Ontario accident benefits
are changing in 2026.

Ontario Regulation 383/24 amends the Statutory Accident Benefits Schedule (SABS, O. Reg. 34/10) to convert most no-fault accident benefits from default coverage into optional coverage. The change took effect on July 1, 2026 for substantive provisions; the regulation itself was filed October 11, 2024 and gazetted October 26, 2024. Four shifts inside that change deserve close attention.

1. Three benefits stay mandatory

Medical, rehabilitation, and attendant care continue to be included in every Ontario auto insurance policy. The standard limits cited across industry sources are unchanged: $3,500 under the Minor Injury Guideline, $65,000 combined for non-catastrophic impairments over five years, and $1,000,000 lifetime for catastrophic impairments. The $65,000 cap can be exhausted in 12 to 18 months at typical attendant-care-and-treatment burn rates, so even mandatory coverage may not be enough for a seriously injured claimant.

2. Nine benefits become optional

Income replacement, non-earner, caregiver, housekeeping, death, funeral, visitor expenses, lost educational expenses, and damage to personal items shift from default coverage to opt-in. Insurers must offer each (s. 4.1 SABS), and brokers must explain them at issuance and renewal (s. 28(1) SABS and the Ontario Court of Appeal duty-to-advise jurisprudence). New policies issued on or after July 1, 2026 default to mandatory minimums. Existing policies carry forward the same coverages at renewal unless the customer agrees in writing to change them.

3. The auto insurer becomes the first payer for medical care

Under the prior rule, an injured claimant had to exhaust private health and workplace benefits before the auto insurer paid for medical and rehabilitation. Effective July 1, 2026, the auto insurer pays first for medical and rehabilitation costs from an auto accident, except medication. OHIP continues to pay for hospital and physician services in the ordinary course. The change simplifies coordination but does not raise the dollar caps.

4. Eligibility for optional benefits narrows

This is the highest-impact change for vulnerable users. From July 1, 2026, the optional benefits — IRB, NEB, caregiver, housekeeping, death, funeral, visitor expenses, lost educational expenses, and damage to personal items — are restricted to:

• The named insured on the policy that purchased the optional coverage,
• The named insured's spouse,
• The named insured's and spouse's dependants,
• Persons specifically listed as drivers on the policy.

The mandatory benefits (medical, rehabilitation, attendant care) remain available to passengers, pedestrians, and cyclists struck by a vehicle, regardless of whose policy responds. The optional benefits do not. Industry guidance from Sonnet and Staebler indicates the eligibility narrowing applies on July 1, 2026 regardless of policy renewal date — a counter-intuitive effect that should be confirmed against the consolidated SABS.

The mandatory benefits — medical, rehabilitation, attendant care — continue to be available to anyone injured by a motor vehicle in Ontario, regardless of whether they own a car. The change is in the optional benefits, where eligibility narrows to the named insured, spouse, dependants, and listed drivers on the policy that purchased the coverage.

That narrowing has the largest practical effect on pedestrians, cyclists, e-bike riders, and passengers in someone else's vehicle. Worked scenarios make the difference concrete.

Pedestrian struck on a sidewalk

You are walking on a sidewalk in Toronto and a car mounts the curb and strikes you. The driver's auto policy is the responding policy. You can claim the mandatory medical, rehabilitation, and attendant care benefits. You can not claim IRB, NEB, caregiver, housekeeping, death, funeral, visitor expenses, lost educational expenses, or damage to personal items unless you fall within the driver's named-insured class — which, as a stranger, you do not.

Cyclist hit at an intersection

You are commuting by bicycle in Mississauga and a vehicle making a right turn strikes you. Same analysis. Mandatory benefits are available through the at-fault driver's policy. Optional benefits are not, unless you are the named insured or a household member of someone whose policy purchased the optional coverage and that policy responds.

Passenger in a friend's car

You are a passenger in a friend's car in Brampton and the driver loses control. The driver's auto policy responds. If you are listed as a driver on that policy, you reach the optional benefits the policy purchased. If you are a guest passenger and not listed, you do not reach the optional benefits — but mandatory benefits remain.

Child injured in a family vehicle vs. a neighbour's vehicle

A child injured in a parent's vehicle is generally a dependant under the parent's policy and reaches whatever optional benefits the parent purchased. A child injured in a neighbour's vehicle is a guest passenger, and unless the neighbour's policy lists the child or has a named-insured connection, only mandatory benefits respond.

These scenarios summarize the structure of the reform; the precise outcome depends on the responding policy, the OPCF 47R endorsement (if attached), and the facts. Speak to a lawyer before signing anything for an adjuster.

My existing policy renews after July 1 — what changes?

FSRA and the Insurance Bureau of Canada confirm that existing policies renew with the same coverages and limits as the expiring policy unless the customer agrees in writing to a change. So a policy effective in November 2025 with all benefits in place renews in November 2026 with the same coverages, even though the underlying regulation has shifted. The eligibility narrowing for optional benefits, however, applies on July 1, 2026 regardless of renewal date — meaning who can collect on the now-optional benefits changes by operation of regulation, not by the policy text.

I bought a new policy on or after July 1, 2026 — what is my default coverage?

New policies issued on or after July 1, 2026 default to the mandatory minimums: medical, rehabilitation, and attendant care. Every optional benefit must be elected and paid for. Insurance brokers and agents have a regulatory duty to explain the available optional benefits at issuance — failing to do so can expose the broker to professional negligence and errors-and-omissions claims.

My accident is days before or after the cutoff — which rules apply?

For accidents that occur before July 1, 2026 with claims continuing after, the pre-reform SABS architecture continues to apply for that loss. Claimants retain access to all benefits available at the time of the loss. For accidents on or after July 1, 2026, the post-reform framework applies — including the eligibility narrowing for optional benefits, even if the responding policy was effective before July 1, 2026.

I am a passenger or pedestrian — whose policy controls?

Priority of payment under section 268 of the Insurance Act is unchanged. The order is: your own auto policy, then a household member's policy, then the at-fault driver's policy, then the Motor Vehicle Accident Claims Fund. The OPCF 47R election lets the claimant write to switch to the optional-benefits policy when one is available. The effective date and OPCF 47R status of the responding policy controls which optional benefits the claimant can reach.

Section 28(1) of the SABS requires every insurer to offer the optional benefits. Brokers and agents have a parallel duty under common law to advise clients about available optional coverage at the time of issuance and renewal. The Ontario Court of Appeal's Zefferino line of cases makes clear that failure to advise is actionable, and brokers carry errors-and-omissions (E&O) insurance for exactly this exposure.

The 2026 reform amplifies the risk. With nine benefits moving from default to opt-in, every renewal becomes a documentation moment. Industry sources warn brokers to "paper their files" — confirming in writing what was offered, what was declined, and on what basis. Where a renewal goes through without that documentation and a claimant later suffers a serious injury without optional coverage, an E&O claim against the broker may be viable.

Whether a particular case has merit is fact-specific. Factors include the broker's documentation, prior dealings with the client, the timing of the renewal, and whether the client signed an acknowledgement of declined benefits. UL Lawyers reviews broker negligence files alongside the underlying accident benefits claim where the facts warrant.