What Happened on July 1, 2026 — and Why It Matters
For most of the past three decades, anyone injured in an Ontario motor vehicle accident could count on a uniform floor of financial and medical support through their automobile insurer, regardless of fault and regardless of whether they ever thought to check the details of their policy. That changed on July 1, 2026.
The provincial government, acting through Ontario Regulation 383/24, amended O. Reg. 34/10 — the Statutory Accident Benefits Schedule — to convert most of that floor into optional, purchasable coverage. Three categories of benefit remain automatic: medical, rehabilitation, and attendant care. Every other protection that Ontarians had come to rely upon — including weekly income payments, support for family caregivers, compensation for housekeeping incapacity, and death and funeral assistance — now exists only for those who specifically opted in at their last policy renewal and paid an additional premium for the privilege.
The practical consequence is significant. A driver or cyclist seriously injured in a crash today may receive funding for physiotherapy and medical care while remaining entirely without income support during a recovery that could last months or years. The 2026 reforms represent the most consequential restructuring of Ontario's no-fault benefit regime since the system's introduction, and the effects will be felt in claims files, at the Licence Appeal Tribunal, and in Ontario courtrooms for years to come.
If You Were Injured On or After July 1, 2026: Your access to weekly income support, caregiver payments, housekeeping reimbursement, and funeral assistance now depends entirely on your — or a household member's — policy elections at last renewal. Many Ontarians will discover this gap for the first time after an accident. Azimi Law offers a free consultation to assess what coverage applies to your specific claim.
Still Mandatory in Every Policy
Medical care, rehabilitation services, and attendant care remain automatic regardless of renewal choices. These cannot be removed from an Ontario auto policy.
Removed From the Standard Policy
Income replacement, non-earner, caregiver, death and funeral, housekeeping, visitors expenses, educational losses, and personal item damage are all now optional.
Tort Rights Are Unchanged
The right to sue an at-fault driver in tort was not altered by the 2026 reforms. The verbal threshold and statutory deductible under the Insurance Act continue to govern personal injury litigation.
Governing Instrument
Ontario Regulation 383/24 amended O. Reg. 34/10 under the Insurance Act, R.S.O. 1990, c. I.8. All accident benefit claims are adjudicated by the Licence Appeal Tribunal (LAT).
Understanding SABS — The System Before July 2026
Ontario's Statutory Accident Benefits Schedule is a no-fault scheme embedded within every automobile insurance policy issued in the province. "No-fault" means the system pays regardless of who caused the crash. A driver, passenger, cyclist, or pedestrian struck by a vehicle did not have to establish negligence to access benefits — they simply had to be injured in a motor vehicle accident and apply through the correct insurer under the priority hierarchy.
Claims are resolved through the Automobile Accident Benefits Service (AABS), a division of the Licence Appeal Tribunal (LAT). The LAT replaced the Financial Services Commission of Ontario's arbitration service in 2016 and now handles all first-instance disputes between injured claimants and insurers. Appeals lie to the Divisional Court on questions of law, and judicial review is available where LAT decisions are unreasonable.
The Pre-Reform Standard Benefit Package
Before July 1, 2026, every Ontario auto policy included the following without any election or additional premium by the policyholder:
- Medical and Rehabilitation Benefits — tiered at $3,500 (Minor Injury Guideline), $65,000 (non-catastrophic over five years), and $1,000,000 (catastrophic, lifetime)
- Attendant Care Benefits — compensation for a personal attendant helping with daily living activities, assessed through the Form 1 process
- Income Replacement Benefits (IRB) — up to $400 per week (70% of gross pre-accident income), with the option to purchase enhanced coverage up to $1,000 per week
- Non-Earner Benefits — $185 per week after a 26-week waiting period for those not employed at the time of the accident who suffered a complete inability to carry on a normal life
- Caregiver Benefits — available to catastrophically impaired individuals who were the primary caregiver for a person in need of care
- Housekeeping and Home Maintenance Benefits — up to $100 per week for those unable to perform household tasks due to their injuries
- Death and Funeral Benefits — lump sum payments to eligible surviving family members and reimbursement of funeral expenses
- Visitors Expenses — reimbursement for close family members' reasonable expenses to visit an injured insured person
- Lost Educational Expenses — recovery of tuition and related costs for students forced to interrupt education due to accident injuries
- Damage to Personal Items — replacement of eyeglasses, hearing aids, dentures, and other items damaged in the collision
Why This History Matters for Your Claim: The date of your accident determines which version of SABS governs your file. A claim arising from a collision on June 30, 2026 is fully subject to the pre-reform mandatory package regardless of your current policy status. Only accidents occurring on or after July 1, 2026 are potentially subject to the reformed, optionality-based framework.
The Regulation 383/24 Restructuring — Side by Side
The table below sets out every benefit category under the pre-July 2026 standard policy and its status after the reforms. The entries in the "After July 1, 2026" column reflect the default position for a new policy or a renewed policy where no optional benefit elections were made — not the maximum possible coverage for someone who purchased all available options.
| Benefit | Before July 1, 2026 | After July 1, 2026 |
|---|---|---|
| Medical Benefits (surgical, dental, hospital, ambulance) | ✓ Mandatory | ✓ Mandatory |
| Rehabilitation Benefits (physio, OT, psychology, chiro) | ✓ Mandatory | ✓ Mandatory |
| Attendant Care Benefits (Form 1 assessment) | ✓ Mandatory | ✓ Mandatory |
| Income Replacement Benefits — up to $400/wk | ✓ Automatic | ✗ Optional — must purchase |
| Non-Earner Benefits — $185/wk after 26 weeks | ✓ Automatic | ✗ Optional — must purchase |
| Caregiver Benefits | ✓ Automatic (CAT only) | ✗ Optional — must purchase |
| Housekeeping & Home Maintenance — up to $100/wk | ✓ Automatic | ✗ Optional — must purchase |
| Death Benefits (lump sum to surviving spouse/dependants) | ✓ Automatic | ✗ Optional — must purchase |
| Funeral Expenses Reimbursement | ✓ Automatic | ✗ Optional — must purchase |
| Visitors Expenses (family visits to injured insured) | ✓ Automatic | ✗ Optional — must purchase |
| Lost Educational Expenses (tuition reimbursement) | ✓ Automatic | ✗ Optional — must purchase |
| Damage to Personal Items (glasses, hearing aids, clothing) | ✓ Automatic | ✗ Optional — must purchase |
| Caregiver / Housekeeping for Non-Catastrophic Injuries | ✗ CAT designation required | ⟳ Expanded — any impairment (if opted in) |
One Genuine Expansion in the Reform: The regulation removed the requirement that a claimant hold a catastrophic impairment designation to access caregiver and housekeeping benefits. Under the old rules, only those with the most severe injuries could trigger these benefits. Under the new framework, any impairment qualifies — but only if the policyholder purchased the optional caregiver or housekeeping coverage. For those who opted in, this is a meaningful improvement. For those who did not, the expansion is irrelevant.
How the Reforms Affect Different Groups of Claimants
The effect of the July 2026 changes is not uniform. Whether you have access to optional benefits after an accident depends on your relationship to the relevant insurance policy — specifically, whether you are identified within a class of persons to whom those elections apply.
Named Insured & Household Members
Policyholders, their spouses, dependants, and listed drivers have the most direct access to whatever optional benefits were elected on the policy. Their coverage equals the mandatory minimum plus any add-ons purchased at renewal.
Passengers in the Insured Vehicle
Passengers who are not named insureds, spouses, dependants, or listed drivers may not be entitled to optional benefits — even if the policyholder paid for enhanced coverage. The endorsement language governs who is covered by which elections.
Pedestrians and Cyclists
Mandatory benefits remain available through the priority hierarchy. However, optional income replacement and other financial benefits attach only to specific policy-connected individuals. A pedestrian with no household auto policy has no pathway to optional coverage, regardless of the at-fault driver's elections.
Uninsured and Under-Insured Persons
Those who do not own vehicles and have no household auto policy are limited to mandatory benefits accessed through third-party priority rules or the Motor Vehicle Accident Claims Fund. They have no optional benefit coverage of any kind.
Why Pedestrians and Cyclists Face Particular Exposure
Before the 2026 reforms, a pedestrian struck by a vehicle could access the at-fault driver's full standard SABS package — including income replacement — through the insurer of the vehicle that caused the injury. That pathway no longer works for optional benefits.
Optional benefit elections under the new SABS framework apply only to identified classes of insured persons connected to the policy: named insureds, spouses, dependants, and listed drivers. A pedestrian with no vehicle registration and no household auto policy falls into none of those categories. Even if the at-fault driver purchased the most comprehensive optional package available, that pedestrian cannot benefit from those elections. Their options are the mandatory benefit floor and, if negligence can be established, a tort claim against the at-fault driver.
Practical Scenario — Post-July 2026: A nurse who does not own a car is struck by a vehicle at a crosswalk and suffers a shoulder fracture, requiring six weeks off work. Under the pre-reform system, she would have claimed income replacement through the at-fault driver's insurer regardless of her own insurance status. Under the post-reform framework, her insurer access is to mandatory medical and rehabilitation benefits only. Her weekly income loss is not covered through the accident benefit system unless a household auto policy with optional income replacement applies to her. Her primary financial remedy is a tort action against the driver — a process that may take two to three years to resolve.
The Self-Employed Gap
Employees who receive disability coverage through a workplace group benefits plan may have some financial buffer after losing access to automatic income replacement. Self-employed individuals rarely do. The old $400-per-week automatic income replacement benefit was, for many sole proprietors and freelancers, the only structured income protection available after an accident. With that benefit now optional, self-employed Ontarians who did not specifically add income replacement coverage at renewal are exposed to potentially catastrophic financial harm if a disabling injury prevents them from working.
Motorcycle Riders
Motorcycle riders and their passengers face the same analysis as other claimants. Mandatory benefits remain available. Optional benefits depend entirely on what was elected on the applicable policy and whether the rider or passenger falls within the qualifying class of insured persons under that policy's endorsement terms.
What Remains — Post-Reform CoreThe Three Mandatory Benefits — Scope and Limits
The following three categories of SABS benefit remain mandatory in every Ontario automobile insurance policy and cannot be removed regardless of any renewal election or optional benefit declination.
1 — Medical Benefits
Medical benefits fund all reasonable and necessary expenses for treatment arising from the accident. The regulation specifies that covered services include medical, surgical, dental, optometric, hospital, nursing, ambulance, and related healthcare services. Treatment must not be experimental, and providers must be appropriately qualified under Ontario's regulated health professions framework.
The limits remain injury-severity tiered:
- Minor Injury Guideline (MIG) — Soft Tissue Injuries: $3,500 combined with rehabilitation, for sprains, strains, whiplash-associated disorders Grade I and II, and contusions where no pre-existing condition complicates recovery
- Non-Catastrophic Impairments: $65,000 combined for medical and rehabilitation expenses, available over five years from the date of the accident
- Catastrophic Impairments: $1,000,000 combined lifetime pool for both medical and rehabilitation benefits
One Procedural Improvement — Auto Insurer Is Now the Primary Payer: Prior to July 2026, claimants were required to exhaust OHIP coverage, group health benefits, and private health insurance before the accident benefit insurer became liable. This "coordination of benefits" approach created delays and disputes. Under the reformed SABS, the auto insurer is the primary payer for mandatory medical and rehabilitation benefits, eliminating the prior obligation to pursue other coverage first. For claimants needing prompt treatment funding, this represents a genuine improvement in accessibility.
2 — Rehabilitation Benefits
Rehabilitation benefits cover prescribed services from regulated health professionals aimed at restoring function and quality of life after accident-related injury. Covered providers include physiotherapists, chiropractors, occupational therapists, registered massage therapists, psychologists, speech-language pathologists, and social workers, among others.
To access rehabilitation funding, the treating provider submits a Treatment and Assessment Plan — historically the OCF-18 — to the insurer. The insurer reviews the plan and either approves, disputes, or requests an insurer-directed examination before approving further treatment. Where a dispute arises, the LAT adjudicates the question of whether the proposed treatment is reasonable and necessary.
3 — Attendant Care Benefits
Attendant care benefits compensate for a personal attendant who assists an injured person with activities of daily living — bathing, dressing, mobility, meal preparation, medication administration, and comparable personal care tasks — when those activities cannot be performed independently due to accident injuries.
The need for and quantum of attendant care is formally assessed through the Assessment of Attendant Care Needs (Form 1). A qualified assessor — typically an occupational therapist or registered nurse — evaluates the injured person and documents the level 1, 2, and 3 care needs that arise from the injury. Monthly attendant care maximums are prescribed by SABS and vary between non-catastrophic and catastrophic claims. For catastrophically injured claimants, attendant care can represent the most substantial component of the entire accident benefit package.
What Was Removed from the Standard PolicyOptional Benefits — Each Explained
The following is a benefit-by-benefit explanation of every SABS coverage removed from the standard mandatory package on July 1, 2026. All of these benefits remain purchasable as optional add-ons — but they are available only to those who specifically elected them and paid the applicable premium at renewal.
Income Replacement Benefits
The income replacement benefit previously provided employed accident victims with weekly payments equal to approximately 70% of their pre-accident gross income, subject to a ceiling of $400 per week under the base policy. Policyholders had the option to purchase enhanced coverage raising that ceiling to $600, $800, or $1,000 per week. The benefit activated within a week of the accident for those who met the employment and impairment test.
After July 1, 2026, none of that applies automatically. The income replacement benefit has been moved out of the mandatory tier entirely. Policyholders who did not elect it at renewal receive nothing from their insurer for lost wages after a crash. The amount payable under an optional election is no longer fixed by regulation — the SABS now stipulates it will be "the amount fixed by the optional benefit," meaning the policyholder's elected coverage amount governs.
The Exposure for Moderate and High Earners: A worker earning $75,000 per year who is off work for six months faces $37,500 in lost income. Without income replacement coverage through their insurer, the only structured alternatives are Employment Insurance sickness benefits (for employees who qualify, covering a fraction of income to a weekly maximum), a tort claim against the at-fault driver (which will take years), or personal savings. This is the single biggest financial risk created by the 2026 reforms for the majority of working Ontarians.
Non-Earner Benefits
The non-earner benefit addressed the gap left by income replacement for those who were not employed at the time of their accident. Students, homemakers, retirees, and those between jobs who suffered a "complete inability to carry on a normal life" as a result of accident injuries could receive $185 per week beginning 26 weeks after the accident. This was not a large sum, but for someone with no employment income and no access to workplace benefits, it represented meaningful financial acknowledgment of their diminished capacity.
That acknowledgment is no longer automatic. Non-earner benefits require an optional election and an additional premium payment. Those who did not purchase the coverage cannot claim it regardless of the severity of their injury's impact on daily life.
Caregiver Benefits
The caregiver benefit compensates a claimant who, due to accident injuries, is unable to continue acting as the primary caregiver for a person who depends on them for care. Under the pre-reform system, this benefit was restricted to catastrophically impaired claimants — only those whose injuries cleared the very high bar of a formal CAT designation could access it.
The 2026 reform simultaneously expands and restricts this benefit. It expands the eligibility threshold by removing the catastrophic impairment requirement — after July 2026, any impairment (not just catastrophic) can trigger caregiver benefit entitlement. But it restricts access by making the benefit optional. The net result: those who purchased optional caregiver coverage and sustain any impairment that prevents caregiving can now claim the benefit regardless of whether they meet the catastrophic designation test. Those who did not purchase the coverage receive nothing, regardless of how profoundly their caregiving responsibilities are disrupted by their injuries.
To be eligible, the claimant must demonstrate they are the primary caregiver for a person in need of care, that they reside with that person, and that they were not receiving payment for the caregiving activity.
Housekeeping and Home Maintenance Benefits
Up to $100 per week was payable under the pre-reform standard policy to anyone who, because of accident injuries, was unable to perform the household tasks — cooking, cleaning, laundry, yard maintenance, snow removal — they had been performing before the collision. This benefit applied to both non-catastrophic and catastrophic claimants, though the catastrophic tier offered a higher weekly maximum.
Post-reform, this coverage requires an optional election. For a single parent, an elderly person living alone, or anyone who cannot afford to hire a housekeeper during a lengthy recovery, the absence of this automatic coverage adds a practical and financial burden that the pre-reform system would have absorbed.
Death Benefits
When a person died as a result of a motor vehicle accident, the pre-reform SABS provided their surviving family members with lump sum death benefits calculated based on the deceased's relationship to the claimant — spouse, dependant child, and so on. These payments provided immediate financial stabilisation to grieving families at the worst possible moment.
Death benefits are now optional. A family whose breadwinner is killed in a crash after July 1, 2026, on a policy that did not include optional death benefit coverage, will receive nothing through the accident benefit system for the loss of that income. Their pathway to financial recovery is a wrongful death tort claim, which can take years and requires establishing the at-fault driver's liability at trial or settlement.
Funeral Benefits
Separate from death benefits, the pre-reform SABS reimbursed reasonable funeral expenses for an insured person killed in an accident. This provided a practical offset against an unexpected and often substantial cost at a deeply difficult time. After July 2026, funeral expense reimbursement is optional and unavailable to those whose policy did not include it.
Visitors Expenses
Where an insured person was hospitalised or otherwise unable to maintain their normal life following an accident, close family members — spouses, children, parents, siblings — could claim reimbursement for the reasonable costs they incurred to provide visits and personal support. Travel expenses, accommodation costs, and similar out-of-pocket expenditures were covered within prescribed limits. This benefit recognised that a serious injury affects the whole family, not just the person directly injured. It is now optional.
Lost Educational Expenses
For students whose accident injuries forced them to withdraw from or interrupt an educational program, the pre-reform SABS reimbursed non-refundable tuition and related educational expenses. Losing a semester due to injuries sustained in a crash is a real and consequential financial harm for young Ontarians. Optional election is now required for this coverage to apply.
Damage to Personal Items
Eyeglasses, hearing aids, dentures, prosthetics, and clothing damaged or destroyed in a motor vehicle accident were reimbursed as part of the standard SABS package. For seniors relying on expensive hearing devices, or anyone wearing corrective lenses, these are significant costs. Under O. Reg. 383/24, personal item damage coverage is capped at the amount specified in the optional benefit elected — zero, if no election was made.
When the New Rules Apply — Transition and Renewal Logic
The interaction between the July 1, 2026 effective date and an individual policyholder's renewal cycle creates a transitional complexity that every claimant and their lawyer must understand at the outset of any claim.
Watch for Passive Renewal Traps: Insurance renewal documents now include a new optional benefit election section. Policyholders who sign renewal documents without reading them carefully may inadvertently confirm the removal of coverage they previously held. A policyholder who initialled a form showing "income replacement: declined" may have unknowingly stripped that coverage. Azimi Law has seen this pattern emerge in early claims arising after July 2026 — it is one of the first things we examine when taking on a new accident benefits file.
What the 2026 Reforms Mean for Tort Claims and the LAT
A Surge in Tort Litigation Is Anticipated
When the accident benefit system provided weekly income payments automatically, injured Ontarians had a financial bridge during the years a tort claim typically takes to resolve. That bridge is gone for the majority of claimants who did not opt into income replacement. With no insurer paying weekly income support, the pressure to move a tort claim forward — and to accept early settlement offers — increases dramatically. Legal practitioners on both sides expect this dynamic to increase the volume and urgency of personal injury litigation in Ontario courts.
The broader pattern is predictable: as the accident benefit system retracts, more losses that SABS previously absorbed will migrate into tort claims. Lost income, caregiving costs, housekeeping expenses, and funeral costs are all heads of tort damage. Claimants without SABS coverage for these losses will argue them in court instead — often against well-funded insurer defence teams.
Tort Rights Remain Fully Intact
Nothing in the 2026 reforms alters Ontario's tort framework for motor vehicle personal injury claims. The right to sue a negligent driver continues under the general law of negligence and the Insurance Act. Recoverable damages in tort remain: general damages (pain, suffering, loss of amenity of life), special damages (income loss, out-of-pocket costs, future care), and Family Law Act claims by family members for care, guidance, and companionship.
The two structural limitations on tort recovery that exist prior to July 2026 remain:
- The Verbal Threshold: Under section 267.5 of the Insurance Act, recovery for general damages in a motor vehicle tort claim requires that the claimant demonstrate a "permanent serious impairment of an important physical, mental or psychological function" or a "permanent serious disfigurement." This threshold filters out claims involving minor injuries from accessing general damages.
- The Statutory Deductible: General damages awards below a legislatively prescribed ceiling are subject to a deductible — currently adjusted annually. For the 2026 year, consult the most current FSRA schedule for the applicable deductible amount. Awards above the threshold ceiling are exempt from the deductible.
New Dispute Categories at the LAT
The LAT's docket will evolve to reflect the new framework. In addition to the traditional categories of SABS dispute — treatment plan approvals, income replacement eligibility, CAT designation contests — practitioners can anticipate disputes around:
- Whether the insurer fulfilled its obligation to explain optional benefits at renewal and whether a broker's failure to advise creates liability
- The scope and meaning of optional benefit endorsement language, particularly where election forms are ambiguous
- Priority disputes involving pedestrians, cyclists, and passengers who lack access to a policy with optional elections in their favour
- Whether the transition rules were properly applied at renewal and whether a written waiver of prior coverage was validly obtained
Motor Vehicle Accident Claims Fund (MVACF)
Where an accident involves an uninsured driver or an unidentified hit-and-run driver, the Motor Vehicle Accident Claims Fund remains Ontario's insurer of last resort for mandatory accident benefits. Post-July 2026, MVACF coverage is also structured around the reformed SABS — mandatory benefits are available, but optional benefits are not extended automatically through MVACF to claimants who lack their own policy elections. If you have your own auto policy, it takes priority over MVACF in the claims hierarchy regardless of the other driver's insurance status.
Azimi Law's Integrated Approach: The accident benefit stream and the tort stream are legally distinct but practically interrelated. Decisions made in one affect the other — a benefit denial at the LAT can alter the value and timing of a tort settlement; early tort settlement can affect ongoing benefit entitlements. Azimi Law manages both streams simultaneously, ensuring no decision in one proceeding inadvertently compromises the other. This integrated strategy is particularly critical in post-July 2026 claims where the benefit safety net is thinner and the tort claim carries proportionally more of the financial recovery.
Steps to Take if You Were Injured On or After July 1, 2026
The reformed SABS environment demands earlier, more thorough legal involvement than ever before. Coverage analysis that was once straightforward — everyone had the same mandatory package — now requires examining specific policy documents, identifying which optional elections were made, and determining where in the priority hierarchy your claim sits. The following steps are essential.
Step 1 — Notify Your Insurer Promptly
SABS imposes a notice obligation: if you intend to make an accident benefits claim, you must notify your insurer within seven days of the accident, or as soon as reasonably practicable. Your insurer must then provide you with the required application forms. Missing this window does not automatically forfeit your claim, but it complicates it. Call your insurer as soon as you are physically able.
Step 2 — Gather All Applicable Insurance Documents
The first and most urgent task for your lawyer will be identifying every auto insurance policy in the priority hierarchy: your own policy, household members' policies, the vehicle operator's policy, and the vehicle owner's policy if different. Each policy must be reviewed for its optional benefit elections. This is the step that determines whether income replacement, caregiver coverage, or any other optional benefit exists anywhere in the chain of coverage that applies to your claim.
Step 3 — Begin Medical Treatment Without Delay
Mandatory medical and rehabilitation benefits fund your treatment. Access to this funding depends on submitting a proper treatment plan through a qualified regulated health professional. Treatment gaps — periods where you stopped attending therapy or did not see a physician — are frequently used by insurers to dispute causation and the ongoing necessity of care. Begin attending your family doctor and relevant treating specialists as soon as your injuries permit, and maintain consistent attendance throughout your recovery.
Step 4 — Complete Application Forms Carefully and Completely
The accident benefit application package includes the Application for Accident Benefits (formerly OCF-1), the Employer's Confirmation Form (formerly OCF-2), and the Disability Certificate (formerly OCF-3) completed by your treating physician. These forms establish your identity, employment status, income, and the nature of your injuries and functional limitations. Errors or omissions in these forms can be exploited by insurers to justify benefit reductions. Your lawyer should review all forms before submission.
Step 5 — Preserve All Financial Evidence
Document every financial impact of your injuries from the moment of the accident: employment income lost, invoices for housekeeping or caregiving assistance you have had to hire, educational fees you have forfeited, out-of-pocket medical expenses, and any other costs arising from your inability to function as you did before the crash. This evidence is essential for both any available accident benefit claims and for quantifying special damages in your tort action.
Step 6 — Consult a Lawyer Before Providing Statements
Do not provide a recorded statement to any insurer — yours or anyone else's — before speaking with an accident benefits lawyer. Early statements are admissible in LAT proceedings and can be used in tort litigation. Answers given while in pain, on medication, or without legal context can create difficulties that take years to address. Azimi Law consultations are free and confidential.
- Notify your insurer within 7 days of the accident
- Request and complete all accident benefit application forms
- Obtain complete copies of all relevant insurance policies and renewal confirmations
- Begin attending medical treatment and ensure a treatment plan is submitted
- Keep a written record of all income lost and accident-related expenses
- Contact Azimi Law before giving any recorded statement to an insurer
- Do not sign any release or settlement document without independent legal advice
- Do not assume income replacement coverage exists — verify your policy elections first
- Do not miss the 2-year limitation period for LAT applications or tort claims
- Do not stop attending treatment before your recovery is complete without legal advice
What Every Ontario Policyholder Should Do Before Their Next Renewal
The most important window for protecting yourself under the new SABS framework is before an accident happens, not after. At your next renewal, you will face choices about optional benefits that most Ontarians have never had to make before. The following guidance is intended to help you navigate that process.
Ask Your Broker the Right Questions
When your policy comes up for renewal, do not simply sign and return the documents. Request a specific conversation with your broker about optional benefit elections and ask explicitly:
- Which optional benefits are currently active on my policy and what are their elected amounts?
- What is the additional premium cost to add income replacement, non-earner, caregiver, and housekeeping benefits?
- Am I covered for death and funeral benefits under the current policy?
- Has anything changed from my last renewal cycle in terms of my coverage?
- If I have a workplace LTD or group benefits plan, does it contain an exclusion for losses covered by SABS — and how does that interact with the new optional coverage framework?
Assess Your Personal Risk Profile Before Declining Coverage
The government's stated purpose in creating optionality was to allow consumers to avoid paying for coverage they do not need — for example, a person with comprehensive workplace disability insurance might not require a second layer of income replacement through their auto policy. That logic is sound in theory. In practice, the risk analysis is more nuanced:
- Employed with group benefits: Verify whether your workplace LTD policy excludes SABS-covered losses before declining income replacement. Many do not yet reflect the post-2026 environment, creating a potential gap.
- Self-employed: You almost certainly need optional income replacement. You have no employer backstop, and EI sickness benefits (if available to you at all) replace far less than the optional SABS coverage would.
- Families with young children: Caregiver benefit coverage addresses the reality that a disabling injury affecting a primary caregiver has household consequences extending far beyond that individual.
- Single-income households: The death benefit and funeral coverage are more significant for households where the loss of one earner would be financially catastrophic.
- Students and recent graduates: Non-earner benefits and lost educational expense coverage are particularly relevant; young people are statistically more likely to be in situations where income replacement would not apply.
The Group Benefits Trap: Some employer disability plans contain a provision that coordinates benefits with SABS, reducing the plan's payments by whatever SABS provides. After July 2026, if you declined optional income replacement, SABS provides nothing — but depending on how your group plan is worded, it may still attempt to treat SABS as the primary payer and reduce its own obligation. Review your group benefits certificate carefully, and if in doubt, carry both coverages.
How Azimi Law Approaches Accident Benefits Claims After July 2026
Bahman (Ben) Azimi has represented accident benefit claimants at every stage of the SABS process — from initial insurer negotiations through to contested LAT hearings and Divisional Court judicial reviews. The July 2026 reforms add a layer of complexity to every claim that makes early, experienced legal involvement more important than it has ever been. The services Azimi Law provides in SABS matters include the following.
Coverage and Priority Analysis
The foundational task in every post-July 2026 accident benefits file is identifying which policy — or combination of policies — applies to the claimant and what optional benefits, if any, were elected on each. Azimi Law obtains complete policy documents, renewal confirmations, and optional benefit election records to construct a precise picture of the available coverage before any claim strategy is set.
Application and Forms Management
The accident benefit application package and ongoing treatment plan submissions must be completed accurately and completely. Our office works directly with treating practitioners to ensure that forms reflect the claimant's functional limitations, that medical evidence is captured early, and that no administrative error gives the insurer grounds to delay or deny payment.
Insurer Negotiations
A significant proportion of accident benefit disputes can be resolved through persistent, well-documented advocacy without proceeding to a LAT hearing. Azimi Law pursues this route where it is realistically available, preserving cost and time for our clients while maintaining the credible threat of full litigation if the insurer fails to act in good faith.
Catastrophic Impairment Designation
For clients with serious injuries, obtaining a formal catastrophic impairment designation is transformative — it moves the available medical and rehabilitation benefit pool from $65,000 to $1,000,000. Building a successful CAT designation application requires careful selection and coordination of qualified assessors across every relevant domain: physiatry, neuropsychology, occupational therapy, and others as required. Azimi Law manages this process from the initial assessment strategy through to defending the designation if the insurer contests it.
LAT Hearings
Where negotiation is unsuccessful, Azimi Law files applications to the Licence Appeal Tribunal and pursues the client's claim through the full adjudication process. We prepare comprehensively for hearings — securing expert reports, identifying and challenging insurer-directed examination bias, and presenting the factual and legal arguments in a form that gives our clients the best available prospect of success before the adjudicator.
Coordinated Tort and SABS Strategy
The most effective outcomes for seriously injured claimants result from managing both the accident benefits claim and the tort action together, with each informing and strengthening the other. Azimi Law handles both streams on a single file, ensuring that a decision to accept a SABS settlement does not inadvertently compromise the tort claim's value, and that evidence developed through LAT proceedings is properly positioned for use in the Superior Court proceeding.
Judicial Review
Where a LAT adjudicator's decision is unreasonable or contains an error of law, Azimi Law brings judicial review applications in the Ontario Divisional Court. Not every unfavourable LAT decision warrants judicial review, but where it does, prompt action is essential.
Fee Arrangement
Personal injury and accident benefit matters at Azimi Law are handled on a contingency fee basis. No legal fees are charged unless and until compensation is recovered for the client. Disbursements and expert costs are advanced by the firm. A free initial consultation is available by telephone or at our Toronto office.
The Policy Debate — Opposition and Ongoing Concerns
The 2026 SABS reforms were not welcomed unanimously. The Ontario Trial Lawyers Association (OTLA) — of which Azimi Law principal Ben Azimi is a member — mounted sustained opposition to the changes, presenting detailed evidence and argument about their likely effects on injured Ontarians before the reforms took effect.
The central concerns raised by OTLA and the personal injury bar remain live policy questions:
- Systematic underinsurance: Research on consumer behaviour in insurance markets consistently shows that individuals underestimate their likelihood of being in an accident and therefore undervalue coverage they cannot see themselves using. A system that relies on consumers to opt into adequate protection will produce a predictable pattern of underinsurance, particularly among lower-income households for whom the additional premium is a genuine hardship.
- Regressive impact: The optional benefits most likely to be declined for cost reasons — income replacement, caregiver benefits — are also the benefits most critical to lower-income earners who have no private disability insurance and no financial reserves to absorb a prolonged income interruption. The reform effectively shifts risk from the insurance pool to individual claimants, with the greatest burden falling on those with the least capacity to absorb it.
- Vulnerable road users: The changes to who can access optional benefits were not crafted with vulnerable road users in mind. Pedestrians, cyclists, and those without vehicles have never had direct control over the policies that covered them under the priority hierarchy. They now bear the consequences of other people's optional benefit elections.
- Long-term social costs: Injured Ontarians who lack income replacement coverage and cannot access the tort system quickly may fall onto OW, ODSP, or other provincial social assistance programs. The cost savings in private insurance premiums may be offset by increased demand for public support systems.
- Litigation volume: The expected increase in tort claims will add to Superior Court dockets already under resource pressure, potentially creating delays that disadvantage claimants most in need of timely resolution.
The Ontario government proceeded with the reforms over this opposition, characterising them as a consumer choice initiative that would reduce premiums and allow policyholders to tailor their coverage to their individual circumstances. The Financial Services Regulatory Authority of Ontario (FSRA) issued filing guidance and a communications toolkit to assist insurers and brokers in explaining the new elections to consumers and has made continuing education resources available to the industry.
OTLA has indicated it continues to engage the government on the potential for protective measures, particularly regarding broker disclosure obligations and the treatment of vulnerable road users. The legal community will monitor how the reforms play out in actual claims experience and whether legislative or regulatory corrections are warranted.