February 5, 2014 by Darcy Merkur
The Ontario government recently blindsided the personal injury community with a further amendment to the Ontario Statutory Accident Benefit Schedule (SABS) designed to essentially eliminate the possibility of friends and family members providing paid attendant care services to injured loved ones following a motor vehicle accident.
The contentious change relates to the revised definition of ‘incurred’ within subsection 3(7)(e) of the SABS. As of September 1, 2010, the definition of “...
October 17, 2013 by Thomson Rogers
Accident benefit insurers may still be responsible for the cost of rebuttal reports in relation to accidents governed by automobile policies predating Sept. 1, 2010, when legislative amendments removed the payment obligation, Toronto plaintiff’s personal injury lawyer Darcy Merkur writes in Law Times.
“In the recent case of R.J. v. Dominion of Canada General Insurance Co., Financial Services Commission of Ontario arbitrator John Wilson faced a motion for interim income replacement benefits...
August 22, 2013 by Deanna Gilbert
In the winter of 2012, Mrs. Baughan, like many other Ontarians, sought to escape the Canadian winter. She booked a Carribbean cruise with day excursions on various islands. The last thing on her mind was insurance coverage in the event of a car accident.
On January 27, 2012, Mrs. Baughan found herself on a day tour of the Island of St. Thomas, part of the United States Virgin Islands. While on the tour, the open air safari taxi in which Mrs. Baughan was a passenger crashed. ...
July 18, 2013 by Stacey Stevens
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.
On July 26, 2013, the Ontario Court of Appeal, in Henry v. Gore Mutual Insurance Company 2013 ONCA 480 upheld the lower court’s ruling that the economic loss requirement contained...
July 11, 2013 by David MacDonald
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.
The goal of this...
June 12, 2013 by Robert Ben
Hoang v. Personal Insurance Company:
An Insurer Must Remain Open to Additional Information as it Becomes Available
What does it mean for an accident benefits insurer to “remain open to additional information as it comes forward” when considering an injured person’s entitlement? What about information that comes to light after the insurer has denied benefits on the strength of its insurer’s examination? Is the insurer required to meet with the injured person’s lawyer to...
June 3, 2013 by Thomson Rogers
It is important to remember that Catastrophic Impairment is a legal definition, not a medical one. Therefore, what does or does not represent catastrophic impairment cannot be based on “science”, nor can it be based on medical opinion. That is the essence of the discussion at hand.
Much of what is being contemplated in the redefinition is an attempt to cloak Policy as Science. If it is Policy to change the definition, so be it. FSCO should be honest and declare its intent to the 12 million...
May 15, 2013 by Stacey Stevens
Esther J. Roche
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...