Do I Qualify for Attendant Care Benefits After an Injury in Ontario?

basic needs from a personal aidIf you have been seriously injured in an accident in Ontario, you may qualify for attendant care benefits, which are intended to assist you in improving your health and recovery.

However, having expenses covered to hire someone to help care for you after an injury is only offered in certain cases. You must be able to show reasonable and necessary cause for requesting these benefits.

Greg Monforton & Partners further discuss what else is covered by attendant care benefits and the eligibility requirements to apply for these benefits. An initial consultation to learn more about your rights with member of our legal team is complimentary and comes with no obligation to hire our firm.

Understanding Attendant Care Benefits

Attendant care benefits are available under the Statutory Accident Benefits Schedule, O. Reg. 34/10 (SABS). SABS is a form of no fault insurance coverage in Ontario. It is also mandatory and included in all standard auto insurance policies across the province.

These benefits allow injured accident victims to be compensated for reasonable and necessary expenses to hire in-home care, such as a personal aide or attendant to help them with their daily responsibilities.

This could include:

  • Bathing
  • Grooming
  • Dressing
  • Cooking
  • Feeding
  • Moving about

Other services, such as housekeeping and performing errands, may also be available. Attendant care benefits could also help pay for care in a long-term care facility or home not covered by the Ontario Health Insurance Plan. These benefits help cover expenses needed for comfortable personal care.  

How Much Are Attendant Care Benefits?

The amount you could receive in attendant care benefits will depend on your situation. The nature and extent of your injury is of utmost importance.

In a standard auto insurance policy in Ontario, the maximum attendant care benefit that can be paid is up to $3,000 per month if the accident victim sustained a serious, but non-catastrophic injury. If the accident victim did sustain a catastrophic injury, the maximum could be up to $6,000 per month.

It is important to note that any policyholder has the option to purchase additional coverage if needed.

Injury Victims Eligible for These Benefits

You may be eligible to receive attendant care benefits as long as your injuries are deemed non-minor or catastrophic. Minor injuries do not qualify.

To apply for these benefits, a registered nurse or occupational therapist needs to determine if such services are necessary and how much care is required. He or she will need to complete an Assessment of Attendant Care Needs (also known as Form 1), as verification for your insurance company.

Your insurance company will then have 10 business days to respond. If they determine your expenses are reasonable and necessary, payments must be made within 30 days from the date of the invoice.

A Windsor personal injury lawyer from our firm is prepared to guide you through the entire claims process for attendant care benefits. This includes making sure that your injury is well documented by medical records and reports, and that you have followed through with any medical or insurer’s exams.

Witness statements and testimony from those who knew you before and after the accident that could offer details about your abilities may also be collected to help support your need for attendant care.

Time Limit for Attendant Care Benefits

Generally, claims for these benefits must be made to your insurance company within seven days. You need to submit your Application for Accident Benefits within 30 days of when the request was received. Payment will not be issued until Form 1 has been completed and filed with the insurance company.

Schedule a Free Consultation Today

To determine your eligibility for attendant care benefits after being injured in an accident, do not hesitate to contact our lawyers at Greg Monforton & Partners. We have represented many personal injury victims involved in car accidents, bicycle accidents, trucks accidents and more.

Set up a free, no-obligation consultation today. Since our firm works on a contingency fee basis, there are zero upfront costs for our services. We only get paid if we help you obtain the benefits you need.

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