Statutory Accident Benefits Schedule

and Esther J. Roche Associate Thomson, Rogers   Changes to Section 3 of the Statutory Accident Benefits Schedule (“the SABS”) were introduced by the Government of Ontario on September 1, 2010. The changes require an insured to prove expenses have been incurred in order to receive attendant care, housekeeping, and med/rehab benefits. Section 3(7)(e) of the SABS states that in order for an expense to be “incurred”, and thus payable by the insurer, it must...

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On March 26, 2013, a decision was rendered by the Financial Services Commission of Ontario in the case of Lenworth Scarlett and Belair Insurance Company Inc. The applicant, Lenworth Scarlett, suffered soft tissue injuries, psychological injury and a TMJ injury arising from a motor vehicle accident which occurred on September 18, 2010. The decision of Arbitrator John Wilson is the first decision regarding the Minor Injury Guideline ("MIG") pursuant to the MIG which came into effect on September 1...

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Since the Sept. 1, 2010 re-introduction of the concept of "incurred" expenses and the qualifying term "economic loss" in the Statutory Accident Benefits Schedule, automobile insurers and accident victims have debated how the terms incurred and economic loss should be applied when paying for allowable goods or services, Toronto personal injury lawyer Stacey L. Stevens writes in Lawyers Weekly. "The debate is even more pronounced when the person providing the goods or services is a...

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Seriously injured accident benefit claimants in Ontario no longer are required to dispute a “catastrophic impairment” denial within two years from the date of the denial, according to a recent arbitration decision, Toronto plaintiff’s personal injury lawyer Darcy Merkur writes in Lawyers Weekly.  Read Lawyers Weekly “Because qualifying as having suffered a ‘catastrophic impairment’ allows an Ontario motor vehicle accident claimant to essentially...

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Just as a common understanding of the term “catastrophic impairment” has been reached, its definition is being completely reworked with an aim for a more accurate and objective system, Toronto plaintiff’s personal injury lawyer Darcy Merkur recently discussed at the Back to School with Thomson Rogers and Spinal Cord Injury Ontario Conference. “Changes to the definition of the term catastrophic impairment are coming,” Merkur, partner with Thomson Rogers,...

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A streamlined accident benefits dispute process is needed to improve the system surrounding recovery for claimants, Toronto plaintiff’s personal injury lawyer Darcy Merkur writes in Law Times.  Read Law Times “What we need is a better dispute process that’s more efficient and timely,” writes Merkur, partner with Thomson Rogers. “We need a system that’s accessible without delays.” In the article, Merkur describes this common scenario: A...

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On November 23, 2012, David MacDonald's presented at the Financial Services Commission of Ontario (FSCO). His seminar topic "Succeeding on Mediations and Arbitrations"is available for viewing.

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With the return of the definition for the term "incurred", Insurers have been applying various interpretations of this term in order to reduce or limit the amount of attendant care payable since September 1, 2010. Recently, FSCO released a decision with respect to an Insurer’s attempt to pay the attendant care benefit based on the minimum wage applicable to the Insured’s residency rather than the Form 1 hourly rate. While this decision relates to a collision, which...

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Thank you to everyone who attended Back to School with Thomson, Rogers and Spinal Cord Injury Ontario (formerly CPAO) – Managing your Injury to Independence. The conference took place on September 13, 2012, at the Delta Chelsea Hotel in Toronto. Your participation helped to make this conference a great success. For those of you who could not attend, the conference materials are now available online. Click here to view the 2012 Back to School conference materials. ** Stay tuned for videos of the...

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On September 13, 2012, Thomson, Rogers and the Canadian Paraplegic Association of Ontario, will be hosting the 4th Annual Back to School Conference. Conference Goals This conference aims to: Provide practical and useful rehabilitation and management strategies for those dealing with catastrophic injuries with a focus on spinal cord injuries; Provide up to date information to help manage spinal cord injuries in order to achieve independence; Provide a brief legal update of the anticipated changes to the...

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