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Who Pays the Bills While an Injury Claim Runs?

Money

The claim is not what pays your rent this month. Knowing what does is the difference between settling well and settling early.

THE SHORT ANSWER

Accident benefits from your own insurer fund treatment and, where the optional coverage was purchased, income replacement. They are what carries you while the claim against the at-fault party is still running.

Accident benefits come first

They come from your own policy, they do not depend on fault, and they are available long before any claim against another party resolves. Medical, rehabilitation and attendant care are mandatory coverage.

Since July 1, 2026, income replacement is optional coverage in Ontario. Whether it is available depends on what the policy bought.

The other sources people forget

Short and long-term disability coverage through work. Employment insurance sickness benefits in some circumstances. Extended health coverage, though auto insurance now pays first for medical and rehabilitation costs, with medication the exception.

These interact with each other, and claiming from the wrong one first can create repayment obligations later.

Why we advance the cost of the case

Building an injury claim properly costs money before it produces any: medical records, expert reports, assessments. We advance those costs so that the timing of a settlement is decided by the evidence rather than by a bill arriving.

That is the practical meaning of a contingency arrangement. It is not only about the fee.

Deadlines that apply to you

These are the dates that end claims. Check them first.

7days

Tell your own auto insurer about the collision as soon as you reasonably can, and no later than seven days.

Statutory Accident Benefits Schedule, O. Reg. 34/10, s. 32(1)

30days

Once the insurer sends you the application package, the completed application for accident benefits (the OCF-1) is due back within 30 days.

Statutory Accident Benefits Schedule, O. Reg. 34/10, s. 32(5)

For an injury that is not catastrophic, medical, rehabilitation and attendant care benefits are capped at $65,000 combined, available for up to 260 weeks after the collision.

Statutory Accident Benefits Schedule, O. Reg. 34/10 · in force 2019-06-03

Changed 2026-07-01

Ontario changed accident benefits on July 1, 2026

  • Medical, rehabilitation and attendant care remain mandatory on every policy.
  • Income replacement, non-earner and caregiver benefits are now optional coverage you have to buy.
  • Auto insurance now pays first for medical and rehabilitation costs, ahead of an extended health plan. Medication is the exception.
  • Someone without their own auto policy, including pedestrians and cyclists, may now only be able to claim the mandatory medical, rehabilitation and attendant care benefits.
STILL MANDATORY
  • Medical benefits
  • Rehabilitation benefits
  • Attendant care benefits
NOW OPTIONAL
  • Income replacement benefits
  • Non-earner benefits
  • Caregiver benefits

If you were hurt on or after July 1, 2026, what you can claim depends on what optional coverage was bought. Check the policy before assuming a benefit is there.

Financial Services Regulatory Authority of Ontario, changes to Statutory Accident Benefits coverage effective July 1, 2026

COMMON QUESTIONS

Questions we get every week

They depend on filing on time. Notice to your insurer and returning the completed application both run on short deadlines, and delay there delays everything downstream.

Some benefits carry repayment or offset obligations depending on their source. That is something to work out early rather than discovering at settlement.

Then it is not available under the policy, which since July 2026 is a real possibility. Other sources such as workplace disability coverage become correspondingly more important.

Written by

Shawn Sidhu, personal injury lawyer

Shawn Sidhu, Lawyer

Called to the bar in British Columbia, 2013

University of British Columbia · University of Birmingham

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