Reimbursement for Out of Pocket Expenses under Ontario’s Statutory Accident Benefits Schedule (“SABS”)

For individuals recovering from injuries sustained in a motor vehicle accident, understanding the full scope of available benefits can be a complex process. An area that frequently prompts questions is regarding the reimbursement of out of pocket expenses incurred following a motor vehicle accident.

Under Ontario’s Statutory Accident Benefits Schedule (“SABS”), an injured person may submit various expenses to his or her insurer, including but not limited to:

1. Medical and rehabilitation expenses: You can claim all reasonable fees for treatments aimed at diagnosing or improving your accident-related injuries. This includes prescription and non-prescription medications, physiotherapy, chiropractic visits, registered massage therapy, psychological counselling, and any other regulated health-care professional services. You are required to keep a record of your receipts or invoices showing service dates, provider names, and amounts paid.
2. Assistive devices and modifications: In Accident Benefits, the insurer will pay for reasonable and necessary devices that help you move, communicate, or live safely while you recover. Eligible items may include crutches, walkers, wheelchairs, prosthetics, orthotic braces, hearing aids, and vehicle or home modifications (e.g., ramps or handrails).
3. Attendant care and housekeeping services: If your injuries prevent you from completing your personal or household tasks, the Accident Benefits insurer will reimburse you for services received from a personal support worker (PSW) or registered nurse (RN). If someone else is providing you with assistance, like a friend or family member, the service provider must prove that they lost wages or income to help you, before the insurer will pay for these services.
4. Transportation expenses: The insurer may also pay for your transportation expenses to and from medical appointments. The insurer will only pay after the first 50 km of each round-trip for transportation expenses. For example, if the round-trip is a total of 60 km, the Accident Benefits insurer will only reimburse you for 10 km. To ensure you are reimbursed, it is important to document each trip’s date, purpose, starting point, destination, and total mileage to support your claim. Note that the 50 km deductible does NOT apply if you have suffered a catastrophic impairment.
5. Damaged or lost personal items: You can seek reimbursement for clothing and personal belongings ruined or lost in the collision. Common claims include prescription eyeglasses, contact lenses, hearing aids, dentures, and specialized footwear.

Understanding and successfully claiming all eligible benefits under the SABS can be complex. At MAZI LAW, we will provide clarity on your specific situation, assist with the claims process, and advocate on your behalf to ensure you and your loved ones receive full compensation for your out-of-pocket expenses. Contact