A car accident claim in Ontario is two claims, and most people only know about one of them. There is the benefits claim against your own insurer, which runs whoever was at fault, and there is the claim against the other driver, which does not.
About this work
Three things, and each word in it is doing work. Under subsection 267.5(5) of the Insurance Act the owner, the occupants and any person present are not liable for non-pecuniary loss unless the injured person died or sustained permanent serious disfigurement, or permanent serious impairment of an important physical, mental or psychological function.
Permanent, so an injury that resolves does not qualify however painful it was at the time. Serious, which is assessed against what the person can no longer do. And of an important function, which is where the evidence usually concentrates: what the impairment prevents in the person's actual work, family and daily life rather than in the abstract.
A psychological impairment counts. So does one that is not visible on any scan. What matters is the evidence, and the evidence is built from treating records over time rather than from a single assessment near the start.
Because the threshold is judged on the state of affairs as it turns out, a claim that looks marginal at six months can look very different at two years. That is a reason to keep the file moving and the treatment documented, not a reason to wait past the limitation period.
How it is structured
Ontario replaced part of the ordinary right to sue with a scheme of benefits paid by your own insurer. What is left of the right to sue is narrowed by a threshold and reduced by a deductible. Both tracks matter and they are pursued in parallel.
Paid regardless of who caused the collision, and claimed from your own policy rather than the other driver's. They cover treatment, rehabilitation, attendant care and income replacement, on limits and timelines set by regulation. This is the track that pays first and the one people most often delay starting.
This is where damages for pain and suffering, and for losses the benefits do not cover, are recovered. It is a court action against the other driver rather than an application to an insurer, and it is subject to the two restrictions below.
Under subsection 267.5(5) of the Insurance Act there is no liability for non-pecuniary loss unless the injured person died or sustained permanent serious disfigurement, or permanent serious impairment of an important physical, mental or psychological function. Not serious. Permanent and serious, of an important function.
Where the threshold is met, the award for non-pecuniary loss is then reduced by an amount prescribed by regulation. The deductible falls away above a prescribed level of damages, and it does not apply at all where the person died as a result of an incident after 31 August 2010.
Side by side
6 points of difference
The two are commonly confused, and the confusion costs people benefits they were entitled to while they waited for a court case that had not started.
The route
5 stages, each with its own clock
Each period and rule below is set by an Ontario statute and the provision is named beside it. The dollar figures attached to the deductible are prescribed by regulation and indexed, so they are not printed here.
The basic limitation period bars a proceeding after the second anniversary of the day the claim was discovered. Discovery has its own definition, including that a proceeding would be an appropriate means of remedying the loss.
A person is presumed to have known of the matters that start the clock on the day the act or omission took place, unless the contrary is proved. So the two years runs from the collision unless somebody can show otherwise, and that is an argument rather than an assumption.
Death, permanent serious disfigurement, or permanent serious impairment of an important physical, mental or psychological function. Whether an impairment meets it is proved with medical evidence assembled over time, which is one reason these claims are not settled early.
The court first assesses non-pecuniary damages as it would in any other case, then reduces the award by the prescribed amount. The deductible does not apply where damages exceed a prescribed level, and it does not apply where the person died.
Where the injured person's own fault contributed, the deductible is applied first and the reduced figure is then apportioned under section 3 of the Negligence Act. Doing it in the other order produces a materially different number.
Before the meeting
6 things to bring
Bring what you have and say what is missing. A meeting with the papers in front of it settles in one sitting what two telephone calls will not.
Our approach
The same four steps on every matter, whether it is a refusal at the Federal Court or a ticket at the Provincial Offences court.
Book a consultationWe take the full history and read the documents before offering an opinion. Most bad advice comes from acting on half the facts.
You get a candid read on strength, timeline and cost, including when the honest answer is that you do not need to hire anyone.
We prepare the application, the defence or the appeal properly the first time, because fixing a weak record later is harder and dearer.
You hear from us at each stage, and you hear what a wait actually means rather than a date chosen to sound better.
Reported decisions
7 allowed of 22 reported since 2023
Public judgments of the Federal Court with Kapil Rathod as counsel of record, each checkable by citation on the court's own site. The rest were dismissed and are listed with these ones.
Super visa, parents and grandparents
2026 FC 99Docket IMM-23381-24
Application allowedWork permit, Temporary Foreign Worker Program
2026 FC 105Docket IMM-18690-24
Application allowedTemporary resident visa
2026 FC 805Docket IMM-20802-24
Application allowedPermanent residence, Express Entry
2025 FC 275Docket IMM-1797-24
Application allowedWork permit, job offer
2024 FC 1928Docket IMM-6445-23
Application allowedStudy permit
2024 FC 1487Docket IMM-3700-23
Application allowedTemporary resident visa
2024 FC 1453Docket IMM-10337-23
Application allowedUpdates
1 note
Dated notes on the rule changes that reach this work. Each records what moved and when it took effect; this page carries the position now.
In force 1 July 2026
Two things happened to Ontario accident benefits on the same day. Four Parts of the schedule became optional, and the rule sending medical expenses to a workplace health plan first was reversed.
A car accident claim in Ontario is won on the benefits claim opened early and on medical evidence built over time, because the threshold and the deductible are applied to whatever the record ends up showing.
The limitation runs from the collision unless somebody can prove otherwise.
Common questions
7 answered here
Written to be read once and acted on rather than to be rung about. Each answer is complete where the law allows a complete answer.
Because it is taken off the top and it is large relative to a modest award. The court assesses non-pecuniary damages in the ordinary way and then reduces them by the prescribed amount. On a serious injury the deduction is a fraction of the award. On a modest one it can consume most of it.
Two features soften it. The deductible does not apply where the damages exceed a prescribed level, so above that point the full award stands. And under subsection 267.5(8.1.1) it does not apply at all to damages in respect of a person who died as a result of an incident after 31 August 2010.
The ordering point is the one that is missed most often. Paragraph 4 of subsection 267.5(7) requires that where the injured person's own fault contributed, the award is reduced by the deductible first and only then apportioned for contributory negligence under section 3 of the Negligence Act. Applying the two in the other order overstates the recovery, sometimes substantially.
The amounts themselves are prescribed by regulation and indexed, so they change. We have not printed them here for that reason, and any figure you read on a page that is not dated is worth checking before you rely on it.
The benefits claim should be opened immediately, and it is the step most often delayed while somebody waits to see whether they feel better. Benefits are payable whoever was at fault, they are claimed from your own insurer, and they fund the treatment that both makes you better and documents the injury.
Treatment records are the evidence. A person who stops attending because they are managing, or who never mentions the sleep problem or the anxiety to anyone, has a file that shows an injury resolving. The threshold is proved from what the records show over time.
The tort side needs the collision itself documented while it can be: the police report, the other driver's information, photographs of the vehicles and the scene, and the names of anybody who saw it. Fault is contested more often than people expect, and reconstructing it a year later is expensive.
None of this requires deciding whether to sue. It preserves the position while the injury declares itself.
Usually yes, on both tracks. Accident benefits are payable whoever caused the collision. On the tort side your damages are reduced to reflect your share under section 3 of the Negligence Act, and the ordering matters: paragraph 4 of subsection 267.5(7) applies the deductible first and apportions afterwards.
Two years from the day the claim was discovered, under section 4 of the Limitations Act, 2002, and section 5(2) presumes you discovered it on the day of the collision unless the contrary is proved. Accident benefits run on their own shorter timelines under the regulation, which is another reason to open that claim straight away.
It can. The threshold in subsection 267.5(5) refers to permanent serious impairment of an important physical, mental or psychological function. What it turns on is evidence of permanence and seriousness and of the importance of the function affected, built from treating records rather than asserted.
Because a prescribed deductible is taken off damages for non-pecuniary loss under subsection 267.5(7). It falls away where damages exceed a prescribed level, and it does not apply where the person died as a result of an incident after 31 August 2010. It is the reason a modest award can produce a small payment.
Speak to us first. Your obligations to your own insurer on the benefits claim are not the same as anything owed to the other driver's insurer, and the two are easy to confuse when both are telephoning in the same week.
Bring the police report and anything your insurer has sent. A car accident claim in Ontario starts with the benefits claim, and that should not wait.
