Motor Vehicle Accidents in Ontario: Insurance, Accident Benefits & Tort Claims

What to Do Immediately After an Accident

1. Call 911 if anyone is injured. Police must be notified for accidents over $2,000 in damage or involving injury.
2. Exchange name, address, licence plate, driver's licence, and insurance information with all drivers involved.
3. Take photographs of the scene, vehicles, damage, road conditions, and any visible injuries.
4. Report to your insurer within 7 days — failure to report promptly can jeopardize your benefits.
5. Seek medical attention, even if you feel fine. Soft-tissue injuries often appear 24–72 hours later. Medical records are critical evidence.

Statutory Accident Benefits (SABS)

Under Ontario's Insurance Act, every auto insurance policy must include Statutory Accident Benefits regardless of who caused the accident. Standard benefits include:

Your insurer will send you an OCF-1 (Application for Accident Benefits) form. It must be submitted within 30 days of receiving it.

Disputing Denied or Reduced Benefits

If your insurer denies or reduces your benefits, you can:

1. Request an internal review from the insurer
2. Apply for mediation through the Financial Services Regulatory Authority of Ontario (FSRA)
3. Apply to the Licence Appeal Tribunal (LAT) for arbitration — filing must occur within 2 years of the denial

Tort Claims: Suing the At-Fault Driver

In addition to accident benefits, you may sue the at-fault driver for pain and suffering(general damages) and other losses. Key rules:

• Threshold: Your injury must be a "permanent serious impairment of an important physical, mental, or psychological function" to sue for pain and suffering
• Deductible: A statutory deductible ($46,053.53 in 2024) is applied to pain and suffering awards under $186,047.73. For smaller awards, this effectively eliminates the award.
• Limitation period: You must start a tort action within 2 years of the accident date
• Contributory negligence: If you were partly at fault, your damages are reduced proportionally

Uninsured or Hit-and-Run Drivers

If the at-fault driver was uninsured or fled the scene, your own insurer covers your tort damages under the OPCF 44R family protection endorsement (if you have it) or under the uninsured automobile coverage that is mandatory on all Ontario policies (up to $200,000).