New Schedule of Accident Benefits – June 2016


Appendix – Glossary of Terms

What do the coverages mean?

Third Party Liability
Claims made by a driver against another driver who causes an accident.
Uninsured Auto coverage
Protects you and your family if you are injured or killed by a hit‐and‐run driver or by an uninsured motorist. It also covers damage to your vehicle caused by an identified uninsured driver.
Direct Compensation‐Property Damage (DC‐PD)
Covers damage to your vehicle or its contents if another person was at fault for the accident. It is called direct compensation because even though someone else causes the damage, you collect directly from your own insurer. The accident must also occur in Ontario and both drivers must be insured by an insurance company licensed in the province.
Collision or Upset Coverage
Pays for losses caused when your vehicle is involved in a collision with another object, including another vehicle, or rolls over.
Comprehensive Coverage
Pays for losses for certain perils, such as falling or flying objects, and vandalism.
Medical and Rehabilitation Benefit
Covers the cost of reasonable and necessary medical and rehabilitation expenses (e.g., physiotherapy, prescriptions) that are not covered by OHIP or your disability insurance plan.
Attendant Care Benefit
Pays for an aide or attendant to look after you if you have been seriously injured in an accident.
Catastrophic Injury
If you suffer an injury in an accident, you can apply for a determination of whether your injury qualifies as “catastrophic” (e.g. loss of a limb, paraplegia). If the injury qualifies as “catastrophic,” you are eligible for an increased level of benefits.
Caregiver Benefit
If you are providing full‐time care to dependants and can no longer provide that care as the result of an auto accident, you may be eligible for caregiver benefits to reimburse you for your expenses to hire someone to care for your dependants.
Housekeeping and Home Maintenance Expenses
If you are unable to perform your usual duties due to your injuries, this benefit pays for reasonable and necessary additional expenses for someone to complete your usual duties.
Income Replacement Benefit
If you cannot work as the result of an auto accident, you may be eligible for basic weekly income replacement benefits of up to $400. This benefit commences after one week.
Dependant Care Benefit
Pays for additional expenses incurred to care for your dependants if you are employed and are injured in an auto accident.
Death and Funeral Benefit
If you die as a result of an auto accident, the death benefit provides a lump sum payout to your spouse and your dependant; the funeral benefit provides a lump sum payout to cover the cost of your funeral expenses.
Indexation Benefit
The automatic adjustment of the income replacement benefit, non‐earner benefit, attendant care benefit or medical and rehabilitation benefit according to the Consumer Price Index for Canada to compensate for inflation.
Tort Deductible
The amount that is deducted from a settlement or court award for pain and suffering.
Covers you for the difference between the at‐fault driver’s Third Party Liability limit and your own Third Party Liability limit if someone with less liability coverage than you injures you in an accident.