Ontario Accident Benefits: Mandatory vs. Optional Coverage After the July 2026 SABS Reform

Ontario's Statutory Accident Benefits Schedule (SABS) still guarantees medical, rehabilitation and attendant care benefits after a car accident, but for policies entered into or renewed on or after July 1, 2026, the income replacement benefit, non-earner benefit, caregiver benefit, other expenses, and death and funeral benefits are no longer automatic and must be purchased as optional coverage.

Information last verified on 2026-09-24. This article has not yet been reviewed by a licensed lawyer.

This article addresses Ontario's Statutory Accident Benefits Schedule (SABS), O. Reg. 34/10, made under the Insurance Act, R.S.O. 1990, c. I.8, as amended by O. Reg. 383/24 effective July 1, 2026. It covers only the no-fault accident benefits payable by your own insurer regardless of fault. It does not cover suing an at-fault driver for pain and suffering, which involves a different legal test and a separate deductible; see Suing After a Car Accident in Ontario. It does not cover other provinces' no-fault benefit schemes; see the Canada Car Accident Claims hub for a province by province comparison, or Canada driving laws for other rules of the road.

What the Statutory Accident Benefits Schedule Covers

Every driver in Ontario must carry accident benefits coverage as part of their auto policy. These benefits pay for medical treatment and, where your policy includes them, income loss, caregiving costs and other accident-related expenses from your own insurer, regardless of who caused the collision. The Financial Services Regulatory Authority of Ontario (FSRA) regulates the schedule, and the specific benefits, limits and procedures are set out in O. Reg. 34/10 under the Insurance Act.

Until July 1, 2026, nearly every benefit category in the schedule was mandatory. Ontario Regulation 383/24 changed that for policies entered into or renewed on or after that date, and understanding which benefits stayed mandatory and which became optional now depends entirely on your policy's start or renewal date.

The July 1, 2026 Reform: What Moved From Mandatory to Optional

Ontario Regulation 383/24 amended the SABS. The current consolidated text of section 2(1.0.1) states:

"The benefits set out in Parts II, IV, V and VI of this Regulation shall be offered as optional benefits under every contract evidenced by a motor vehicle liability policy entered into or renewed on or after July 1, 2026." (SABS, O. Reg. 34/10, s.2(1.0.1))

Section 4.1(1), added by O. Reg. 383/24, requires every insurer to offer the income replacement, non-earner and caregiver benefits as optional purchases. The old fixed dollar tiers for topping up the income replacement benefit, the 600, 800 and 1,000 dollar options in the former section 28(1), were revoked by O. Reg. 383/24, section 19(1). The weekly ceiling is now the amount fixed by the optional benefit purchased under the contract rather than a statutory tier, but section 7(1) still limits the weekly payment to the lesser of that amount and 70 percent of gross weekly income, less other income replacement assistance.

Here is what changed, for a policy entered into or renewed on or after July 1, 2026:

FSRA, the regulator, summarizes the change this way:

"As of July 2026, medical, rehabilitation and attendant care benefits will remain mandatory, while all other accident benefits coverage will be optional allowing consumers more flexibility to choose coverage that fits their needs and budgets." (FSRA, Changes in Statutory Accident Benefits coverage in Ontario on July 1, 2026)

What Your Policy Date Actually Means for You

The reform does not strip coverage from every Ontario driver on July 1, 2026. It applies benefit by benefit, policy by policy, based on when each individual policy is entered into or renewed.

If your policy was already in force before July 1, 2026 and simply carries on to its scheduled renewal, the SABS transition provisions (section 2, subsections (1.0.2) through (1.0.4)) provide that the benefits you already had are deemed to continue as optional benefits, in the amounts previously payable under your contract, once that renewal happens. In plain terms, doing nothing does not automatically shrink your coverage. The risk sits elsewhere: with a brand new policy purchased after July 1, 2026, where the optional benefits are not included unless you actively elect and pay for them, and with any policyholder who agrees in writing with their insurer to change or decline a benefit in order to reduce their premium, without fully understanding what they are giving up.

Because the change is rolling through the market gradually, as each policy comes up for its own renewal date, two Ontario drivers can have meaningfully different accident benefits coverage well into 2027, depending solely on when their policies last renewed.

Who the optional benefits cover also narrowed. SABS section 2(1.0.4) provides that, on and after July 1, 2026, the optional benefits in Parts II, IV, V and VI "are only applicable to" the named insured, the named insured's spouse, the dependants of the named insured and of the spouse, and "the persons specified in the policy as drivers of the insured automobile." A passenger or pedestrian who is not in one of those groups cannot claim income replacement, non-earner, caregiver, other expense or death and funeral benefits under another person's optional coverage. Those optional benefits reach them only through a policy under which they fall into one of those four groups.

The Benefits That Remain Mandatory, and Their Dollar Limits

Medical, rehabilitation and attendant care benefits under Part III of the SABS are mandatory on every policy, regardless of the reform. Section 14 of the regulation states that an insurer is liable to pay these benefits. The current dollar limits are:

• Non-catastrophic impairment: medical, rehabilitation and attendant care benefits combined are capped at $65,000, for accidents occurring on or after June 3, 2019 (SABS s.18(3)(a)).
• Minor injury, where the Minor Injury Guideline applies: medical and rehabilitation benefits are capped at $3,500 (SABS s.18(1)).
• Catastrophic impairment: medical, rehabilitation and attendant care benefits combined are capped at $1,000,000 (SABS s.18(3)(b)), with an optional top up available to $2,000,000. That optional top up survived the 2026 reform because it is a medical, rehabilitation and attendant care add-on, not one of the benefit categories the reform moved to optional status.

The reform also changed who pays first. Before July 1, 2026, an auto insurer did not have to pay the part of a medical or rehabilitation expense that a workplace or other health plan would cover. For an accident in Ontario on or after July 1, 2026, SABS section 47(2.1) requires the auto insurer to pay medical and rehabilitation benefits, other than medication expenses, even for the portion "reasonably available to the insured person under a supplementary health insurance plan," which section 47(3) defines to include employer, union, professional association and individual health plans.

Catastrophic impairment is defined in SABS section 3.1 through a detailed list of medical criteria, including paraplegia or tetraplegia assessed on the ASIA Impairment Scale, traumatic brain injury meeting specific criteria, amputation and vision loss, among other categories. Anyone assessing whether an injury meets that definition should review section 3.1 directly rather than rely on a general description.

For a minor injury, the Minor Injury Guideline requires a treatment confirmation form prepared and signed by an authorized health practitioner. The Guideline itself, not the regulation, sets the specific deadline for submitting that form, and this article has not independently confirmed that day count against the Guideline document.

Notice and Application Deadlines

Missing a deadline can put a benefit at risk, and the SABS sets two separate time limits.

Section 32(1) states that a person who intends to apply for a benefit "shall notify the insurer of his or her intention no later than the seventh day after the circumstances arose that give rise to the entitlement to the benefit, or as soon as practicable after that day." Section 32(5) requires that "the applicant shall submit a completed and signed application for benefits to the insurer within 30 days after receiving the application forms." Missing one of these limits is not automatically fatal. SABS section 34 provides that "a person's failure to comply with a time limit set out in this Part does not disentitle the person to a benefit if the person has a reasonable explanation." That is a safety valve, not a guarantee: the explanation has to be reasonable, so notify and apply as early as you can.

Disputing a Denied or Reduced Benefit: The Licence Appeal Tribunal

If your insurer denies or reduces a SABS benefit, the dispute does not go to court in the first instance. Insurance Act section 280 states that "the insured person or the insurer may apply to the Licence Appeal Tribunal to resolve a dispute," and that "no person may bring a proceeding in any court with respect to a dispute described in subsection (1), other than an appeal from a decision of the Licence Appeal Tribunal or an application for judicial review."

An application to the Tribunal is subject to its own limitation period. SABS section 56 provides that an application under Insurance Act section 280(2), for a benefit, "shall be commenced within two years after the insurer's refusal to pay the amount claimed." That two year clock runs from the insurer's refusal, and it is separate from the limitation period that applies to a lawsuit against an at-fault driver for pain and suffering; for that different claim and its own deadline, see Suing After a Car Accident in Ontario.

The Pre-Reform $400-a-Week Figure You May Still See Online

A lot of material published before the 2026 reform describes Ontario's income replacement benefit as 70 percent of gross income, up to $400 a week, with optional top ups to $600, $800 or $1,000 a week. Only part of that structure is gone. O. Reg. 383/24 removed the $400 default and the $600, $800 and $1,000 tiers for policies entered into or renewed on or after July 1, 2026, because the income replacement benefit for those policies is optional. The 70 percent rule remains. SABS section 7(1) sets the weekly amount at the lesser of two figures: the weekly base amount (70 percent of gross weekly employment and self-employment income under section 7(2)) less other income replacement assistance, and "the amount fixed by the optional benefit." The amount you elect is therefore a ceiling, not a guaranteed payment: someone who buys a weekly amount above 70 percent of their gross income will still be paid only 70 percent.

Treat $400 a week as history, not as a number to plan around, unless your specific policy predates the reform and has not yet reached its next renewal. If you are unsure which rules apply to your policy, the safest step is to ask your insurer directly what date your current policy was entered into or last renewed, and to review your policy's declaration page or optional benefits endorsement (often labelled OPCF 47R) for the amount you actually elected.

Disclaimer: This article provides general information about Ontario's Statutory Accident Benefits Schedule, O. Reg. 34/10, under the Insurance Act, R.S.O. 1990, c. I.8, as amended by O. Reg. 383/24, current as of September 2026. It is not legal advice and does not address every fact pattern or policy wording. Consult a lawyer licensed in Ontario, your insurer, or the Financial Services Regulatory Authority of Ontario for advice on your specific situation.

Frequently Asked Questions

What changed in Ontario's accident benefits on July 1, 2026?

Ontario Regulation 383/24 amended the Statutory Accident Benefits Schedule so that, for motor vehicle liability policies entered into or renewed on or after July 1, 2026, the income replacement benefit, non-earner benefit, caregiver benefit, other expenses (such as housekeeping and home maintenance, lost educational expenses and visitor expenses), and death and funeral benefits are offered as optional benefits rather than included automatically. Medical, rehabilitation and attendant care benefits stay mandatory.

Do I still get income replacement benefits automatically after a car accident in Ontario?

It depends on your policy date. If your policy was entered into or renewed before July 1, 2026 and has not yet come up for its next renewal, the pre-reform automatic benefit structure still applies until that renewal happens. For a policy entered into or renewed on or after July 1, 2026, the income replacement benefit is optional. You only have it if the named insured elected and paid for it, and even then SABS section 2(1.0.4) limits optional benefits to the named insured, the named insured's spouse, their dependants, and drivers listed on the policy. A passenger or pedestrian outside those groups cannot claim optional benefits under someone else's policy.

My policy renews after July 1, 2026. Do I lose my accident benefits automatically?

No. SABS section 2 provides that benefits under an existing policy are deemed to continue as optional benefits in the amounts previously payable, unless you and your insurer agree in writing to change or decline them. Renewal alone does not strip the coverage. The change matters most for a brand new policy, or if you actively agree to alter your coverage to reduce your premium.

Is the 400 dollar a week income replacement benefit still available in Ontario?

No, not as a statutory figure for a policy entered into or renewed on or after July 1, 2026. The 70 percent of gross income up to 400 dollars a week structure, along with its 600, 800 and 1,000 dollar optional top up tiers, was repealed. The 70 percent rule itself still applies. For a policy on the new rules, SABS section 7(1) pays the lesser of 70 percent of gross weekly income (less other income replacement assistance) and the weekly amount the named insured elected and paid for, so the elected amount works as a ceiling and a higher election does not pay more than 70 percent of gross income.

How long do I have to notify my insurer or apply for accident benefits in Ontario?

You must notify your insurer of your intention to claim a benefit no later than the seventh day after the circumstances giving rise to the claim arose, or as soon as practicable after that, under SABS section 32(1). Once you receive the application forms, you must submit a completed and signed application within 30 days, under section 32(5). Missing either limit does not by itself cost you the benefit if you have a reasonable explanation, under SABS section 34.

What can I do if my insurer denies or reduces an accident benefit?

A dispute over SABS entitlement or amount goes to the Licence Appeal Tribunal, under Insurance Act section 280. Court proceedings are not available for that kind of dispute, apart from an appeal from a Tribunal decision or an application for judicial review. An application to the Tribunal must be commenced within two years of the insurer's refusal to pay the amount claimed, under SABS section 56.