What's News Blog
By Darcy Merkur
A recent Financial Services Commission of Ontario arbitration decision has confirmed that any financial outlay by a service provider can qualify as an economic loss within the meaning of the definition of "incurred" in subsection 3(7)(e) of the Ontario statutory accident benefits schedule.
To qualify for the weekly non-earner benefit under the Statutory Accident Benefits Schedule (SABS), an insured person must meet the rigorous “complete inability to carry on a normal life” test (the “complete inability test”). Accident victims who do not work at the time of the accident (and do not qualify for an income replacement benefit) will need to satisfy this test in order to qualify for a weekly benefit.
On January 4, 2013, I discussed two key decisions requiring an Accident Benefit Insurer to pay its insured an attendant care benefit based on a Form 1 Assessment of Attendant Care and not the costs associated with obtaining this service or the economic loss suffered by the care provider in doing so.
Ian W. K. Furlong
Courts and Arbitrators have helped us to understand how the definition of catastrophic impairment may apply to individuals who suffer very severe injuries in motor vehicle accidents. These same decisions have helped us to understand that clinical findings by treating and assessing health care professionals are integral to the process of evaluating whether a person has sustained a catastrophic impairment.
In what seems to be an increasing phenomenon, injured Plaintiffs/Insureds are being asked to sign Consent Forms when they attend a tort defence medical examination or an insurer examination (“IE”) pursuant to the SABS. A common scenario arises when the Plaintiff/insured is suddenly presented with a Consent Form; refuses to sign it without first consulting with her lawyer; the examiner refuses to proceed with the assessment; and the whole process is stalled.
Is There a Legal Requirement to Sign?
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.
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