Access to Accident Benefits under Alberta’s New “Care-First” Auto Insurance System

Kelly Tang

If you are injured in a motor vehicle accident in Alberta, you are likely entitled to no-fault accident benefits that provide coverage for medical treatment as well as disability payments if you are unable to work due to your injuries. These benefits are available to you regardless of who caused the accident and are found at Section B of your standard auto insurance policy (for more information about accident benefits, see our blog posts on this topic found here and here).

In addition to accident benefits, under Alberta’s current auto insurance system, you are entitled to seek compensation against an at-fault driver through a lawsuit for pain and suffering, income loss, future care costs, and reimbursement for out-of-pocket expenses you incurred due to the accident. This court-based system, also known as the tort-based system, is being overhauled by the province’s new Automobile Insurance Act, which will shift the current compensation model to a no-fault system, severely restricting an injured person’s ability to sue for compensation (for a deep dive into the new Automobile Insurance Act, see our blog post found here).

Accident benefits are already administered on a no-fault basis, but the Government of Alberta promises that the new “care-first” system will provide Albertans with access to increased and more comprehensive benefits. Unfortunately, based on a new case from the Saskatchewan Court of Appeal, the new Automobile Insurance Act may have the opposite effect, making it more difficult for injured people to access accident benefits.

In Umpherville v Saskatchewan Government Insurance, 2025 SKCA 69, the Court addressed how an injured person’s entitlement to accident benefits changed under Saskatchewan’s no-fault auto insurance provisions (Saskatchewan has a hybrid auto insurance system where individuals can choose to have no-fault coverage or tort-based coverage, but this case dealt with a no-fault policy). Under the tort-based system, an injured person was entitled to benefits if they could satisfy the following test for causation:

1. They were injured in an accident that resulted from an ordinary and well-known use of a vehicle; and
2. If there was some connection, even indirectly, between the person’s injuries and the use of the vehicle.

Under the no-fault system, however, the second condition noted above was modified to:

1. They were injured in an accident that resulted from an ordinary and well-known use of a vehicle; and
2. If there was a direct or consequential connection between the person’s injuries and the use of the vehicle.

This change clearly serves to narrow and limit who is entitled to accident benefits. The Court held that the modification to the causation test was necessary because of certain wording used in the no-fault provisions of Saskatchewan’s Automobile Accident Insurance Act, wording that is now replicated in Alberta’s Automobile Insurance Act. This means that Albertans may also be similarly limited in accessing accident benefits once the new “care-first”, no fault auto insurance system is put into place.