Ontario Statutory Accident Benefits (SABS) coverage changed on July 1, 2026.
About Recent Changes
The SABS is a regulation under Ontario law (O. Reg. 34/10) that specifies the benefits payable to insured persons following an automobile accident, independent of liability coverage.
As of July 2026, there were changes to the Statutory Accident Benefits Schedule (SABS).
Specifically, medical, rehabilitation and attendant care benefits will remain mandatory, while all other accident benefits coverage is optional.
OPA raised concerns with Hon. Peter Bethlenfalvy, Minister of Finance in our September 2024 letter, about the proposal to reduce mandatory coverage to only medical, rehabilitation, and attendant care benefits.
OPA has received questions regarding the changes, and we aim to address them in this FAQ.
Top 10 FAQs
1. Are physiotherapists allowed to charge fees higher than what is covered in the Professional Services Guideline?
Yes. The SABS and the Professional Services Guideline (PSG) set the maximum payable amounts for the auto insurance companies, but they do not control or limit fees charged by physiotherapists. Physiotherapists can charge above and beyond what is payable from the auto insurer.
2. Can patients still use their extended health benefits for MVA-related physiotherapy services?
Yes. Patients may choose to use their extended health benefits to cover eligible remaining balances after the automobile insurer has paid, including co-payments resulting from fees above the amount covered by auto insurance.
3. Are patients required to use their extended health benefits?
No. Using extended health benefits is optional. Patients can choose whether they want to use their extended health coverage for their MVA-related physiotherapy services.
4. What happens if a patient chooses not to use their extended health benefits?
If a patient declines to use their extended health benefits, they may be responsible for any remaining balance owing after the automobile insurer has paid, in accordance with the clinic’s fee agreement and applicable requirements.
5. Does a patient need to provide consent before extended health benefits are used?
Yes. Patients must consent to the use of their extended health benefits for MVA-related services and provide the necessary information required by their insurer.
6. Will extended health insurers cover the full difference between the clinic’s fee and the automobile insurer payment?
Not necessarily. Coverage depends on the patient’s individual extended health plan, including benefit limits, deductibles, co-insurance amounts, and insurer requirements.
7. Do all extended health insurers have the same process for adjudicating these claims?
No. Extended health insurers do not have a standardized approach to processing co-payment submissions from an auto claim. Requirements may vary, including whether a referral is needed, whether direct billing is available, whether accident-related services must be identified, and whether other coverage must be coordinated first.
8. Has FSRA provided guidance on coordination of benefits between automobile insurers and extended health insurers?
Currently, OPA is not aware of any FSRA intention to establish guidance documents or standardized processes for coordination of benefits between automobile insurers and extended health insurers. Coordination of benefits is managed by individual extended health insurers and may differ between plans.
9. How should clinics handle remaining balances after automobile insurance has been paid?
Clinics should continue to follow appropriate billing practices and the requirements of the patient’s extended health insurer, where applicable. If extended health benefits are not used or do not fully cover the remaining balance, the patient may be responsible for any outstanding amount in accordance with the clinic’s fee agreement and applicable requirements.
10. Do these changes affect how clinics submit treatment plans or invoices to automobile insurers?
No. The requirements and processes for submitting documentation and billing automobile insurers remain the same. Clinics should continue to follow the applicable SABS and insurer processes.
OPA will continue to monitor developments related to MVA billing and provide updates as further information becomes available.
