OPCF 47R Explained: Ontario SABS Changes and the 2026 Reforms

FSRA has released the new OPCF 47R Ontario accident benefits endorsement, named Optional accident benefits coverage & priority of payment. It comes into effect on July 1, 2026 and replaces the old OPCF 47 endorsement. What looks like a minor edit actually fixes a technical trap in the priority system and lines up with the 2026 SABS overhaul.

Ontario Accident Benefits Changes in 2026: More Coverage Becomes Optional

Optional benefits aren’t new. But the number of optional benefits available has increased significantly over the years. For example, before the 2010 SABS overhaul, most benefits under the Schedule were mandatory and available to all insureds who met the entitlement criteria. Consequently, the number of policies containing optional benefits was relatively small. After 2010, mandatory benefits such as housekeeping and caregiver benefits became optional for non-catastrophic claims. In 2016, the mandatory minimum limits for non-CAT medical/rehabilitation and attendant care benefits were reduced. Insureds wanting to increase those new limits could do so by purchasing optional benefits.

As of July 1, 2026, Ontario’s SABS landscape changes significantly again, favouring optional over mandatory benefits. These changes are part of the wider July 2026 SABS reforms, which shift many benefits from mandatory to optional under Ontario’s auto insurance system:

• Medical/rehabilitation and attendant care benefits remain mandatory.
• The other benefits/coverage become optional (income replacement, non-earner, death, etc).

The Legislature frames this overhaul as giving consumers flexibility to tailor coverage to needs and budget. In practice, I expect that more insureds will be purchasing optional benefits to maintain the same coverages they have had for years. If so, the number of policies that contain optional benefits will increase.

What Was the Purpose of the Original OPCF 47 Endorsement?

Section 268 (2) of Ontario’s Insurance Act contains a priority pecking order that determines which insurer is responsible and required to pay accident benefits to a claimant after a motor vehicle accident:

1. The claimant first has recourse against their own insurer as a named insured, spouse of a named insured, dependant of a named insured/spouse, or listed driver.
2. If they don’t have one, they next have recourse against the insurer of the vehicle they were in, or in the case of a non-occupant, the insurer of the vehicle that struck them.
3. If there is still no insurance available (for example, the vehicle was uninsured), the claimant next has recourse against the insurer of any other vehicle involved in the accident.
4. If there is still no insurance available, the claimant finally has recourse against the Motor Vehicle Accident Claims Fund.

Recourse under the first and third levels can trigger coverage under more than one policy. In these scenarios, sections 268 (4)-(5.2) provide tie-breaking provisions between two or more “equally ranked” insurers. In most situations, the claimant has the absolute discretion to choose to which insurer they are claiming recourse. Once chosen, that insurer has priority. However, if a person is a named insured, spouse, or dependant under more than one policy, and the person was an occupant of a vehicle that insured them as such, they must claim benefits from that insurer.

The original OPCF 47 was created to fix a very specific priority problem in this priority scheme when an insured claimant had purchased optional benefits from an insurer that did not have priority over their claim. For example:

• Suppose a named insured bought optional income replacement benefits on their own auto policy, but they were in their spouse’s vehicle at the time of an accident. Section 268(5.2) would make their spouse’s policy the priority payor.
• If the claimant’s spouse’s policy did not contain optional benefits, the claimant would be unable to access the optional benefits they purchased from their own insurer.
• Even if the claimant applied to their insurer for those benefits, their insurer could pursue a successful priority dispute against the spouse’s insurer, pursuant to section 268(5.2) of the Act and the claim would transfer to the policy without optional benefits.

The OPCF 47 addressed this problem by containing the following provision:

If optional statutory accident benefits are purchased and are applicable to a person under this policy, and the person claims SABS under this policy as a result of an accident and agrees not to make a claim for SABS under another policy, we agree that we will not deny the claim, for both mandatory and optional statutory accident benefits coverage purchased, on the basis that the priority of payment rules in Section 268 of the Insurance Act may require that the person claim SABS under another insurance policy. [emphasis added]

Essentially, the OPCF 47 made optional benefits portable and allowed an insured who purchased them to access them regardless of the priority rules under section 268(2) of the Insurance Act. That said, the phrase “and agrees not to make a claim for SABS under another policy” left room for disputes when someone had already applied to another insurer (even uninformed applications) and then tried to pivot back to the policy that carried the optional limits. Sometimes those claimants were barred from submitting their application to the optional carrier because they had already made “a claim for SABS under another policy”.

OPCF 47R vs OPCF 47: Key Changes and Why They Matter

The new OPCF 47R replaces the OPCF 47 language:

We also agree not to rely on the priority of payment rules in Section 268 of the Insurance Act. This means that the persons listed above will not be prevented from making a claim and we agree that we will not deny the claim for both mandatory and optional accident benefits purchased by the operation of Section 268, if they agree that they intend to proceed with the claim for accident benefits under this policy and forego the right to maintain any claim for accident benefits under another policy. [emphasis added]

The new wording explicitly lets the insured (and other covered persons) claim both mandatory and optional SABS under the policy that sold the optionals if they agree to forgo pursuing benefits under any other policy. Crucially, the language focuses on the person agreeing to proceed under this policy and to forgo the right to maintain any claim under another policy, rather than being disqualified simply because they once ‘applied elsewhere.’ In other words, an insured who applied first to “the wrong insurer” can apply to their optional benefits carrier without forfeiting their entitlement to the optional benefits they purchased from that insurer.

The OPCF 47R clarifies any ambiguity in the old wording and solidifies the portability of optional benefits.

Finally, the OPCF 47R contains a handy checklist/table outlining the many optional benefits that are available under the 2026 SABS, with examples.

OPCF 47R SABS Claims Handling: Guidance for Insurers

Insurers who receive applications for benefits under a policy with optional benefits should adopt claims handling protocols to minimize risks:

1. Intake scripts: Update first notice of loss (FNOL) and adjuster policies so staff don’t bounce claimants away reflexively on priority grounds when optionals were purchased here.
2. Election language: Get a clean, written election where the insured agrees to proceed under the policy with the optionals and forgoes any SABS claim under other policies.
3. If the insured initially applied to another insurer, proactively notify that carrier once an election under 47R is signed. This helps cut off possible reimbursement disputes before they escalate and also prevents double recovery.

OPCF 47R and Priority Disputes: What Insurers Should Know

If an insured claims first from an insurer without optional benefits and then decides to claim from the insurer with optional benefits (and forgo their right to claim from the first insurer), could the first insurer claim reimbursement from the optional benefits insurer for the standard benefits they paid?

Current caselaw suggests that the standard carrier cannot maintain a priority dispute against the optional carrier where the insured applied to the standard carrier first. One such case (that I am arguing) is under appeal and is scheduled to be heard in October 2025. The outcome might provide an answer for us.

Until the Court clarifies this issue, expect disputes in scenarios where the standard carrier has already paid before the insured elects under 47R.

Stay tuned.

Agent and Broker Duties: Explaining Optional Accident Benefits in 2026

Section 28(1) of the Schedule states, “[e]very insurer shall offer the following optional benefits:…”[emphasis added] The Ontario Court of Appeal has confirmed that agents and brokers must advise their clients of the optional benefits that are available under the Schedule and give them a chance to buy them. Failure to do so is a breach of their applicable standard of care and could lead to E+O claims.

With more mandatory accident benefits becoming optional, agents and brokers face additional challenges. They must explain optional accident benefits to clients clearly and make sure they provide plain language descriptions/examples to their clients. Most importantly, agents and brokers need to make sure their clients understand that many of their familiar benefits are becoming optional.

Agents and brokers should consider the following when reviewing policies with their clients before their post-July 2026 renewals:

• Explain clearly and concisely what each optional benefit covers.
• Review and highlight the July 2026 changes so the insured can appreciate what mandatory benefits are becoming optional.
• Consider the insured’s family situation, income, and support needs when reviewing the standard and optional benefits available.
• Keep records of communications/discussions/explanations. Document everything.
• Give clients written summaries of their elections. It’s not just good service. It’s also your best defense in an E&O claim.

OPCF 47R Takeaways: Preparing for Ontario’s 2026 SABS Changes

The OPCF 47R clarifies the portability of optional benefits and removes a priority-based technicality that could unfairly block an insured’s access to those purchased benefits after a misdirected first application. That clarity will matter even more once most SABS coverages become optional on July 1, 2026.

For agents and brokers, the upcoming changes create good opportunity to review current practices and protocols, not just to enhance customer service but also to minimize risk and E+O exposures.

The new OPCF 47R is published by FSRA. It’s a small form change now, but it will matter in a big way once July 1, 2026 arrives. Have a look at the official OPCF 47R Ontario Accident Benefits Endorsement (PDF, FSRA 2026).