to build the strongest possible claim.

Whether your case proceeds through settlement negotiations or the Licence Appeal Tribunal (LAT), our team is focused on securing the benefits and support you need for your recovery.

A Collaborative Team Focused on Your Recovery

Our personal injury lawyers work alongside dedicated Accident Benefits Specialists from the earliest stages of a claim. Many of our specialists previously worked within the insurance industry, giving them valuable insight into how accident benefits claims are assessed, managed, and disputed.

Together, our team coordinates benefits, communicates with insurers, gathers medical documentation, monitors deadlines, identifies denied or delayed benefits, and helps clients access treatment and rehabilitation. When a case also involves a personal injury lawsuit, we manage both the accident benefits claim and the tort claim together to protect every aspect of your recovery.

Why Clients Choose Oatley Vigmond

  • Personal injury law is the only area of law we practise.
  • Dedicated Accident Benefits Specialists, many with previous insurance industry experience.
  • Extensive experience with accident benefits claims, insurer examinations, denied benefits, and Licence Appeal Tribunal (LAT) disputes.
  • Proven experience handling catastrophic injuries, traumatic brain injuries, spinal cord injuries, orthopaedic injuries, chronic pain, and psychological injury claims.
  • Strong relationships with leading medical, rehabilitation, vocational, accounting, and future care experts.
  • Recognized by Canadian Lawyer as one of Canada’s Top Personal Injury Boutiques.
  • Trusted by seriously injured clients throughout Ontario.

— QUESTIONS & ANSWERS

Frequently Asked Questions About Accident Benefits in Ontario

Our personal injury lawyers and dedicated Accident Benefits Specialists combine decades of experience helping injured people navigate Ontario’s accident benefits system. We understand the physical, emotional, and financial challenges that can follow a serious motor vehicle accident and work to secure the benefits our clients need throughout their recovery.

FAQ accordion

Accident benefits are insurance benefits available to people injured in motor vehicle accidents in Ontario, regardless of who caused the accident. These benefits are governed by the Statutory Accident Benefits Schedule, known as SABS.

They may help pay for treatment, rehabilitation, income replacement, attendant care, transportation, assistive devices, and other injury related expenses, depending on the coverage available and the facts of the claim.

No. Accident benefits are part of Ontario's no fault automobile insurance system. You may still qualify for benefits even if you caused the accident.

A separate lawsuit against an at fault driver may also be available depending on the circumstances of the accident.

Accident benefits are usually paid by your own automobile insurance company. If you do not have insurance, coverage may still be available through another policy connected to the accident.

Determining which insurer is responsible can be complicated, especially in cases involving passengers, pedestrians, cyclists, company vehicles, uninsured drivers, or hit and run accidents.

There are important deadlines after a motor vehicle accident. You should notify the insurance company as soon as possible and complete the required application forms promptly.

Missing deadlines can create problems with the claim. If you are unsure what forms must be filed or what insurer should receive them, get legal advice quickly.

Accident benefits claims may involve several standard forms, including the application for accident benefits, disability certificate, employer confirmation form, expenses claim form, treatment and assessment plan, catastrophic impairment application, and attendant care assessment forms.

The forms required depend on the benefits being claimed and the facts of the case.

You may still have options. Insurance companies sometimes deny treatment plans by arguing that treatment is not reasonable or necessary.

A lawyer can help gather medical evidence, obtain support from treatment providers, respond to the denial, and pursue the dispute through the appropriate process, including the Licence Appeal Tribunal if necessary.

Yes. Accident benefits are separate from a personal injury lawsuit against the at fault driver.

Accident benefits may provide access to treatment and support regardless of fault. A lawsuit may seek compensation for pain and suffering, income loss, future care, and other damages not fully covered by accident benefits.

A catastrophic impairment designation recognizes very serious injuries that significantly affect a person's functioning. This designation may increase the amount of accident benefits available for medical treatment, rehabilitation, attendant care, and future care.

Catastrophic impairment may be relevant in cases involving traumatic brain injuries, spinal cord injuries, severe orthopaedic injuries, amputations, blindness, psychological impairments, chronic pain, or multiple serious injuries.

Yes, if your injuries prevent you from working, you may qualify for income replacement benefits, depending on the coverage available, your employment status, your medical evidence, and the effect of the injuries on your ability to work.

Income replacement disputes often require medical records, employment records, tax documents, disability certificates, and vocational evidence.

For policies entered into or renewed on or after July 1, 2026, income replacement coverage may be optional rather than automatically included. This means the availability of income replacement benefits may depend on the policy, the optional coverage purchased, the date of the accident, and the applicable SABS rules.

Anyone injured after July 1, 2026 should have the policy reviewed carefully.

Attendant care benefits may help pay for assistance with personal care and daily activities after an accident. This can include help with bathing, dressing, mobility, transfers, supervision, medication management, and other personal care needs.

These care needs are part of why Oatley Vigmond built its Total Care Network, connecting legal advocacy with treatment access, rehabilitation planning, accident benefits support, and long term care coordination.

Attendant care is often important in serious injury cases, including brain injury, spinal cord injury, orthopaedic injury, amputation, and catastrophic impairment claims.

Pedestrians and cyclists injured in motor vehicle accidents may still qualify for accident benefits. You do not need to be inside a vehicle to apply for benefits after a motor vehicle accident.

These claims can involve complicated priority rules about which insurer should respond.

Insurance companies sometimes argue that injuries fall within the Minor Injury Guideline. This can limit access to treatment funding.

You may still have options if your injuries are more serious than the insurer accepts. Medical evidence, treatment records, psychological evidence, functional limitations, chronic pain evidence, or concussion evidence may help challenge the insurer's position.

Yes. Anxiety, depression, post traumatic stress, driving fear, sleep problems, and other psychological injuries may form part of an accident benefits claim if they are connected to the accident and supported by medical evidence.

Psychological injuries can affect treatment needs, work capacity, daily functioning, and catastrophic impairment assessment.

An insurer examination is an assessment arranged by the insurance company. The insurer may use it to decide whether benefits should be approved, continued, reduced, or denied.

Insurer examinations can affect treatment funding, income replacement benefits, attendant care, and catastrophic impairment applications. It is important to understand the purpose of the assessment and respond carefully to unfair conclusions.

The Licence Appeal Tribunal, Automobile Accident Benefits Service, hears disputes about statutory accident benefits in Ontario.

If an insurer denies benefits, disputes the amount payable, rejects treatment, terminates income replacement, or disputes catastrophic impairment, the injured person may be able to bring the dispute to LAT AABS.

Important evidence may include medical records, treatment plans, disability certificates, employment records, tax documents, rehabilitation reports, attendant care assessments, insurer correspondence, pain journals, receipts, expert assessments, and witness information.

The evidence needed depends on the benefit being claimed and the reason for the insurer's denial.

A lawyer can help if benefits are denied, delayed, reduced, terminated, or disputed. Legal representation may be especially important in catastrophic impairment claims, complex medical cases, income replacement disputes, attendant care disputes, Minor Injury Guideline disputes, and LAT proceedings.

Oatley Vigmond's accident benefits team helps clients gather evidence, deal with insurers, pursue treatment funding, and protect the larger personal injury claim.

The value of an accident benefits claim depends on the severity of the injuries, the available insurance coverage, the benefits claimed, the date of the accident, the policy terms, future care needs, income loss, and the long term impact on daily life.

For serious and catastrophic injuries, accident benefits can be worth a substantial amount because they may fund long term treatment, rehabilitation, and attendant care.

The timeline depends on the injuries, treatment process, insurer position, medical evidence, and whether disputes arise. Some claims resolve quickly. Others involving serious injuries, denied benefits, income replacement disputes, or catastrophic impairment may continue for years.

What matters most is that the claim is properly documented and not resolved before the full impact of the injuries is understood.

Speak with a Lawyer or Accident Benefits Specialist in Ontario today

If your accident benefits have been denied, delayed, reduced, or terminated, Oatley Vigmond can help. We represent injured people across Ontario in accident benefits disputes involving catastrophic, brain, spinal cord, and orthopaedic injuries, chronic pain, and other serious impairments, whether resolved through negotiation or before the Licence Appeal Tribunal.
 

Consultations are free, and you pay no legal fees unless we recover compensation for you.

Free
Consultation

$0

Unless we win

Intake Form
First
Last
Consent
Communications