Accepting Accident Benefits Offer: What You Should Do Before You Accept Your Settlement Offer

If you’ve been injured in a car accident in Ontario and received a settlement offer from an insurance company, don’t rush to accept it. 

Accident benefits can help cover lost income, medical treatment, and other costs, but once you sign, you may lose the right to claim anything further.

Before you agree to any settlement, it’s critical to understand what you’re giving up, what your injuries are truly worth, and whether the offer reflects your long-term needs. 

As experienced injury lawyers who frequently fight for victims against insurance companies, this guide will walk you through everything you need to know about accepting an accident benefits offer in Ontario.

What Is an Accident Benefits Settlement in Ontario?

Accident benefits (often called AB claims) are part of Ontario’s no-fault insurance system. If you’re hurt in a motor vehicle accident, you’re entitled to these benefits regardless of who caused the crash.

An accident benefits settlement is a financial offer from your insurer to close out your claim, often in a lump-sum payment. Once accepted, you usually give up the right to make any further claims related to the same accident. This is not the same as suing the at-fault driver. It’s part of your insurance policy’s Statutory Accident Benefits Schedule (SABS).

Types of Accident Benefit Claims You Might Be Offered

An accident benefits settlement may include compensation for several categories. These are often bundled into one lump-sum proposal, but it’s important to know what you’re being paid for.

Here are the main types:

• Medical and Rehabilitation Benefits: Covers treatment and therapy not paid by OHIP.
• Income Replacement Benefits: Up to 70% of your gross income, max $400/week unless optional coverage applies.
• Non-Earner Benefits: For people who can’t return to normal life but weren’t working at the time of the accident.
• Attendant Care Benefits: Covers in-home personal support or nursing assistance.
• Housekeeping and Home Maintenance: Available only in catastrophic cases unless you have optional coverage.

Each benefit has its own eligibility rules and limits under Ontario personal injury law. 

“Many insurers try to settle before you fully understand which benefits you qualify for. These offers are typically lower than what you could otherwise receive.”

Should You Accept the First Settlement Offer?

In most cases, no;  at least not without having it reviewed by a personal injury lawyer.

Insurance companies often make low initial offers, especially early in your recovery. Their goal is to reduce long-term payouts, not to ensure you receive everything you’re entitled to. 

Like many businesses they care more about their profits.

Quick Tip: Never accept an offer unless you’ve recovered fully or have a clear prognosis from a licensed medical professional.

Even then, it’s best to call an injury lawyer and get a quick free consultation before you sign anything.

Some reasons to wait:

• Your injuries may worsen or require long-term treatment and general damages apply
• Your entitlement may increase if your condition becomes catastrophic
• You could lose out on income replacement or medical coverage

Questions to Ask Before Accepting a Settlement Offer

Before signing anything, ask yourself:

• Have I fully healed, or is my recovery still ongoing?
• Has a medical expert assessed my condition?
• Have I considered long-term needs like rehab or personal support?
• Is the offer broken down by benefit type, or is it a vague lump sum?
• Has an Ontario personal injury lawyer reviewed it?

If you answered “no” to any of the above, you should not accept the settlement yet.

How Insurers Calculate Accident Benefits in Ontario

Accident benefits settlements are calculated based on your:

• Level of impairment
• Medical prognosis
• Income level
• Care needs (e.g., attendant care or rehab)
• Whether your injuries are classified as catastrophic impairment or non-catastrophic

They may also account for how long you’ve received benefits and what your expected future needs are. 

However, many insurers lowball these estimates unless pushed with medical documentation and legal pressure.

Note: For many non-catastrophic injuries, initial offers might only range from a few thousand to low tens of thousands — far less than your total possible entitlement over time.

Catastrophic vs. Non-Catastrophic Injury Settlements

The amount you receive depends heavily on whether your injury is classified as catastrophic.

Non-Catastrophic Injuries:

• Lower benefit caps (e.g., $65,000 combined for medical and attendant care)
• Shorter duration of payments

Catastrophic Injuries:

• Up to $1,000,000 in combined medical, rehab, and attendant care
• Lifelong support available

The definition of “catastrophic” is technical. It includes brain injuries, paralysis, loss of limbs, and severe mental or behavioral disorders.

HIGHLIGHT Pastore v. Aviva Canada Inc., 2012 ONCA 642

Source

The Ontario Court of Appeal confirmed that psychological impairments can be catastrophic even if physical function isn’t completely lost.

This means many injuries that insurers treat as minor could qualify for major benefits with the right evidence.

Common Tactics Used by Insurance Companies

Insurance companies are not on your side. They use several tactics to pressure claimants into settling early or for less:

• Time Pressure: “This offer expires in 5 days.”
• Medical Undervaluation: Relying on insurer-chosen doctors who downplay injuries.
• Vague Lump Sums: Offers that don’t explain what benefits you’re giving up.
• Friendly Tone: Adjusters may sound helpful, but their goal is cost control and profits..

Watch for red flags like:

• Refusing to provide a breakdown
• Suggesting you don’t need a lawyer
• Pushing for a signature before you’ve seen a specialist

Why You Should Never Sign a Release Without Legal Advice

When you accept a settlement, you’ll usually be asked to sign a release form.

This is a legal document that ends your accident benefits claim. Once signed, you generally can’t go back, even if your injuries worsen or new symptoms appear.

What you give up:

• Further medical, rehab, or income support
• Any review or reassessment of your condition
• The chance to seek additional help if your situation deteriorates

An injury lawyer can help you delay signing until your condition stabilizes or negotiate a better offer with future needs included.

How a Personal Injury Lawyer Helps Protect Your Rights

A qualified injury lawyer ensures you get the full value of your claim, especially for serious or long-term injuries.

Here’s how they help:

• Arrange independent medical evaluations to challenge insurer assessments
• Identify missing benefit categories in the offer
• Negotiate higher payouts using proper documentation
• Represent you at LAT (License Appeal Tribunal) hearings if necessary

You only get one chance to settle. A lawyer ensures you’re not leaving money or care behind.

What Happens If You Reject a Settlement Offer?

Rejecting a first offer doesn’t mean you lose your claim.

If you say no:

• The insurer may return with a better offer
• You can continue to receive ongoing benefits
• You can challenge the insurer’s position at the LAT Tribunal

Just be aware: insurers may slow down communication or pressure you to settle “or else.” 

Don’t give in. 

As long as your claim is valid and supported by documentation, they remain obligated to pay ongoing eligible benefits.

How Long Does It Take to Settle an Accident Benefits Claim in Ontario?

There’s no fixed timeline — it depends on:

• How severe your injuries are
• How cooperative the insurer is
• Whether your condition is stable enough for a final settlement
• If there are disputes requiring mediation or a hearing

Ontario accident benefits settlements can take months to several years.

Some settle faster when injuries are clearly non-catastrophic. Others take longer if the injury classification is in dispute or the insurer is uncooperative.

Key Takeaways Before Accepting a Settlement Offer From an Insurer

Before you sign anything:

• Make sure your medical treatment is complete or you’ve reached maximum recovery
• Understand which benefits are included (and which are left out)
• Review the offer with an experienced lawyer
• Know whether your injury could be reclassified as catastrophic
• Don’t rush; even if they pressure you

Talk to a Lawyer Before You Accept Any Settlement

Accident benefits can be worth thousands, even hundreds of thousands, depending on your injury. Once you accept an offer, it’s almost impossible to go back.

At WVGB Law Group, we help people across Ontario understand their rights and fight for what they deserve. Before you accept a settlement, speak with our team of Ottawa car accident lawyers.

There’s no fee to talk, and no obligation to hire us. Just straight answers so you can make the right decision.

Like many other injury law firms, we work on a contingency-fee basis so you only pay if we help you recover compensation.