Early this year, the government asked for public input into the future of auto insurance in Ontario. We were cautiously optimistic that they wanted genuine participation from the people most affected by any reforms. However, now that the “Blueprint” has been published as part of the 2019 Budget, it is clear the Liberals have little interest in putting drivers first.
In Gilbraith v. Intact Insurance Company (2019 ONSC 1875), Intact brought a Summary Judgment Motion to dismiss Ms. Gilbraith’s claim. She had been seriously injured following an unusual chain of events that she claimed was an “accident” as defined in the Insurance Act. On April 11, 2014 she and a friend were walking when she was struck in the eye by an egg, thrown from a passing carwhich fled the scene. As a result, Ms. Gilbraith lost central vision in her right eye.
Significant amendments to the Statutory Accident Benefits Schedule (SABS) came into effect in June2016. Changes to the criteria for determining catastrophic impairment (CAT) were finally put to the test in M.C. and BelairDirect (2019 ONLAT 18-004112/AABS)the first published decision under the new rules.
In H.S. and Allstate Insurance (2018 CanLII 132563), the parties held a Preliminary Issue hearing before Adjudicator Deborah Neilson of the Licence Appeal Tribunal (LAT). The Applicant, H.S. was seriously injured in a car accident on August 18, 2016. She submitted an application for Determination of Catastrophic Impairment (CAT) to the Respondent, Allstate, her automobile insurer. Allstate rejected the application. It claimed that she had used the form for accidents that occurred before June 1, 2016, whereas her collision occurred after June 1, 2016, when the current version of the Statutory Accident Benefits Schedule (SABS) came into force. The significance of this distinction involved both the...
An ongoing source of frustration for seriously injured car accident victims concerns the refusal by their accident benefits insurers to fund assessments for a determination of Catastrophic Impairment (CAT). The Statutory Accident Benefits Schedule (SABS) sets out the obligations on insurers to pay for assessments. Typically, assessments that relate to a benefit or payment are funded out of the rehabilitation and treatment limits under the policy- either $50,000 (or $3,500 if a claimant has been categorized under the Minor Injury Guideline (MIG)). This is set out in s. 14, 15 and 18 of the SABS. However, s. 25 of the SABS...
In Surani v. Perth Insurance Company (2018 ONSC 7254), the Divisional Court reviewed a Financial Services Commission of Ontario (FSCO) appeal that found the applicant, Mrs. Surani’s post-accident business income should be deducted from her Income Replacement Benefit (IRB) entitlement.
ACCIDENT BENEFITS UPDATE: Car-surfing injury is an “Accident” -Divisional Court upholds LAT decision
In order to receive accident benefits under an auto insurance policy, a claimant must prove that they have been injured in an “Accident” as defined in the Statutory Accident Benefits Schedule (SABS). Under the two-part test set out by the Supreme Court of Canada, the claimant must how that the injuries were a) caused by or as a result of b) the ordinary and well-known use and operation of a motor vehicle.
In Applicant and Royal and Sun Alliance, a recent decision of the Licence Appeal Tribunal (LAT), the applicant was injured in a car accident on March 3, 2014 while she was still a minor (age 14). She applied for accident benefits including non-earner benefits (NEBs) under the Statutory Accident Benefits Schedule (SABS). Her insurance company, Royal and Sun Alliance (RSA) denied the NEBs and treated her injuries under the Minor Injury Guideline (MIG), which caps treatment at $3,500.
Many of you are unaware that there is a statutory deductible imposed on non-pecuniary general (pain and suffering) damages below a certain monetary threshold. Prior to August 2015, the defendant insurance company was entitled to deduct $30,000 from an award for pain and suffering under $100,000 (Family Law Act (FLA) claimants faced a $50,000 threshold with a $15,000 deductible). This meant that a plaintiff would receive no compensation despite a jury award of $30,000 or less at trial. This obviously unfair practice was designed to discourage lawsuits in what were perceived as less serious cases. The “no-fault” accident benefit system...
Mr. Cowdrey was involved in a serious motorcycle accident on September 15, 2013. He was riding alone just after midnight in Innisfil, Ontario when he struck a pothole and was thrown from his motorcycle. He suffered life-threatening injuries including a serious traumatic brain injury and extensive physical injuries including the loss of his left eye. He was airlifted to Sunnybrook Hospital in Toronto and placed in a medically induced coma for 2 weeks. As a result of the severity of his injuries, he was deemed catastrophically impaired pursuant to the Statutory Accident Benefits Schedule (SABS) under the Insurance Act.