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Housekeeping and Maintenance Benefit Provides Compensation to Injury Victims Unable to Perform Usual Household Duties
Question: What benefits does the Statutory Accident Benefits Schedule provide for accident victims unable to perform household chores?
Answer: The Statutory Accident Benefits Schedule offers up to $100 per week to assist with housekeeping and maintenance expenses for catastrophically injured accident victims who can no longer manage these tasks due to their injuries, ensuring essential support during difficult times.
When An Accident Victim Is Unable to Do Household Chores, What Happens?
The Statutory Accident Benefits Schedule Within An Automobile Insurance Policy Provides a Limited Coverage to Pay the Cost of Hiring a Housekeeper On Behalf of a Catastrophically Injured Accident Victim.
Understanding the Housekeeping and Maintenance Expense Benefit Including Coverage Qualifications and Limitations
The housekeeping benefit component of the Statutory Accident Benefits Schedule, O. Reg. 34/10, provides compensation for the cost of hiring assistance with housekeeping and maintenance, such as vacuuming, lawn mowing, clearing of eavestroughs, raking of leaves, snow shoveling, among other tasks, of the principal residence of a catastrophically injured accident victim who is unable to perform such duties because of the injuries directly suffered by the accident victim.
The Law
The housekeeping benefit as prescribed within the Statutory Accident Benefits Schedule is a mandatory automobile insurance coverage and is subject to strict eligibility criteria as well as a nominal sum as coverage whereas the Statutory Accident Benefits Schedule states:
Housekeeping and home maintenance
23. The insurer shall pay up to $100 per week for reasonable and necessary additional expenses incurred by or on behalf of an insured person as a result of an accident for housekeeping and home maintenance services if, as a result of the accident, the insured person sustains a catastrophic impairment that results in a substantial inability to perform the housekeeping and home maintenance services that he or she normally performed before the accident.
Interestingly, the housekeeping benefit is available only for the hiring of a person genuinely in the business of providing the housekeeping service hired or for reimbursing another person, such as a family member who steps up to perform housekeeping duties and as a result of doing so suffers a correspondence loss.
This requirement of hiring a genuine housekeeper or maintenance service, or for reimbursing a friend or family member who suffers a corresponding loss, appears as intended to prevent an accident victim from using the housekeeping benefit as a means to provide supplemental income for a friend or family member. Essentially, whereas the coverage is available only as a reimbursement to a corresponding loss of income, such prevents any advantage from being gained and thereby thwarts any ability to misuse the coverage.
These criteria were confirmed within the case of Micanovic v. Intact Insurance, 2022 ONSC 1566, wherein it was said:
[4] Under s. 23 of the Statutory Accident Benefits Schedule – Effective September 1, 2020, O.Reg. 34/10 (the “Schedule”), the Appellant is entitled to claim reasonable and necessary additional expenses incurred by him for such services to the extent he can demonstrate a substantial inability to perform housekeeping and home maintenance services that he normally performed before the accident.
[5] Section 3(7)(e) of the Schedule provides that, to be “incurred” in respect of any services, the following requirement must be satisfied:
3(7) For the purposes of this Regulation, …
(e) subject to subsection (8), an expense in respect of goods or services referred to in this Regulation is not incurred by an insured person unless, …
(iii) the person who provided the goods or services,
(A) did so in the course of the employment, occupation or profession in which he or she would ordinarily have been engaged, but for the accident, or
(B) sustained an economic loss as a result of providing the goods or services to the insured person;
Summary Comment
The Statutory Accident Benefits Schedule as contained within policies of automobile insurance includes coverage for the cost of hiring a housekeeping or maintenance service. The coverage is limited to one hundred ($100.00) dollars per week. The coverage is also available only to pay the cost of hiring a genuine housekeeping service or for reimbursing a friend or family member who suffers a corresponding loss of income. The coverage is unavailable to provide a bonus source of income for a friend or family member.
