Ontario Auto Insurance Reform 2010
 Why the change?

On September 1, 2010, the Ontario government introduced significant changes to your auto insurance that will provide you with more choice over your coverage and the price you pay. This will allow you to customize your policy to best suit your needs.

These changes will provide you with choice to ensure that you have the coverage that is best suited to your lifestyle and the needs of your family.

Your policy now...

The Ontario government determines the standard coverage that consumers must purchase, and your policy includes the following mandatory coverage:

As a result of the recent changes, some of the features under your policy have changed. As of September 1, 2010, whether you are buying a new auto policy or renewing an existing one, you will have the option to purchase the coverage best suited to your needs and lifestyle.
 What are the benefits?

We want to keep insurance as affordable as possible for you. In the past few years, injury costs have risen. To ensure that insurance remains affordable and accident victims receive the care they need, the Ontario government implemented reforms to provide Ontario drivers with more choice.

What's new?

The new auto reforms are laying the foundation for greater price stability and greater protection for you.  Along with the Accident Benefit reforms, some of the key changes include:

  •  Using credit score continues to be prohibited when providing quotes for auto insurance.
  • Accidents where you are deemed 25% or less at fault will no longer affect your premium.
  • If your vehicle is damaged or written off, and you’re not happy with the settlement amount offered, or if you do not agree with the fault determination, you have the option to go through the Ontario Auto Policy appraisal process and we will participate in this process with you.
  • The deductible applied to court awards for fatal accidents has been eliminated.
  • Coverage will be extended on rented vehicles with a Gross Vehicle Weight Rating (GVWR) of more than 4, 500 kg,  if they are for personal use and rented for up to 7 days.
  • Minor injuries that are directly related to an automobile accident are limited to $3, 500 in medical and rehabilitation benefits, regardless of the coverage you have selected.
  • In the event of a claim, we will send you benefit statements to keep you informed of how much medical, rehabilitation and attendant care benefits you continue to be eligible for and the amount we have paid out. This will allow you to partner with your adjuster to manage your claim effectively.

You can customize your deductible when your policy renews:

  • Tort deductible – we are now giving you the option to reduce the deductible associated with the court awarded compensation for pain and suffering to $20,000 from $30,000 and for Family Act claims to $10,000 from $15,000.
  • Direct Compensation – Property Damage Coverage (DCPD) – You now have the option of $500, $300 or no deductible at all on the coverage to repair the vehicle of the driver who is not at fault.

Who pays when I am injured?

If you are injured in an automobile accident, we want to make sure that you receive the best care possible. As your insurer, we will pay for health care services necessary to effectively manage your Accident Benefit claim.

In the event that your Accident Benefits are exhausted, or if the level of service required exceeds specified maximums, the Ministry of Health may consider paying for the following services:

  • Medical costs (all physician services)
  • Hospital services
  • Mental Health Facilities
  • Air Ambulance
  • Several professional in-home health services in a range of settings including the home, school or community
  • Any other ministry funded services not covered under the Long-Term Care Act, 1994

Who pays first?

OHIP and extended health care plans are first-payers. However, automobile insurance may cover expenses over-and-above those plans. The order of payment is as follows: 

  1. Ministry Programs:
    • OHIP
    • Professional services arranged or provided through Community Care Access Centres  (CCAC)
  2. Private supplementary health and disability insurers and private employer plans.
  3. Your automobile insurer – Statutory Accident Benefits.
  4. Money awarded in a lawsuit.
  5. Provincial government plans are the last payer for:
    • Non-professional services arranged or provided through CCACs
    • All services and benefits such as vocational rehabilitation and welfare payments, administered by the Ministry of Community and Social Services.
 Providing More Choice

We are here to help you make the best choice for you and want to make the process as simple as possible.

The benefits most affected by the recent changes are the Statutory Accident Benefits. Regardless of fault, you are entitled to these benefits when you are injured in an automobile accident; however, this is subject to the terms, conditions and limitations outlined in your Ontario Automobile Policy (OAP1 Owners Policy) and the Statutory Accident Benefits Schedule.

Coverage Coverage under your existing auto insurance policy Coverage under New Standard Auto Insurance Policy Options available to increase your benefits
Medical, Rehabilitation and Attendant Care benefits for non-catastrophic injuries $100,000 for medical and rehabilitation benefits $72,000 for attendant care benefits $50,000 for medical and rehabilitation benefits, including assessment costs; $36,000 for attendant care benefits $100, 000 or $1,100,000 for medical and rehabilitation benefits including assessment costs; $72,000 or $1,072,000 for attendant care benefits
Medical, Rehabilitation and Attendant Care benefits for catastrophic injuries $1,000,000 for medical and rehabilitation benefits; $1,000,000 for attendant care benefits $1,000,000 for medical and rehabilitation benefits including assessment costs; $1,000,000 for attendant care benefits An additional $1,000,000 for medical, rehabilitation and attendant care benefits including assessment costs
Caregiver Benefit Up to $250 per week for the first dependant plus $50 for each additional dependant; available for all injuries Up to $250 per week for the first dependant plus $50 for each additional dependant; available only for catastrophic injuries Up to $250 per week for the first dependant plus $50 for each additional dependant; available for all injuries
Housekeeping and Home Maintenance expenses Up to $100 per week; available for all injuries Up to $100 per week, available only for catastrophic injuries Up to $100 per week, available for all injuries
Income Replacement Benefits 80% of net income up to $400 per week 70% of gross income up to $400 per week Weekly limit can be increased to $600, $800 or $1,000 per week
Dependant Care Benefit Not Provided Not Provided Up to $75 per week for the first dependant and $25 per week for each additional dependant to a maximum of $150 per week
Death and Funeral Benefits $25,000 lump sum to an eligible spouse; $10,000 lump sum to each dependant; maximum $6,000 funeral benefits $25,000 lump sum to an eligible spouse; $10,000 lump sum to each dependant; maximum $6,000 funeral benefits $50,000 lump sum to an eligible spouse; $20,000 lump sum to each dependant; maximum $8,000 for funeral benefits
Indexation benefit – applicable to income replacement benefit, non-earner benefit, caregiver benefit, attendant care benefit or medical and rehabilitation benefit Not provided Not provided Annual adjustment according to the Consumer Price Index for Canada

If you would like more information on purchasing these options, please contact your agent and one of our insurance specialists will be happy to assist you.
 Auto Reform 101

How is my policy affected by Ontario Auto Reform?

Ontario auto reform came into effect on September 1, 2010; therefore, your policy limits will remain unchanged until your next renewal. Along with your renewal, we will be sending the information you need to make an informed decision on the type of coverage that best suits your needs. The choice will be yours.

My policy renews after September 1, 2010 but I am interested in taking advantage of the changes now – is this possible?

Yes! Every client is entitled to change their policy. If you would like to make changes prior to your renewal, please contact your agent for a quote based on the new changes.

How will my Accident Benefits coverage be affected by the new changes?

If your policy renews prior to September 1, 2010, there will be no change to your current coverage limits. If your policy renews after September 1, 2010, the new standards, as well as any optional benefits you may have purchased, will apply.

What are the additional Accident Benefits choices? How can I customize my policy?

Every auto policy will renew with a standard limit of Accident Benefits coverage. The choices include optional coverages that you can purchase to increase the standard limit and/or add a type of coverage for Accident Benefits. You will be able to choose the type of coverage and limits that fit your situation or needs.

Where can I get more information about the new auto reform changes?

If you have any questions or concerns, please contact your agent and one of our insurance specialists will answer your all questions.

Insurance Bureau of Canada

Financial Services Commission of Ontario
 Glossary

Attendant Care Benefit: Pays for an aide or attendant to look after you if you have been seriously injured in an auto accident.

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 dependents.

Catastrophic Injury: If you suffer an injury in an accident, you can apply for a determination of whether your injury qualifies as “catastrophic” (ie: loss of a limb, paraplegia). If the injury qualifies as being “catastrophic”, you are eligible for an increased level of benefits.

Death and Funeral Benefit: If you were to die as a result of an auto accident, the death benefit would provide a lump sum payout to your spouse and any dependents; the funeral benefit would provide a lump sum payout to cover funeral expenses.
Dependant Care Benefit: Pays for additional expenses incurred to care for your dependants if you are employed and are injured in an auto accident.

Direct Compensation – Property Damage (DC-PD): Covers damage to your vehicle or its contents if another person was at fault for the accident. For direct compensation to apply, the accident must occur in Ontario and both drivers must be insured by an insurance company licensed by the province. Any compensation would be collected directly from your own insurer.

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.

Indexation Benefit: Is 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.

Medical and Rehabilitation Benefit: Covers the cost of reasonable and necessary medical and rehabilitation expenses (ie: physiotherapy, prescriptions) that are not covered by OHIP or extended health care plan.

Minor Injury: Can consist of a sprain, strain, whiplash associated disorder, contusion, abrasion, laceration and any other clinically associated symptom. This term is applied to a person who sustains any one or more of these injuries.

Third Party Liability: Claims made by a driver against another driver who causes an accident.

Tort Deductible: The amount that is deducted from a settlement or court award for pain and suffering.

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.

Some Information used in this article was obtained from the Financial Services Commission of Ontario (FSCO), the Insurance Bureau of Canada (IBC) and the Ministry of Health.