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Posts Categorized: accident benefits

$50,000 for a Broken Ankle

The Issue

A simple case which values a nasty broken ankle for a (then) 34 year old man injured in a bar fight, which required surgery and the installation of a metal plate and numerous screws to set his injured ankle.

Why This Matters

This is one simple illustration of the type of factors considered by a Court when assessing the pain and suffering damages claims of a plaintiff.

Legal Speak – all cases are different, so you cannot apply a formula to any one injury. … Continue Reading

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Changes to the Car Accident Treatment System > May Reduce Consumer Care Options

The Issue

Premised on the need to fight fraud, Ontario Regulation 194/11 is being introduced effective July 1, 2011.
The Effect

Car insurers can ask for backgfound information and identity confirmation for all service providers who seek to provide treatment to people involved in car accidents.

Car insurers can also request copies (or inspect originals) of all supporting documentation relating to treatment plans which are submitted on behalf of people hurt in car accidents.

Payment for treatment is not required until all of this information is provided.… Continue Reading

Expert Reports Can be Claimed Against Accident Benefits Carrier, Even if Used in Tort

The Background:  When injured in an Ontario car accident, plaintiffs suing in tort (i..e against the other driver) also have an ongoing claim with their Accident Benefits carrier, which very often turns into a dispute claim.

The Issue:  Can the cost of an expert report be claimed against the Accident Benefits carrier, even when the report is partially used in the tort lawsuit?

Why This Matters:  Plaintiffs incur significant expenses (disbursements) when prosecuting their tort lawsuit and/or accident benefits disputes.  It is important to seek re-imbursement whenever possible. … Continue Reading

Priority Disputes, Loss Transfer > Private Arbitrations Between Insurers to be Publicly Recorded by FSCO

As part of the ongoing changes to the auto insurance regime in Ontario, starting in September, 2010, FSCO (Financial Services Commission of Ontario) is requiring that insurers send their private arbitration decisions to FSCO, who will then post them to a publicly available database of FSCO decisions.

The FSCO bulletin in October, 2010 setting out the procedure is found here.

This is an important change to a remaining significant aspect of auto insurance law, which is long overdue.

Before the September, 2010 changes, absent a central database to record decisions regarding these inter-company disputes, no doubt there were numerous issues litigated and re-litigated, among different insurers, on the basis that there was no precedent to provide guidance to the disputing parties. … Continue Reading

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Catastrophic Impairment Designation Set to Undergo Changes

In November, 2010, FSCO (Financial Services Commission of Ontario) announced that it was Forming the “catastrophic impairment expert panel” to study and make recommendations on definition of catastrophic impairment.

The 8 person catastrophic impairment expert panel will post their preliminary report on the issue on April 11, 2011.

The panel will then hold an informational session on April 28, 2011, as well as receiving feedback in writing.

Written feedback is accepted until May 13, 2011.
Gregory Chang
Toronto Insurance Lawyer… Continue Reading

Double Recovery for One Accident? How About a Double Deduction against your Damages? A Plaintiff’s Perspective.

After a car accident in Ontario, you are usually entitled to receive some Accident Benefits, regardless of who caused the accident.

One of the decisions that many injured people will make, when applying to Accident Benefits, is whether to receive income replacement benefits (“IRB”) or caregiver benefits.

What happens if you choose caregiver benefits, when you could have equally qualified for IRB, and then you go on to commence a tort lawsuit arising from the same accident?

If you claim past or future income loss in the tort lawsuit (or even loss of earning capacity), will you be penalized for failing to have chosen IRB benefits instead of caregiver benefits?… Continue Reading