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Understanding the
Auto insurance 
claims process

Benefits from the Insurance Company

Immediately following my accident, the insurance company offered me $3500.00. This is the benefit you get from the most minor injury category (see below). I was so happy but later realized it was way too soon to truly assess the care I would need, but once lock in to an amount you can’t change it so they will try to lock you in early. This is where it is important to hire a lawyer to negotiate this with the insurance company. I ended up needing 10’s of thousands of dollars in rehab.

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You have these options for Statutory Accident Benefits (SABS) from your insurance company if you have been injured in an auto accident, regardless of who was at fault.

 

Medical, Rehab, Attendant Care

Medical/Rehab: If you need treatment because of your injuries. Covers things like physiotherapy, prescriptions, counseling, and transportation to medical appointments 

Attendant Care: This covers the cost of an attendant (helper) if you need someone to care for you at home or in a healthcare facility, because of your injuries

 

Caregiver Benefit

If you can no longer provide full-time care to a dependant because of your injuries 

 

Housekeeping and Home Maintenance

If you need to hire someone for housekeeping or home maintenance

 

Income Replacement

If you can’t work because of your injuries

 

Death and Funeral Benefits

If you die because of your injuries

 

Injury Categories

 

Minor Injury

-strain or sprain of muscles, tendons, ligaments, including partial but not total -tearing

-whiplash

-cuts, bruises, lacerations

-joint dislocation

Medical-Rehabilitation Benefits reduced to a limit of $3,500 and no access to Attendant Care Benefit

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Non-Catastrophic

(Non-Minor and not Catastrophic) often called Mild

Up to $65,000 for medical, rehabilitation and attendant care benefits, including assessment costs, for a duration of 5 years

70% of gross income up to $400 per week

$25,000 lump sum to an eligible spouse

$10,000 lump sum to each dependant

Maximum $6,000 funeral benefits

 

Catastrophic

(Major Injury)

Up to $1,000,000 for medical, rehabilitation and attendant care benefits, including assessment costs

Up to $250 per week for the first dependant and $50 for each additional dependant. Available only for catastrophic injuries

Up to $100 per week. Available only for catastrophic injuries

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