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The parties who pay for accident victims’ health services

Drivers, passengers and other road users who are injured in Ontario vehicle accidents are entitled to paid non-professional health care services by automobile insurers under the Statutory Accident Benefit Schedule of the Insurance Act. However, the Ministry of Health and Long-Term Care might cover other expenses.

Some of the health care services that automobile insurers may pay for are community support such as caregivers, social or recreational services, transportation and meals, and home repair and maintenance. They might also pay for attendant care, homemaking and personal support services such as house cleaning, preparing meals, laundry and personal hygiene assistance. Auto insurers generally arrange these services through long-term care facilities, Community Care Access Centres or other agencies that receive funding through the ministry, and they directly pay the service providers.

The ministry only considers providing funding for these health services when the statutory benefits are depleted or the car accident victims require excessive levels of service. However, the victims are subject to an assessment first. Some of the services that the ministry could pay for include hospitals, air ambulances and physician expenses. It may also cover in-home services, including physiotherapy, occupational therapy, nursing, nutrition assistance or social work. Some of the maximum limits for paid services are $100 a week for homemaking and $72,000 a year to $1 million total for attendant care of catastrophic injury.

Car accidents cause thousands of injuries every year, from broken bones to spinal cord and brain injuries. While the victims may receive support from auto insurers or the ministry, they could receive further compensation after filing personal injury claims against the at-fault parties if those parties were negligent. Accident victims may seek help getting health care support or filing lawsuits from personal injury lawyers.

Source: Ministry of Health and Long-Term Care, “Who Pays for Health Care: Injuries from Motor Vehicle Accidents,” Dec. 16, 2014