Criminal convictions

Criminal Conviction and Accident Benefits

Criminal convictions significantly impact Statutory Accident Benefits.  

Occasionally an insured is involved in a serious motor vehicle accident and subsequently charged with a criminal offence such as a drinking and driving offence.  Being convicted of the drinking and driving offence for example will reduce the benefits available to the injured operator.  

Section 30(2) of Part IX of the Statutory Benefits Schedule states:

The insurer is not required to pay an income replacement benefit, a non earner benefit or a benefit under section 20-21 of the the Schedule.  Section 20-21 cover lost educated expenses, visitor expenses and housekeeping and home maintenance expenses.

A person convicted of a criminal offence will not be eligible to receive income replacement benefits.  Income replacement benefits are the benefits that an insured may be entitled to receive should he or she not be able to return to their employment due to their accident related impairment.  

A person convicted of a criminal offence will not be eligible to receive non earner benefits.  These are benefits that are payable to an insured if the insured person suffers a complete inability to carry on a normal life.

A person convicted of a criminal offence will not be eligible to receive lost educational expenses up to $15,000.

A person convicted of a criminal offence will not be eligible to receive expenses for visitor such as parents, grandparents, children, spouse and brothers and sisters.  These benefits are payable until 104 weeks of the accident but this does not apply to catastrophically impaired individuals.

A person convicted of a criminal offence will not be eligible to receive housekeeping and home maintenance expenses.  These are benefits payable to incurred expenses by or on behalf of the insured person where the insured suffers an impairment that results in a substantial inability to perform these tasks that he or she normally performed before the accident.  This amount would not exceed $100 a week and is payable to 104 weeks after the onset of the disability with the exception for catastrophically impaired persons.  

Those injured individuals who have criminal charges have a real and substantial interest to not only protect their criminal records but also to protect their accident benefit rights.  If they are able to prevail in criminal court then the benefits ought to be paid by the insurer.